Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y3 Patient sem 1 > Adrenal Glands and Corticosteroids as potential drug targets > Flashcards

Adrenal Glands and Corticosteroids as potential drug targets Flashcards

1
Q

Where do the adrenal glands sit?

A

On top of the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 3 parts are the adrenal glands separated into?

A

Capsule, cortex and medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The cortex is further divided into 3 sections, what are they?

A

Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
- they all produce different hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What hormone does the Zona Glomerulosa produce?

A

Mineralcorticoids –> Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What hormone does the Zona fasciculata produce?

A

Glucocorticoid –> Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What hormone does the Zona Reticularis produce?

A

“Adrenal androgens”, “Androstenediones”

* adrenal androgens go on to producing testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What makes up corticosteroids?

A

Glucocorticoids and mineralcorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What sort of cells does the medulla have?

A

electrically active cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In what way are steroids made?

A

On demand - not exocytosed across cell membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are steroids synthesised from?

A

Cholesterol (precursor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where does steroidogenesis take place?

A

in the adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the rate limiting step in steroidogenesis ?

A

cholesterol to pregnenolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What enzyme catalyses the step from cholesterol to pregenolone?

A

PS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What regulates enzyme PS?

A

ACTH - stimulates induction of PS enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What sort of corticoid is cortisol?

A

primary corticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the physiological actions of glucocorticoids? (3)

A
  • metabolic effects (glucose like effect on the body)
  • Anti-inflammatory
  • Immunosuppressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the physiological actions of mineralocorticoids on the body?

A

water and electrolyte balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the physiological actions of adrenal androgens on the body?

A

maturation and development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is transcortin?

A

Corticosteroid binding globulin

20
Q

What does transcortin do?

A

Detects and binds 90% of cortisol and 60% of aldosterone when in circulation.
It does NOT bind synthetic steroids

21
Q

What does albumin do?

A

Binds synthetic and natural steroids

22
Q

What does stress lead the hypothalamus to do (and all following effects)

A
  • hypothalamus becomes activated and releases CRH
  • this stimulates the release of ACTH from the pituitary gland
  • this then works on the adrenal glands and stimulates the release of cortisol, promoting a number of effects
23
Q

What effects does cortisol have?

A
  • lipolysis
  • gluconeogenesis
  • protein catabolism
  • sensitising blood vessels
  • reduce inflammation
24
Q

What is the mechanism of action for mineralcorticoids?

A

They cause Na+ uptake, leading to fluid resorption and K+ loss

25
Q

What does spironolactone act as in relation MCs?

A

Acts as a competitive inhibitor of MC receptors: diuretic and anti-hypertensive

26
Q

How does the release of aldosterone lead to the increase of blood pressure?

A

Aldosterone release partly triggered by angiotensin 2 – aldosterone promotes salt retention which increases blood pressure

27
Q

Name 2 short acting steroids

A

t1/2 8-12 hrs

  • hydrocortisone
  • fludrocortisone
28
Q

Name an intermediate steroid?

A

t1/2 12-36 hrs

- prednisolone

29
Q

Name 2 long acting steroids

A

t1/2 36-72 hrs

  • dexamethasone
  • betamethasone
30
Q

What steroid has mixed GC/MC activity, and what part of the molecule is responsible for this? (Glucocorticoid receptor/Mineralcorticoid receptor)

A

prednisolone

-ring A double bond, ketone group and single bond of aromatic ring

31
Q

What steroids have pure GC activity, nd what part of the molecule is responsible for this?

A

dexamethasone, betamethasone and beclomethasone

- OH bond

32
Q

What steroid has mainly MC activity, nd what part of the molecule is responsible for this?

A

fludrocortisone

- CH3OH group

33
Q

What is Addison’s disease?

A

It’s a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. - HYPOFUNCTION

Appetite loss, unintentional weight loss
Discolouration of the skin 
Dehydration
Increased thirst and need to urinate frequently 
Salt, soy sauce or liquorice cravings 
Oligomenorrhoea (irregular or infrequent periods)
No energy or motivation (fatigue)
Sore/painful, weak muscles and joints
34
Q

What is used for the treatment of Addison’s?

A

Hydrocortisone (GC) with or without fludrocortsone (MC)

Has limited side effects as plasma levels mimic natural situation

35
Q

What is Congenital Adrenal Hyperplasia?

A

HYPERFUNCTION - overproduction of androgens and underproduction of other hormones such as cortisol, so there is no negative feedback which can switch off physiological signals to produce hormones - therefore androgen is overproduced.
ACTH output is also raised

36
Q

What is used in the treatment of Congenital Adrenal Hyperplasia?

A

Exogenous cortisol is used as a treatment - replaces cortisol and restores negative feedback loop to reduce production of androgen.

Synthetic steroids are used to recover the missing feedback e.g. dexamethasone, betamethasone have few side effects as plasma levels mimic natural situation

37
Q

How can steroids act as anti-inflammatory immunosuppressants?

A

They reduce mediators of inflammation and immune responses including prostaglandin, cytokines, Nitric Oxide, Immunoglobulin G etc

38
Q

In what conditions are steroids used as anti-inflammatory immunosuppressants?

A 
Asthma
Eczema 
Arthritis
Psoriasis
Allergic rashes
Itching etc
39
Q

What steroids can be used as anti-inflammatory immunosuppressants?

A

hydrocortisone,prednisolone, beclomethasone, dexamethasone, budesonide

40
Q

What side effects and problems can arise from the use of steroids?

A

Excessive Glucocorticoid use can lead to:

  • drug-induced Cushing’s Syndrome
  • osteoporosis
  • increased risk of infection - A common unwanted side of inhaled GCs.. ..reduced by using a spacer device - or by rinsing the mouth after inhaler use.
41
Q

What are some symptoms of Cushing’s Syndrome?

A 
Increased abdominal  fat
Red round “moon” face
Hypertension
Hyperglycaemia
Vertigo
Blurry vision
Acne
Female balding
Water retention
Menstrual irregularities
Thin skin & bruising
Poor wound healing
Muscle wasting
Osteoporosis
Purple striae
Hirsutism
Depression
Cognitive difficulties
Emotional instability
Sleep disorders
Fatigue
42
Q

What is Aminoglutethimide used for?

A

Used in the treatment of hyperfunction. It inhibits several enzymes including pregnenolone synthase (inhibits cholesterol to pregnenolone step) 21-, 11β- and 18-hydroxylase; aromatase (oestrogen production from testosterone).
Reduces steroid output.
Used in Cushing’s syndrome, Postmenopausal breast cancer and Prostate cancer
INHIBITION OF STEROID SYNTHESIS

43
Q

What is Metyrapone used for?

A

SELECTIVE INHIBITION, in the treatment of hyperfunction.
Inhibits 11 b-hydroxylase and reduces GC, MC synthesis.
Used in Cushing’s syndrome and Hyperaldosteronism.

44
Q

What is a side effect of Metyrapone?

A

hirsutism in women because of excess androgens

45
Q

What is used to test for pituitary function?

A

Metyrapone.

It will decrease GC, decrease negative feedback drive and increase ACTH (Adrenocorticotropic hormone)

46
Q

What is used to test for adrenal insufficiency?

A

Tetracosatide/synacthen.
ACTH mimetic:
- Synthetic peptide & ACTH analogue
- Stimulates synthesis and release of adrenal hormones
- Used to diagnose adrenal cortical insufficiency

Y3 Patient sem 1 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions