Adrenocorticoids Flashcards
What are examples of glucocorticoids?
-cortisol (natural)
-cortisone
-corticosterone
-prednisone (synthetic)
-prednisolone
-triamcinolone
-betamethasone
-dexamethasone
-fluticasone
-flunisolide
What are examples of Mineralcocorticoids?
-aldosterone (natural)
-deoxycorticosterone
-fludrocortisone (synthetic)
What are examples of androgens?
DHEA
What is transcortin (CBG)?
corticosteroid-binding globulin, protein that binds cortisol in the blood to keep it inactive and as a supply
note that synthetic glucocorticoids do not do this
What are the metabolic effects of corticosteroid binding?
-increase blood glucose
-increase amino acids
-increase triglycerides
to maintain energy supplies to critical organs during stress
What effect does cortisol have on the HPA axis?
inhibits further release corticotropin releasing hormone (CRH), from the hypothalamus, and adrenocorticotropic hormone (ACTH), from the anterior pituitary gland
What can override the feedback inhibition of cortisol?
severe or chronic stress
What are the immune system effects of cortisol?
cortisol has anti-inflammatory effects by blocking mediators of inflammation and inflammatory cytokines
Describe Cushing’s syndrome/disease
hyper-secretion of glucocorticoids
What are the treatment options for Cushings?
-surgery, radiation, chemotherapy (bc typically tumor related)
-cortisol inhibiting drugs
What is the main cause of endogenous Cushings?
pituitary ACTH- producing adenoma (responsible for 70% of cases)
Describe Addison’s Disease
hypocortisolism, adrenal insufficiency
What is the cause of PRIMARY adrenal insufficiency?
lack of glucocorticoids and mineralocorticoids due to autoimmune reactions that destroy the adrenal cortex, infection, or surgical removal of adrenal glands
What is the cause of SECONDARY adrenal insufficiency?
lack of ACTH due to hypothalamic or pituitary disorders or abrupt ceasing of long-term glucocorticoid treatment
What is the treatment for Addisons?
replacing/substituting glucocorticoids and mineralocorticoids