Paper II — 2019 February (2010 Scheme) — Q2

Paper II

2019 February (2010 Scheme)

Question

Classify corticosteroids. Describe the uses and adverse effects of glucocorticoids (2+2+2)

Q26 marksEssays★✓

Answer

Classification of corticosteroids

• Glucocorticoids: Hydrocortisone, Prednisolone, Dexamethasone, Betamethasone
• Mineralocorticoids: Fludrocortisone
• (By duration of action: short-acting — hydrocortisone; intermediate — prednisolone; long-acting — dexamethasone, betamethasone)

Uses of glucocorticoids

• Replacement therapy: Addison’s disease, adrenal insufficiency
• Anti-inflammatory/immunosuppressive: rheumatoid arthritis, SLE, autoimmune disorders
• Allergic conditions: anaphylaxis (adjunctive), severe allergic reactions
• Respiratory: bronchial asthma, COPD exacerbations, antenatal fetal lung maturity
• Haematological: autoimmune haemolytic anaemia, ITP
• Malignancy: component of chemotherapy regimens, cerebral oedema from brain tumours
• Transplantation: prevention of graft rejection
• Dermatological: severe eczema, pemphigus

Adverse effects of glucocorticoids

• Cushingoid features
• Osteoporosis
• Hyperglycaemia
• Hypertension and fluid retention
• Increased susceptibility to infections
• Peptic ulceration
• Muscle wasting/myopathy
• Skin thinning, poor wound healing
• Adrenal suppression (HPA axis suppression)
• Cataract and glaucoma
• Psychiatric disturbances

Related Concepts

1. 1Corticosteroids

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