adrenal cortex

Question 1

mineralocorticoids

Answer 1

aldosterone, binds to MR
water and electrolyte homeostatis
- reabsorption of Na and H2O
- excretion of K and H
- maintaining volume of extra cellular fluid
- blood pressure regulation

stimulated by RAAS

Question 2

glucocorticoids

Answer 2

cortisol binds MR (cortisone does not bind MR)

physiological
- metabolism; glucose-sparing (gluconeogenesis, insulin resistance), protein catabolic (reduced synthesis, cushing’s syndrome), lipolytic (insulin resistance, increased sensitivity to adrenaline , glucagon, GH)
- stress resistance

pharmacological;
- anti-inflammatory; reduced synthesis cytokines, inflammation mediators, cytotoxic substances
- immunosuppression; reduced T-cell proliferation and function

mechanism of action;
reduced transcription of pro-inflammatory genes
increased transcription of anti-inflammatory genes

administered in addison’s disease

Question 3

androgens

Answer 3

estrogens and testosterone
- androgenic effect

Question 4

CRH

Answer 4

released by hypothalamus
used in diagnositics

Question 5

ACTH

Answer 5

released by the pituitary
- growth of adrenal cortex
- glucocorticoid synthesis and secretion

used in diagnositics

Question 6

anti-corticosteroids

Answer 6

inhibit the enzyme, for the conversion to a corticosteroid
- aminoglutethimide;
- trilostane;
- metyrapone;
- ketoconazole; antimycotic effect
- osilodrostat;
- pasireotide; inhibition of ACTH release by neuro-endocrine tumors

Question 7

mifepristone

Answer 7

competative antagonist of GR
for reduction of corticosteroids

Question 8

spironolactone and eplerenone

Answer 8

antagonist of MR
aldosterone antagonist
for reduction of corticosteroids
as treatment in conn’s disease

Question 9

11B-hydroxysteroid dehydrogenase

Answer 9

type 1; in liver turns cortisone to cortisol (activation)
type 2; in kidney turns cortisol to cortisone (deactivation)

Question 10

ADH

Answer 10

• maintaining osmolarity and volume of extracellular fluid
• blood pressure regulation

effects;
- reabsorption of water in lkidney, increase in number of water pores
- vasoconstriction
- facilitation of ACTH release > corticosteroids

released when;
- increased blood osmolarity
- decreased blood volume
- decreased blood pressure

stimulated by angiotensin 2

treatment in diabetes insipidus

Question 11

desmopressin

Answer 11

ADH derivative
increased anti-diuretic activity
less susceptible to hydrolysis

Question 12

chlorothiazide

Answer 12

diuretic, beneficial effect on ADH

Question 13

terlipressin

Answer 13

ADH derivative
vasoconstriction with oesophageal bleeding

Question 14

felypressin

Answer 14

ADH derivative
vasoconstriction with local anaesthesia

Question 15

demeclocycline

Answer 15

V2 antagonist