Produces Cushing’s habitus – moon face, supraclavicular hump, trunkal obesity and relatively thin limbs, hirsuitim.
It causes proximal myopathy – shoulder, arms, hip, thigh
Fragility and thinning of skin – causes purple striae, especially on lower abdomen and thigh, easy bruisability and telangectasias
Decreased wound healing
Increased susceptibility to infections – flaring of tuberulosis can occur, predispose to oppurtunistic infections like candidiasis
Can cause posterior subcapsular cataract
Can cause peptic ulcer and silent perforation (two fold increase in risk)
Can cause hyperglycemia and may precipitate diabetes mellitus.
In pregnant females, steroids can cause gestational diabetes mellitus, hypertension and …

Lactulose is a semi-synthetic disaccharide composed of fructose and galactose. It is not absorbed in the intestine. It is broken down into osmotically more active products by the intestinal flora. This causes osmotic diarrhoea.
Hence it is used in the treatment of constipation. 10 gm twice daily is the dosage. It softens stools in one to three days.
Use in hepatic precoma
The products of lactulose degradation decreases the pH of the intestine. This converts the ammonia produced by the intestinal flora into NH4+ ions, thus decreasing the absorption. Hence it is used …

Aminoglycosides are highly ionised molecules and hence they are not absorbed orally.

High potency
Completely absorbed from the intestine with no interference by food
Long plasma half life (T 1/2) of 18 to 24 hours
Least effect on the normal flora of the intestine
Less propensity to cause diarrhoea

Extended spectrum beta lactamases (ESBLs) are enzymes that mediate resistance to extended-spectrum or third generation cephalosporins like ceftazidime, cefotaxime, and ceftriaxone and monobactams like aztreonam. ESBLs do not affect cephamycins like cefoxitin and cefotetan or carbapenems like meropenem or imipenem.

Incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cells after eating, even before blood glucose levels become elevated. The two main incretins are glucagon-like peptide-1 (GLP-1) and Gastric inhibitory peptide(GIP). Both GLP-1 and GIP are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4). DPP-4 inhibitors improve glucose control by increasing incretin levels in type 2 diabetes. They are less likely to produce hypoglycemia. DPP-4 inhibitors target the beta cells through the incretin pathway. Sitaglipgtin is an FDA approved …

derivatives of fibric acid (isobutyric acid)
activate Peroxisome Proliferator Activated Receptor alpha (PPAR) – a gene transcription regulating receptor present in liver, fat and muscles

Activation of PPAR alpha results in:

increased synthesis of lipoprotein lipase – hydrolyse triglycerides – decrease circulating TG’s
increased expression of LDL receptor in liver – mainly with II generation fibrates
increased fatty acid oxidation
decrease TG synthesis in liver
 reduce circulating free fatty acids

Outcome:

decrease TG 20-50%
decrease LDL 10-15%
increase HDL 10-15%

ACE inhibitors are contraindicated in pregnancy because they cause:

Foeal anuria
Foetal skull ossification defects

Methyldopa
Methyl analogue of dopa. It is used as a centrally acting adrenergic antihypertensive. Methyldopa is converted to methyl noradrenaline, which is a central alpha 2 agonist. This decreases central sympathetic outlfow.
It has more action on decreasing total peripheral resistance (TPR) than on cardiac output or heart rate. Levels of circulating NA decreases due to decrease in central sympathetic outflow.
Presently it is used to treat hypertension in pregnancy.