of Glucocorticoids
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U.S. Pharmacist
Continuing Education
ACPE Program No. 430-000-99-028-H01
This program provides 2.0 hours of credit (0.2 CEU).
Lesson Expires: August 31, 2001
Instructions:
After reading the lesson, complete all of the information and questions that follow. Social Security number is required for certification. Print a copy of the completed form for your records, and submit for grading. Pharmacists receiving a score of 70% or better will be able to immediately print their certificates. Those who fail may retake it only once.
U.S. Pharmacist Continuing Education is approved in all states where mandatory continuing education is required. This article has been accredited for two Continuing Education Hours (0.2 CEUs) for each examination successfully completed.
Questions
1. Which of the following are physiologic effects of glucocorticoids?
(A) Increase circulating lymphocytes, basophils, and monocytes
(B) Decreased hemoglobin and erythrocytes
(C) Hypoglycemia
(D) None of the above
2. Which of the following influence secretion of cortisol from the adrenal cortex?
(A) Emotional stress
(B) Physical stress
(C) Exogenous corticosteroids
(D) All of the above
3. Which of the following best reflects the classification of corticosteroids?
(A) Aldosterone is the principal glucocorticoid hormone
(B) Mineralocorticoids are commonly used for their anti-inflammatory effects
(C) Common mineralocorticoid effects include edema and hypertension
(D) Cortisol is the principal mineralocorticoid
4. Which of the following are equipotent glucocorticoid doses?
(A) Prednisone 10 mg and methylprednisolone 125 mg
(B) Prednisone 10 mg and hydrocortisone 40 mg
(C) Prednisone 10 mg and triamcinolone 50 mg
(D) Prednisone 10 mg and dexamethasone 20 ng
5. Glucocorticoids may be used in which of the following disease states:
(A) Rheumatoid arthritis
(B) Hirsutism
(C) Ulcerative colitis
(D) All of the above
6. Topical glucocorticoids may be used in all of the following except:
(A) Allergic contact dermatitis
(B) Psoriasis
(C) Impetigo
(D) Eczema
7. Ocular steroids may be used in all of the following except:
(A) Allergic conjunctivitis
(B) Herpes simplex keratitis
(C) Uveitis
(D) Iritis
8. Which of the following minimize the risk of developing glucocorticoid-induced osteoporosis?
(A) Calcium supplementation
(B) Alternate-day glucocorticoid dosing
(C) Weight-bearing exercise
(D) A and C
9. Which of the following monitoring parameters is not recommended in long-term glucocorticoid use?
(A) Blood pressure readings at physician visits
(B) Annual bone mineral density exam
(C) Annual slit-lamp exams
(D) Monthly urinalysis
10. Which of the following may place a patient at increased risk of developing glucocorticoid- induced ulcers?
(A) Coadministration with NSAIDs
(B) Total dose of prednisone >1 g
(C) Duration of therapy >30 days
(D) All of the above
11. Local adverse effects related to topical glucocorticoids are minimized by:
(A) Using the lowest-potency steroid for the shortest duration possible
(B) Applying fluorinated agents to the face
(C) Using occlusive dressings
(D) All of the above
12. Which of the following best summarizes the strengths of alternate-day glucocorticoid dosing?
(A) Alternate-day dosing minimizes all glucocorticoid associated complications
(B) Alternate-day dosing may be used in spite of worsening symptoms on the off day
(C) All types of glucocorticoids may be used in alternate-day dosing
(D) Alternate-day dosing minimizes the risk of HPA-axis suppression and most glucocorticoid adverse effects
13. What is the optimal time of administering oral glucocorticoids?
(A) 6? pm
(B) Noon
(C) 6? am
(D) 3 am
14. The following statements about taper regimens are correct except:
(A) The goal of taper regimens is to prevent adrenal crisis
(B) If disease flare-up occurs during tapering, institute the previous glucocorticoid dose
(C) Most taper regimens reduce the glucocorticoid dose by 2.5 mg? mg of prednisone equivalent weekly
(D) The goal of taper regimens is to minimize adverse effects
15. Patients using ocular steroid preparations should be counseled to:
(A) Avoid direct contact of the applicator to the eye
(B) Continue to use contact lenses during steroid therapy
(C) Continue to use steroid despite ocular discharge or photophobia
(D) None of the above
16. Which of the following is appropriate advice for patients using oral inhaled glucocorticoids?
(A) Use glucocorticoids for acute asthma attacks
(B) Rinse mouth after use
(C) Utilize a spacer device if appropriate
(D) B and C
17. Patients dependent on oral glucocorticoids should be advised to:
(A) Wear a medical alert bracelet
(B) Not discontinue abruptly or without medical supervision
(C) See a physician if infection is suspected
(D) All of the above
18. Which of the following is true regarding steroid psychosis?
(A) It is not dose-related
(B) Patients do not recover
(C) Symptoms tend to occur in the first few weeks of treatment
(D) All patients will require life-long antipsychotic treatment
19. Which of the following correctly describes the sequence of events leading to cortisol secretion?
(A) Pituitary, hypothalamus, adrenal cortex
(B) Adrenal cortex, parathyroid, hypothalamus
(C) Hypothalamus, pituitary, adrenal cortex
(D) Adrenal cortex, pituitary, hypothalamus
20. Which of the following drugs may interact with glucocorticoids?
(A) Rifampin
(B) Phenobarbital
(C) Phenytoin
(D) All of the above
Evaluation Questions
21. The CE goals and objectives were achieved:
(A) Very well
(B) Adequately
(C) Poorly
22. The information presented was:
(A) Very useful
(B) Useful
(C) Not very useful
23. Your knowledge of the subject was increased by the program:
(A) Greatly
(B) Somewhat
(C) Poorly
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