Adrenocortical Steroids

Question 1

Where are adrenocortical steroids stored?

Answer 1

Adrenocortical steroids are synthesized not stored

Question 2

Explain the synthesis of cortisol.

Answer 2

Cholesterol LDL binds to an LDL receptor

Triggers cholesterol to be transported to the mitochondria where it converts to pregnenolone by 20 alpha hydroxylase

Pregnenolone is transported to the smooth ER and converted to 11-desoxycortisol

11-desoxycortisol is transported back to the mitochondria to be converted to cortisol by 11 beta -hydroxylase

Cortisol is released to cytoplasm

Question 3

What happens to cortisol in the cytoplasm?

Answer 3

Cortisol binds to binding globulin to prevent degradation.

This globulin transports cortisol to the nucleus. Once in the nucleus, cortisol binds to glucocorticoid receptors.

Two receptors dimerize and bind on response elements on DNA to induce protein synthesis

Question 4

Chronic use of corticosteroids can lead to toxicities. What are they?

Answer 4

supression of pituitary/adrenal
Hypokalemia alkalosis and edema
Infection susceptibility
Ulcers

Question 5

Which corticosteroids exhibit the longest DOA?

Answer 5

Betamethasone

Desamethasone

Question 6

Which corticosteroids exhibit the shortest DOA?

Answer 6

Hydrocortisone

Cortisone

Question 7

Which corticosteroids exhibit no effect on sodium retention?

Answer 7

Triamcinolone
Betamethasone
Dexamethasone

Question 8

Why is cortisone not used as an anti-inflammatory agent?

Answer 8

It has higher mineralocorticoid action (must be converted to cortisone)

Question 9

What is prednisolone DOC for?

Answer 9

Systemic anti-inflammatory

Question 10

Which corticosteroids are prodrugs?

Answer 10

Cortisone

Prednisone