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BScN Corticosteroids.pptx

  2. CORTICOSTEROIDS Steroid hormones produced by the adrenal cortex. 1-Glucocorticoids 2-Mineralocorticoids 3-Androgens
  3. CORTICOSTEROIDS 1. SHORT ACTING (t ½ 8-12 hrs) Cortisone Cortisol 2. INTERMEDIATE ACTING (t ½ 12-36 hrs) Prednisolone Methylprednisolone Triamcinolone 3. LONG ACTING (t ½ 36-72 hrs) Paramethasone Betamethasone Dexamethasone
  4. CORTICOSTEROIDS Inhalational corticosteroids: Beclomethasone Budesonide Fluticasone Triamcinolone Mometasone
  5. CORTICOSTEROIDS Mechanism of action: 1-Corticosteroids enter the cell and bind to cytosolic receptors( bound with Hsp90) 2-Binding of steroids with receptor releases Hsp90 3-Receptor dimerization Receptor activation 4-Steriod receptor complex moves into nucleus and binds with GRE 5-Transcription of mRNA  Regulatory Proteins are formed
  6. CORTICOSTEROIDS Pharmacological effects: 1-Metabolic effects: Stimulate gluconeogenesis Hyperglycemia Catabolism of muscle protein Increased Insulin secretion Increased lipolysis and lipogenesis  increase of fat deposition in face , shoulders and back.
  7. CORTICOSTEROIDS Pharmacological effects: 2-Catabolic effects: Muscle protein catabolism Lymphoid and connective tissue, fat, and skin undergo wasting Catabolic effects on bone osteoporosis. Growth inhibition  Children 3-Immunosuppressive effects Inhibit cell mediated immunity
  8. CORTICOSTEROIDS CLINICAL USES: Adrenal uses: (Replacement therapy) 1-Acute adrenal insufficiency 2-Chronic adrenal insufficiency 3-Congenital adrenal hyperplasia Non-Adrenal uses: Rheumatoid arthritis Systemic lupus erythematous Polyarteritis Nodosa
  9. CORTICOSTEROIDS Non-Adrenal uses: Glomerulonephritis Allergic disorders Urticaria Bee sting Drug reactions Bee stings Contact dermatitis Anaphylaxis Serum sickness
  10. CORTICOSTEROIDS Non-Adrenal uses: Bronchial asthma Eye inflammations Malignancies Cerebral edema Transplant rejection
  11. CORTICOSTEROIDS Adverse effects of corticosteroids: 1-Iatrogenic Cushing Syndrome 2-Acne 3-Weight gain & Visceral fat deposition 4-Myopathy & muscle wasting 5-Thining of skin with striae & brusing 6-Hyperglycemia Diabetes 6-Osteoprosis & necrosis of the hip 7-Impaired wound healing 8-Peptic Ulcers
  12. CORTICOSTEROIDS Adverse effects of corticosteroids: 9-Clinical findings of Bacterial & Mycotic Infections are masked 10-Hpomania 11- Acute Psychosis 12-Depression 13-Posterior Cataracts 14-Glaucoma 15-Growth retardation in children 16-Adrenal suppression