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Pharmacology 2 Final Dr. Balqees Ikhmais > Adrenal Hormones > Flashcards

Adrenal Hormones Flashcards

1
Q

What does the cortex of the adrenal gland secrete?

A

Adrenocorticoids and adrenal androgens.

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2
Q

What does the medulla of the adrenal gland secrete?

A

Epinephrine.

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3
Q

Into how many zones is the adrenal cortex divided?

A

Three zones.

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4
Q

What does the outer layer of the adrenal cortex produce?

A

Mineralocorticoids (e.g., aldosterone).

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5
Q

What does the middle layer of the adrenal cortex synthesize?

A

Glucocorticoids (e.g., cortisol).

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6
Q

What does the inner layer of the adrenal cortex secrete?

A

Adrenal androgens (e.g., dehydroepiandrosterone).

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7
Q

What controls the secretion of the two inner zones and the outer zone of the adrenal cortex?

A

Pituitary ACTH.

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8
Q

What serves as feedback inhibitors of ACTH and CRH secretion?

A

Glucocorticoids.

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9
Q

List four therapeutic uses of adrenal cortex hormones.

A

Replacement therapy, treatment and management of asthma and other inflammatory diseases (e.g., rheumatoid arthritis), treatment of severe allergic reactions, and treatment of some cancers.

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10
Q

Where do adrenocorticoids bind in target tissues?

A

To specific intracellular cytoplasmic receptors.

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11
Q

How is the distribution of glucocorticoid receptors different from mineralocorticoid receptors?

A

Glucocorticoid receptors are widely distributed throughout the body, whereas mineralocorticoid receptors are mainly confined to excretory organs like the kidney, colon, and salivary and sweat glands.

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12
Q

Which type of receptor has a wider spectrum of activity, glucocorticoid or mineralocorticoid?

A

Glucocorticoid.

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13
Q

What is the principal glucocorticoid?

A

Cortisol.

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14
Q

How is glucocorticoid production characterized diurnally?

A

Peak early in the morning, followed by a decline, then a smaller peak in the late afternoon.

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15
Q

What factors influence glucocorticoid secretion?

A

Stress.

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16
Q

How do glucocorticoids favor gluconeogenesis?

A

By stimulating protein catabolism (except in the liver) and lipolysis, providing building blocks for glucose synthesis, leading to hyperglycemia.

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17
Q

How do glucocorticoids increase resistance to stress?

A

By raising plasma glucose levels, providing the body with energy to combat stress.

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18
Q

How do glucocorticoids affect blood pressure?

A

They can cause a modest rise by enhancing vasoconstrictor action of adrenergic stimuli on small vessels.

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19
Q

How do glucocorticoids alter blood cell levels in plasma?

A

Decrease eosinophils, basophils, monocytes, and lymphocytes; increase hemoglobin, erythrocytes, platelets, and neutrophils.

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20
Q

What are the anti-inflammatory actions of glucocorticoids?

A

Reduce the inflammatory response and suppress immunity by lowering and inhibiting peripheral lymphocytes and macrophages, inhibiting phospholipase A2, reducing COX-2 synthesis, and decreasing histamine release.

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21
Q

How do glucocorticoids affect other components of the endocrine system?

A

Feedback inhibition of ACTH and TSH production, and increased GH production.

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22
Q

Why is adequate cortisol essential?

A

For normal renal glomerular filtration (GF).

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23
Q

How can high doses of glucocorticoids affect the stomach?

A

They stimulate gastric acid and pepsin production, which may exacerbate ulcers.

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24
Q

How do glucocorticoids influence the CNS?

A

They influence mental status.

25
Q

What are the long-term effects of chronic glucocorticoid therapy?

A

Severe bone loss, myopathy, and weakness.

26
Q

What do mineralocorticoids help control in the body?

A

Water volume and concentration of electrolytes, especially sodium and potassium.

27
Q

How does aldosterone affect the kidneys?

A

It acts on kidney tubules and collecting ducts, causing reabsorption of sodium, bicarbonate, and water.

28
Q

What effect does aldosterone have on potassium reabsorption?

A

It decreases reabsorption of potassium, which, with H+, is lost in the urine.

29
Q

What can elevated aldosterone levels cause?

A

Alkalosis and hypokalemia.

30
Q

How does the retention of sodium and water affect blood volume and pressure?

A

It leads to an increase in blood volume and blood pressure.

31
Q

What is the purpose of hydrocortisone in primary adrenocortical insufficiency (Addison’s disease)?

A

To correct the deficiency.

32
Q

How is the daily dose of hydrocortisone divided for Addison’s disease treatment?

A

Two-thirds in the morning and one-third in the afternoon.

33
Q

What might be administered in addition to hydrocortisone to raise mineralocorticoid activity to normal levels?

A

Fludrocortisone.

34
Q

What is used for replacement therapy in secondary or tertiary adrenocortical insufficiency?

A

Hydrocortisone.

35
Q

What test is used to diagnose Cushing’s syndrome?

A

Dexamethasone suppression test.

36
Q

How is congenital adrenal hyperplasia treated with corticosteroids?

A

By normalizing hormone levels through suppressing CRH and ACTH release.

37
Q

How do glucocorticoids relieve inflammatory symptoms?

A

By reducing rheumatoid and osteoarthritic inflammations and inflammatory conditions of the skin.

38
Q

In what conditions are glucocorticoids beneficial for treating allergies?

A

Asthma, allergic rhinitis, and allergic reactions.

39
Q

How do glucocorticoids accelerate lung maturation in premature infants?

A

Cortisol enhances lung maturation; betamethasone or dexamethasone is administered intramuscularly before delivery.

40
Q

Which glucocorticoid has no effect on the fetus during pregnancy?

A

Prednisone.

41
Q

Why is prednisone safe for the fetus?

A

It is not converted to the active compound prednisolone in the fetal liver.

42
Q

What occurs with long-term use of large doses of glucocorticoids?

A

Suppression of the hypothalamic-pituitary-adrenal (HPA) axis.

43
Q

How can the suppression of the HPA axis be prevented?

A

By using an alternate-day administration regimen of the adrenocortical steroid.

44
Q

Why is withdrawal from corticosteroids a serious problem?

A

Because the patient may have experienced HPA suppression.

45
Q

What can abrupt removal of corticosteroids cause?

A

Acute adrenal insufficiency syndrome, which can be lethal.

46
Q

How should the dose of corticosteroids be adjusted when discontinuing therapy?

A

The dose must be tapered gradually.

47
Q

What is a major side effect of long-term corticosteroid therapy related to bones?

A

Osteoporosis.

48
Q

Why do glucocorticoids cause osteoporosis?

A

They suppress intestinal Ca2+ absorption, inhibit bone formation, and decrease sex hormone synthesis.

49
Q

Can alternate-day dosing prevent osteoporosis in long-term corticosteroid therapy?

A

No, patients are advised to take calcium and vitamin D supplements.

50
Q

What syndrome can long-term corticosteroid therapy induce that mimics another disease?

A

Cushing-like syndrome.

51
Q

What effect do long-term corticosteroids have on the eyes?

A

Increased frequency of cataracts.

52
Q

What is a potential metabolic side effect of long-term corticosteroid therapy?

A

Hyperglycemia, which may lead to diabetes mellitus.

53
Q

How do glucocorticoids affect potassium levels?

A

They can cause hypokalemia.

54
Q

What effect can long-term corticosteroid use have on children’s growth?

A

Decreased growth in children.

55
Q

What is a common appetite-related side effect of long-term corticosteroid therapy?

A

Increased appetite.

56
Q

How do corticosteroids affect infection risk?

A

They increase the risk of infection.

57
Q

What is a potential fluid-related side effect of long-term corticosteroid use?

A

Peripheral edema.

58
Q

Why might the glucocorticoid dose need adjustment when coadministered with certain medications?

A

Because they are metabolized by liver P450s, and medications that induce or inhibit hepatic mixed-function oxidases may require dose adjustment.

Pharmacology 2 Final Dr. Balqees Ikhmais (6 decks)

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