Corticosteroids Flashcards
Adrenal glands are located on top of the _________.
They’re composed of the cortex and the _________
kidneys
medulla
Adrenal cortex and steroid hormones:
Zona glomerulosa: synthesize and secrete _________.
Zona fasciculata: synthesize and secrete _______.
Zona reticularis: secrete ____________
mineralocorticoid (aldosterone)
glucocorticoid (cortisol)
androgen precursor
function of aldosterone?
regulate sodium and potassium reabsorption in kidney
function of cortisol?
affect carb, fat, and protein metabolism, catabolism, immune response, and inflammation
Hypothalamic-Pituitary-Adrenal (HPA) Axis:
The hypothalamus is activated to release _______________ to the anterior pituitary which produces ______ to the Adrenal cortex which produces _______ which creates a negative feedback loop to inhibit both the hypothalamus and anterior pituitary to decrease cortisol levels.
If there is an increase in steroidogenesis in response to stress signals, they stimulate the hypothalamus and pituitary to ________ glucocorticoid (cortisol)
corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), cortisol
increase
The retinal ganglion cells are responsible for mediating the activation of the ________________ via the retinohypothalamic tract which mediates the actions of the ______________ which regulates the downstream release of the hormone ______ which activates the release of the hormone _____ which activates the release of cortisol
suprachiasmatic nucleus (SCN), paraventricular nucleus (PVN), corticotropin releasing factor (CRF), adrenocorticotropic hormone (ACTH)
Both stress and the circadian clock promote the activation of _____ and ______ in the hypothalamus, whereas ______ inhibits their activation.
suprachiasmatic nucleus (SCN), paraventricular nucleus (PVN), cortisol
Cortisol’s effect on different systems:
Brain?
Adrenal Medulla?
Liver?
Kidney?
Brain: inhibit stress response
Adrenal Medulla: NE synthesis
Liver: gluconeogenesis
Kidney: fluid-retention (similar to aldosterone
ACTH pharmacology:
ACTH increases synthesis of ___________.
ACTH-R is coupled to ______.
The rate-limiting step in glucocorticoid biosynthesis is _______ to _________, which is catalyzed by ________.
glucocorticoids (cortisol)
G-protein
cholesterol, pregnenolone, P450
Corticosteroid hormone action:
Corticosteroids bind to _____________ in the blood.
Corticosteroid receptors bind to _________ in the cytosol.
Corticosteroid-receptor complex binds to ___________ response element on DNA.
corticosteroid-binding globulin (CBG)
heat shock protein 90 (Hsp90)
mineralocorticoid/glucocorticoid
Metabolic effects of glucocorticoid:
promote _________, _________, and __________________: blood glucose increase.
Fat redistribution: peripheral _______ and central fat accumulation
Catabolic effects include?
gluconeogenesis, lipolysis, protein breakdown
fat loss
skin, fat, muscle, bone and connective tissue
Immunosuppressive and anti-inflammatory effects of glucocorticoid:
Immunosuppressive effects?
Anti-inflamm effects:
decrease the number of _________ and _______.
inhibit ________ migration.
inhibit proinflammatory __________ production.
inhibit cell-mediated immunologic response
lymphocytes, monocytes
leukocyte
cytokine
Other effects of glucocorticoid:
maintain renal _______ of water loads.
affect the ___________
support ____________ development
excretion
central nervous system
fetal lung
Cortisol and the stress response: it restores homeostasis following exposure to stress via:
Maintenance of _____________ via effects in the liver.
Conservation of __________ in kidney.
Enhancement of ___________ in lungs.
Suppression of _______.
blood glucose
sodium
alveolar function
auto-immunity
Fludrocortisone has decent anti-inflamm properties, but why is it never used?
it has strong mineralocorticoid properties
