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Anti-inflammatory (Corticosteroids (Side effects (Endocrine-metabolic…

- - - - Aldosterone
        
        Salt and water metabolism
        
        Upregulate Na/K ATPase gene expression
        
        Promote sodium re-absorption at distal tubule
        
        Hypernatremia
        
        Increase Potassium and hydrogen excretion
        
        Hypokalemia, metabolic alkalosis, edema
      - Cortisol
        
        Metabolic, anti-inflammatory, immunosuppressive
  - - - Increase glucose via increase gluconeogensis and decrease peripheral uptake
      - Increase fat deposition
      - Increase Glycogen deposition
      - Decrease protein
        
        Negative nitrogen and calcium balance
      - Surfactant production in lungs :pen:
  - - - Globulin bind to and travel around the body
        
        Release steroid to enter the cell
        
        Bind to receptor, forms ligand and binds to the DNA
        
        Transactivation
        
        Happen in higher dose of steroid
        
        Bind to Glucocorticoid Response Element (GRE)
        
        1 more item...
        
        Trans-repression
        
        Happen in lower dose of steroid
        
        Bind to negative Glucocorticoid Response Element (nGRE)
        
        1 more item...
  - - - Hyperglycaemia, water retention, edema, HTN
      - Moon face + Buffalo hump :pen:
      - Growth retardation
      - Delayed wound healing
      - Muscle wasting
    - - Osteoporosis (hypocalcemia) :pen:
      - Aseptic necrosis of femoral head :pen:
- - - - Reduce all 3
        
        Vasoconstriction, decrease permeability, reduce pain, increase platelet aggregation
      - Antipyretic
        
        Produces PGE in the brain, resets the thermostat causing fever :pen:
      - Anti-platelet
        
        Irreversible inhibitor of COX enzyme :warning: so effects is greater
        
        Platelet cells produces more TXA
        
        platelet relies on bone marrow, recover slower
        
        Loss of TXA more than PGI2
        
        Loss of aggregation :pen:
        
        Endothelial cells produce more prostacyclin
        
        Endothelial can replicate, recover faster
    - - Tinnitis :warning:
        
        Hyperventilation
        
        Respiratory alkalosis
        
        Renal and respiratory failure :warning:
      - REYE's syndrome :warning:
        
        Swelling of brain and liver
        
        Pressure on the brain thus vommitng,delirium, convulsion
        
        Increase risk if taken by children with aspirin :warning:
  - - - Prostaglandin function:
        
        Gastric acid secretion
        
        Increase mucosal blood flow
        
        Increase mucus secretion
        
        Increase secretion of bicarbonate
    - - PGE: inhibits NA reabsorption in ascending limb
        PGI2: detects at distal tubule, stimulate RAAS for sodium reabsorption and potassium excretion
    - - Determine if its true allergy by looking for presence of antibodies
    - - Over flow of arachidonic acid, resulting in high amounts of leukotrienes which is involve in bronchospasm
  - - - Present in synovial joints and brian
        
        Unwanted effects
        
        Less effect on kidney but does not completely spare
        
        Delayed follicular rupture
        
        Premature closure of ductus arteriosus in late pregnancy
        
        Impaire wound healing
        
        If there are existing ulcer, it will worsen
        
        Increased thrombosis
        
        When inhibit COX-2, it goes to COX-1, increase in TXA
- - - - Prostanoids
        
        PGE classical prostaglandin
        
        Vascular permeability
        
        Pain
        
        TXA thromboxane
        
        Vasoconstriction
        
        Platelet aggregation
        
        PGI Prostacyclin
        
        Vasodilation
        
        Inhibit platelet aggregation
      - Lipoxins
      - Leukotrienes