NAPLEX Practice Question # 78

NAPLEX Examination.

Practice Question # 78.



corticosteroid therapy










Corticosteroids. Prednisone (Deltasone®) and methylprednisolone (Solumedrol®) are the major corticosteroid products used for transplant patients.

Mechanisms of action. Corticosteroids have multiple pharmacological eff ects in various cells. Corticosteroids bind with intracellular glucocorticoid receptors, which results in altering DNA and RNA translation. As a result, corticosteroids cause a rapid and profound drop in circulating

T lymphocytes. Th ey have potent anti-infl ammatory eff ects by inhibiting arachidonic acid release and macrophage phagocytosis.

Dosing and monitoring. Th ey are used in both preventing and treating graft rejection and acute graft versus host disease. In general, prophylactic doses in solid organ transplantation are in the range of 1 to 2 mg/kg/day and tapered over months to 0.1 to 0.3 mg/kg/day. In the case of treatment, the dosage is 500 mg of methylprednisolone IV for 3 to 5 days or 1 to 2 mg/kg/day of oral prednisone, which should be tapered rapidly.

Side effects. In the long-term, corticosteroids cause more troubling side eff ects. Th ey include psychological disturbances (i.e., euphoria, depression), adrenal axis suppression, hypertension, sodium and water retention, myopathy, impaired wound healing, increased appetite, osteoporosis, hyperglycemia, and cataracts.

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