Corticosteroids. Cortisol is the endogenous glucocorticoid in the body. It is produced and secreted on a feedback system like thyroid hormones from the hypothalamus-pituitary-adrenal (HPA) axis. The adrenal cortex synthesizes and secretes the steroid hormones that include mineralocorticoids and glucocorticoids and, to a lesser extent, androgens. This feedback system is depicted in your textbook. Corticosteroids have a major role in the management of a variety of disease processes. Corticosteroids can be used to treat various conditions that include but are not limited to adrenal cortex insufficiency, rheumatic disorders, collagen disease, dermatological conditions, asthma, allergic rhinitis, neoplastic disorders, inflammatory bowel disease, as well as others (Woo & Robinson, 2016).
Aspirin and salicylates have analgesic, anti-inflammatory, anitpyretic, and antiplatelet effects. Their anti-inflammatory and analgesic activities are mediated through inhibition of prostaglandin synthesis. You may have known that aspirin inhibits platelet aggregation and this is why it is often given when a patient is either having or at risk for a myocardial infarction. However, did you know this platelet aggregation is irreversible (Woo & Robinson, 2016)? After completing the reading in your text book about aspirin and salicylates, test your knowledge by completing the drag and drop activity below regarding pharmacokinetics, adverse drug reactions, aspiring poisoning, clinical use and dosing, monitoring, and patient education.
Nonsteroidal Anti-inflamatories (NSAIDs)
NSAIDS inhibit cyclo-oxygenase (COX-1 and COX-2) activity, thus inhibiting prostaglandin synthesis. COX-1 is present in all tissues and cells, especially platelets; endothelial cells; the GI tract; and renal microvasculature, glomeruli, and collecting ducts. COX-2 is an “inducible” enzyme that is synthesized mainly in response to pain and inflammation. NSAIDs are primarily used for their anti-inflammatory activity but are also effective analgesics for the relief of mild to moderate pain. Perhaps the most common NSAID is acetaminophen which can be used as an analgesic or an antipyretic. The mechanism of action for acetaminophen is not well-known. However, it is thought to act by inhibiting central and peripheral prostaglandin synthesis. Acetaminophen reduces fever by direct actions on the hypothalamic heat-regulating centers.