Adrenal Steroids Flashcards
2 types of corticosteroids
Glucocorticoids
Mineralocorticoids
Is cortisol stored or secreted when needed?
Secreted when needed
Cortisol secretion is highest when?’
Early in the morning
Cortisol is secreted in response to ____
Stress
What hormones stimulate the release of cortisol?
Corticotropin releasing factor
Corticotropin (ACTH)
Cortisol increases/decreases blood glucose
Increases
Cortisol increases protein breakdown leading to:
Muscle atrophy
Redistribution of fat (buffalo hump, moon face)
Cardiovascular effects of glucocorticoids
Increase cardiac output
Increases epinephrine vasoconstriction
Other effects of glucocorticoids
Decrease body Ca2+
Increase gastric acid
Inhibit growth
Induce fetal lung surfactant
Inhibit ACTH
Aldosterone regulated mainly by ____ system and activated by ___
RAAS system
Low blood volume, high potassium
Effects of aldosterone
Increase sodium and water retention
Increase potassium and H+ excretion
Disease of hypercortisolism
Cushing’s syndrome
Disease of adrenal deficiency
Addison’s Disease
All adrenal steroids are lipid-____ and activates ____ receptors
Lipid-soluble
Intracellular nuclear transcription factor receptors
Most adrenal steroids are highly ___-bound
Protein-bound
Adrenal steroids are excreted by ____
Kidneys/urine
Drug name for cortisol
Hydrocortisone
Prodrug of hydrocortisone
Cortisone
Hydrocortisone activates which receptors?
Both GC and MC receptors
Difference between prednisone and hydrocortisone
Prednisone has slower metabolism so is more potent
Prednisone is partially selective for GC vs MC receptors (better for inflammation)
Hydrocortisone is usually used for ____ and not for ____
Endocrine replacement
Not for inflammation
Dexamethasone is highly __ selective
GC
When is dexamethasone used?
Very severe inflammation
Fludrocortisone has increased ___ potency
MC (still strong GC potentcy)
Fludrocortisone is used to replace what hormone?
Aldosterone
Spironolactone is a MC _____
Antagonist
What is spironolactone used for/as?
K+ sparing diuretic
Why are some steroids administered locally?
Avoid systemic toxicity/effects
Glucocorticoids are the most powerful anti-inflammatory drugs but are not 1st line. Why?
Toxicity
Lots of systemic effects
How do glucocorticoids decrease inflammation?
Decrease redness and swelling (vasoconstriction and decrease histamine release)
Decrease fever/heat and pain (inhibit arachadonic acid metabolism, decrease prostaglandins, and decrease COX2 expression)
Diseases treated by glucocorticoids
RA
Dermatitis
Lupus
Allergic reactions
Asthma
Adverse effects of glucocorticoids
Hypernatremia
Hypokalemia
Edema
Hypertension
Alkalosis
Muscle wasting
Weight gain
Cataracts
Peptic ulcer
Osteoporosis
Increased risk of infection/immunosuppression
Safe ways to administer corticosteroids
Short term high dose
Long term low dose
(Use lowest dose for shortest time possible)
Glucocorticoids usually do/don’t treat underlying disease
Don’t treat underlying disease, help with pain and further tissue damage
