Adrenal Flashcards
cortisol
glucocorticoids
dexamethasone
glucocorticoids
Oral, Injectable, Topical
prednisolone
glucocorticoids
Ratio of GC to MC is 5:.3
ORAL, Injectable
fludrocortisone
mineralocorticoids:
ORAL
spironolactone
mineralocorticoid antagonists:
Treats primary aldosteronism
Androgen antagonist also
eplerenone
mineralocorticoid antagonists:
No anti-androgen activity as seen in spironolactone
aminoglutethimide
synthesis inhibitors
Inhibit conversion of cholesterol to pregenenolone
Treat Cushing Syndrome
metyrapone
synthesis inhibitors
Treat Cushing Syndrome
inhibits
ketoconazole
synthesis inhibitors
Treat Cushing Syndrome
What are the main stimulators of mineralcorticoid production?
Increased K, Ang II, ACTH
Increase Aldosterone production from zona glomerulosa
What is the common progenitor to glucocorticoids, androgens, and mineralcorticoids?
Pregnenolone
What are the main stimulators of glucocorticoid production?
ACTH
Produces cortisol from zona fasciulata, reticularis
What is a result of increased ACTH levels?
Adrenal hyperplasia
Adrenal hypoplasia caused by decreased ACTH levels
What are the target tissues and actions of glucocorticoids?
Many tissues
Effect:
- Carb, protein, lipid metabolisms to increase blood glucose
Decrease glucose utilization
INHIBIT the IMMUNE SYSTEM and INFLAMMATORY RESPONSE
What is the main action of mineralcorticoids?
Aldosterone
Kidney is main target
Affects water and electrolyte balance
- Increase Na reabsorption
- Increase K excretion
- Increase H excretion
Loss is an acute and life threatening condition
What are some uses of GC in non-adrenal disorders?
Speed up lung maturation prior to birth
Suppress immune system for organ transplant
Treat childhood acute lymphoblastic leukemia (w/methotrexate)
Suppress immune system for symptomatic treatment of inflammatory/immune disorders
What are side effects of GC use?
Few if topically or administered less than 2 weeks
If continued use that adds up to 100 mg
- Hyperglycemia, glycosuria
- Increased protein breakdown
- Increased risk of infection
- Myopathy
- Osteroporosis
- Behavioral changes
- Cataracts
- ulcers
- Sodium/fluid retention
- Growth retardation in children
- Suppress HPA axis
What occurs in congenital adrenal hyperplasia 1?
21B hydroxylase BROKEN
Everything shifted from cholesterol to ANDROGENS
What is the cause of CAH-2?
11B hydroxylase knocked out but stil same effect as CAH-1
However, now have some MC function due to 11-deoxycorticosterone
