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1.11
Corticosteroids
Term | Definition |
---|---|
Adrenal(suprarenal) contains which two parts: | 1. adrenal cortex 2. adrenal medulla |
Adrenal cortex contains mineralocorticoids, the main one: | aldosterone |
Adrenal cortex contains glucocorticoids, the main one: | cortisol (hydrocortisone) |
Adrenal medulla secretes: | epinephrine (85%) norepinephrine (15%) |
The precursor for corticosteroid biosynthesis is: | cholesterol |
Aldosterone (mineralocorticoid) secreted when there is a decline in: | blood volume or blood pressure |
Aldosterone MOA: | prompts kidney to reabsorb more sodium increases blood volume, CO and BP |
DRUG: Fludrocortisone (FLUORINEF) | synthetic mineralocorticoid has zero anti-inflammatory effects |
DRUG: Fludrocortisone (FLUORINEF) is given as a replacement therapy for which disease? | Addison's disease |
Glucocorticoid: Cortisol is essential for life and helps with: | stressful situations |
Short-term stress (minutes) is corrected by: | epinephrine/adrenaline |
long-term stress (chronic) is corrected by: | cortisol |
Cortisol and stress: with stress, hypothalamus... | sends CRH to anterior pituitary |
specific actions of glucocorticoids on body: metabolic effects | raises blood glucose, amino acids and triglyceride levels maintains homeostasis during stress |
specific actions of glucocorticoids on body: catabolic effects | break down effects in muscle |
specific actions of glucocorticoids on body: maintenance effects | maintenance of blood pressure and sodium retention normal erythropoiesis |
glucocorticoids in large quantities: | depresses immune and inflammatory response |
specific actions of glucocorticoids on body: bone effects | glucocorticoid-induced osteoporosis |
specific actions of glucocorticoids on body: CNS effects | brain excitability can lead to insomnia, euphoria, restlessness |
glucocorticoids inhibit: | phospholipase enzyme |
corticosteroids DO NOT inhibit | COX and LOX |
Glucocorticoid anti-inflammatory action results in: | anti-inflammatory and immunosuppressive effects |
Prolonged glucocorticoid therapy increases: | risk of infection |
Therapeutic uses of Glucocorticoid: (6) | Asthma Dermatologic: Dermatitis, psoriasis inflammatory bowel: ulcerative colitis, crohn's disease allergic: rhinitis, contact dermatitis, hypersensitivity reactions autoimmune diseases anti-rejection (organ transplant) |
Glucocorticoid is a replacement therapy for: | adrenal insufficiency (plus add mineralocorticoid supplement) |
Glucocorticoid ADRs | adrenal suppression: affects cortisol levels (decrease) |
Glucocorticoid counseling point: | NEVER abruptly stop therapy after long-term use |
Glucocorticoid ADRs (continued use of large doses) | acne osteoporosis obesity diabetes mellitus bruises and dermal atrophy psychological: nervousness, insomnia gastric ulcerations edema, sodium retention, hypertension |
Glucocorticoid's lowest potency: | hydrocortisone, cortisone |
Glucocorticoid's low potency: | prednisone, prednisolone, desonide |
Glucocorticoid's medium potency: | methylprednisolone, triamcinolone |
Glucocorticoid's high potency: | betamethasone, dexamethasone, fluocinonide |
Glucocorticoid's super high potency: | Betamethasone dipropionate (DIPROLENE) clobetasol propionate (TEMOVATE, CORMAX) halobetasol propionate (ULTRAVATE) |
DRUG: treatment of hyperaldosteronism: Metyrapone | inhibit glucocorticoid synthesis inhibitor of 11-b-hydroxylase (CYP11B1) |
DRUG: treatment of hyperaldosteronism: Ketoconazole (antifungal drug) | inhibitor of CYP450s |
Drug: treatment of hyperaldosteronism: Mifepristone (RU 486) | inhibit glucocorticoid receptors |