Pharmacology: Anti-Inflammatory Steroids Basics
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Questions and Answers

Which steroid formulation has the greatest anti-inflammatory effect compared to the others?

  • Steroid acetate derivatives (correct)
  • Steroid alcohol derivatives
  • Steroid salt formulations (sodium phosphate, hydrochloride)
  • All steroid formulations have equal anti-inflammatory effects

    • How does the presence of an intact corneal epithelium and inflammation affect the penetration of different steroid formulations into the anterior chamber?

  • Phosphate formulations have greater penetration than acetate formulations in the presence of an intact epithelium and inflammation.
  • Alcohol formulations have the greatest penetration regardless of epithelial integrity or presence of inflammation.
  • Acetate formulations have greater penetration than phosphate formulations in the presence of an intact epithelium and inflammation. (correct)
  • Steroid formulation penetration is not affected by the presence of an intact epithelium or inflammation.

    • Why are steroid suspensions commonly used for ophthalmic formulations?

  • Most steroids are inherently delivered as suspensions. (correct)
  • Suspensions provide a more stable formulation.
  • Suspensions improve patient compliance.
  • Suspensions allow for better drug solubility.

    • Which steroid formulation property is associated with greater corneal penetration?

    <p>Increased lipophilicity/fat solubility</p> Signup and view all the answers

    How does the presence of an intact epithelium affect the bioavailability of different steroid formulations?

    <p>Intact epithelium increases the bioavailability of acetate and alcohol formulations, but decreases the bioavailability of phosphate formulations.</p> Signup and view all the answers

    Which steroid formulation has the highest anti-inflammatory efficacy when the epithelium is intact?

    <p>Prednisolone acetate 1%</p> Signup and view all the answers

    Which steroid property contributes to increased affinity for the receptor?

    <p>Increased lipophilicity</p> Signup and view all the answers

    Why is the phosphate derivative of prednisolone less preferred for treating anterior segment inflammation compared to the acetate derivative?

    <p>The phosphate derivative has higher corneal penetration.</p> Signup and view all the answers

    Which steroid formulation has the highest anti-inflammatory efficacy when the epithelium is absent?

    <p>Dexamethasone alcohol 0.1%</p> Signup and view all the answers

    Which steroid is considered the exception to being ketone-based?

    <p>Loteprednol</p> Signup and view all the answers

    Which of the following is the primary reason why steroids may mask the symptoms and underlying disease?

    <p>Steroids go after the inflammation, not the actual disease</p> Signup and view all the answers

    What is the primary reason why topical or periocular steroid administration has fewer systemic adverse effects compared to intralesion injection?

    <p>Topical and periocular steroids have lower bioavailability</p> Signup and view all the answers

    Which of the following is the most likely explanation for the paradoxical exacerbation of uveitis with steroid treatment?

    <p>The underlying mechanism for the paradoxical effect is not well understood</p> Signup and view all the answers

    Which property of steroids is most likely responsible for the observed difference in corneal epithelial healing between black and white patients?

    <p>Lipid solubility</p> Signup and view all the answers

    Which of the following is the most likely reason for the temporary mydriasis observed with topical steroid administration?

    <p>The vehicle used in the topical steroid formulation</p> Signup and view all the answers

    Which of the following statements about steroid bioavailability is correct?

    <p>Lipid-soluble steroids have higher bioavailability than water-soluble steroids when administered topically.</p> Signup and view all the answers

    Which of the following factors primarily determines the anti-inflammatory efficacy of a steroid?

    <p>The glucocorticoid receptor binding affinity.</p> Signup and view all the answers

    Which of the following steroid formulations is most suitable for the treatment of posterior segment inflammation?

    <p>Intravitreal injections.</p> Signup and view all the answers

    Which of the following properties of steroids contributes to their potential for causing cataracts?

    <p>Their ability to disrupt lens protein structure.</p> Signup and view all the answers

    Which of the following statements about steroid formulations is correct?

    <p>Intravitreal injections are preferred over subconjunctival injections for posterior segment delivery.</p> Signup and view all the answers

    Which of the following statements about steroid formulations and bioavailability is correct?

    <p>Water-soluble salts form solutions and do not require shaking, while lipid-soluble derivatives form suspensions that need to be shaken before use.</p> Signup and view all the answers

    Which of the following factors affects the penetration of steroids through the cornea?

    <p>All of the above.</p> Signup and view all the answers

    Based on the anti-inflammatory efficacy data provided, which steroid formulation has the highest efficacy when the corneal epithelium is intact?

    <p>Dexamethasone acetate 0.1%</p> Signup and view all the answers

    What is the primary difference between lipid-soluble and water-soluble steroid formulations in terms of their ability to penetrate the cornea?

    <p>Lipid-soluble steroids penetrate better through the hydrophobic corneal epithelium and endothelium lipid layers, while water-soluble steroids penetrate better through the hydrophilic corneal stroma.</p> Signup and view all the answers

    According to the anti-inflammatory efficacy data, which steroid formulation has the lowest efficacy when the corneal epithelium is absent?

    <p>Dexamethasone phosphate 0.1%</p> Signup and view all the answers

    Which statement about prednisolone acetate suspension is correct?

    <p>The 1% suspension (Pred Forte) has smaller and more uniform particles than the 0.125% suspension.</p> Signup and view all the answers

    Which statement accurately describes the bioavailability of dexamethasone alcohol and dexamethasone phosphate?

    <p>Dexamethasone alcohol has higher anti-inflammatory activity and bioavailability on intact epithelium compared to dexamethasone phosphate.</p> Signup and view all the answers

    Which property distinguishes dexamethasone from prednisolone?

    <p>Dexamethasone is a ketone-based steroid, while prednisolone is an alcohol-based steroid.</p> Signup and view all the answers

    Which statement accurately compares the anti-inflammatory efficacy of lipid-soluble and water-soluble steroid formulations?

    <p>Lipid-soluble steroid formulations have higher anti-inflammatory efficacy than water-soluble formulations.</p> Signup and view all the answers

    Which statement accurately describes the properties of prednisolone sodium phosphate 1% solution?

    <p>It is a generic formulation with larger and less uniform particles compared to brand name versions.</p> Signup and view all the answers

    Which of the following is the primary reason that steroid suspensions are commonly used for ophthalmic formulations?

    <p>Suspensions allow for controlled and sustained release of the steroid.</p> Signup and view all the answers

    Which steroid property contributes to its increased affinity for the glucocorticoid receptor?

    <p>Lipophilicity</p> Signup and view all the answers

    Why is the phosphate derivative of prednisolone less preferred for treating anterior segment inflammation compared to the acetate derivative?

    <p>The phosphate derivative is less lipophilic and has reduced corneal penetration.</p> Signup and view all the answers

    Which steroid formulation has the greatest anti-inflammatory effect in the presence of an intact corneal epithelium?

    <p>Lipophilic steroid esters</p> Signup and view all the answers

    How does the presence of an intact corneal epithelium affect the bioavailability of different steroid formulations in the anterior chamber?

    <p>Intact epithelium increases the bioavailability of lipophilic steroid formulations but decreases the bioavailability of hydrophilic steroid formulations.</p> Signup and view all the answers

    Which steroid is considered the exception to being ketone-based?

    <p>Hydrocortisone</p> Signup and view all the answers

    Which steroid formulation property is associated with greater corneal penetration?

    <p>Increased lipophilicity</p> Signup and view all the answers

    Which steroid formulation has the highest anti-inflammatory efficacy when the corneal epithelium is absent?

    <p>Steroid solutions</p> Signup and view all the answers

    How does the presence of inflammation affect the penetration of different steroid formulations into the anterior chamber?

    <p>Inflammation increases the penetration of all steroid formulations.</p> Signup and view all the answers

    Which steroid formulation has the greatest anti-inflammatory effect compared to the others?

    <p>Lipophilic steroid esters</p> Signup and view all the answers

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