CD 17 Flashcards
Where is the adrenal Glands(stress glands) of our body ?
On top of our kidneys.
Adrenal glands produces
Mineralocorticoids Glucocorticoids Androgens Catecholamines Peptides
Adrenal gland is made of 2 different parts ?
Medulla
Cortex
Cortex has 3 different zone ?
Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
Glucocorticoids produces
Cortisol and Cortisone
Cortisol is the predominant corticosteroid secreted
from ?
Adrenal cortex in humans
What influence Cortisol
Secreted according to a diurnal (Night and day) pattern under the
influence of ACTH from the pituitary gland under the
influence of CRH from the hypothalamus
HPA axis
Hypothalamus (CRH hormone)=>Anterior Pituitary(Corticotropes)=> Adrenal Cortex=>Cortisol which try to react stress but when enough than it signal negative and turn cortisol production down.
From where cortisol produce ?
adrenal cortex
What is the sorce of secration for Glucocorticoids ?
Zona faciculate
What is the sorce of secration for Mineralcorticoids ?
Zona glomerulosa
What is the half life of Glucocorticoids
70- 90 mins
What is the half life of Mineralcorticoids
20 min
Where is the main action of Glucocorticoids
metabolism of glucose via
carbohydrate , protein and
lipid metabolism
Where is the main action of
Mineralcorticoids
on minerals for example : sodium, potassium and
hydrogen ions
Glucocorticoids controls the carbohydrates,
fats and other proteins
within the system
Mineralcorticoids Control of electrolytes and
water balance of the body
Glucocorticoids help with
healing wounds
of minimising pain in injury
Glucocorticoids used as antiinflammatory drugs
Anti-inflammatory and immunosuppressant drugs
Mechanism of Action for Glucocorticoid ?
-Activated GR complex upregulates the expression of anti-inflammatory proteins -Activated GR complex decreases the expression of pro-inflammatory proteins
Mechanism of Action for Glucocorticoid ?
Phospolipids=> Arachidonic acids=>Cyclooxygenase=>prostaglandins,Thromboxane, Prostacyclins
Glucocorticocoids Not stored
Rate of synthesis and rate of release equal.
Glucocorticocoids synthesized
rhythmically and control by irregular pulses of ACTH
Glucocorticoids act via their receptors
in the nucleous
Mineralocorticoid and glucocorticoid receptors are closely related and share similarities
in their ligand and DNA binding domain
Most of the physiological effects of glucocorticoids and mineralocorticoids
hormones are mediated through
binding to intracellular that operate as
ligand-activated transcription factors to regulate gene expression
Long Term Risks of Glucocorticoids ?
Adrenal axis suppression
Effects on carbohydrate , protein and fat metabolism
Topical corticosteroids
Topical corticosteroids are used for the treatment of inflammatory
conditions of the skin (other than those arising from an infection), in
particular eczema, contact dermatitis, insect stings, and eczema of
scabies
• Corticosteroids suppress the inflammatory reaction
• They are not curative and on discontinuation a rebound exacerbation
of the condition may occur
• They are generally used to relieve symptoms and suppress signs of
the disorder when other measures such as emollients are ineffective
What is topical?
Powder • Paste • Cream • lotion • Ointment • Drops
Which part of the bodily skin absorb Corticosteroids maximum ?
Eyelids and genitals
30 % (This is maximum)
Which part of the bodily skin absorb Corticosteroids maximum ?
Palm 0.1%
Sole 0.5%
(which is Minimum)
How much Corticosteroids Face absorb?
7 %
How much is absorbed systemically?
• There is little evidence as to what percentage of a topical corticosteroid
dose is absorbed systemically
• Studies investigating systemic effects do not measure how much of the
corticosteroid is in the blood, but instead focus on measuring cortisol as
a marker of hypothalamic-pituitary-adrenal (HPA) axis suppression
• After a few weeks’ treatment with potent or very potent topical
corticosteroids temporary HPA axis suppression does occur
• However, this resolves upon cessation of the topical corticosteroid,
without the need for dose tapering
What are the adverse effects of Corticosteroids ?
Skin thinning Stretch marks Easy bruising Central fat deposition Enlarged blood vessels Susceptibility to skin infections Allergy
Minimising adverse effects – using
appropriately!
- apply it to affected areas only
- Do not apply more frequently than twice daily -once daily is often
sufficient - use the least potent formulation which is fully effective
- Use appropriate formulation for the area
- Use appropriate quantity
- Use for the shortest time possible (but still ensure skin condition
clears)
Corticostiroid suppress the ?
Inflammatory reaction
They are not curative
