Corticosteroids

Question 1

What are corticosteroids?

Answer 1

Steroid hormones produced by the adrenal cortex

Question 2

What are corticosteroids used for?

Answer 2

Treatment of inflammatory and autoimmune diseases

Question 3

What are the 2 classes of corticosteroids?

Answer 3

Mineralocorticoids

Glucocorticoids

Question 4

Where are corticosteroids made specifically and what are they used for?

Answer 4

• mineralocorticoids -> zona glomerulosa of the kidney (outer layer), for electrolyte and water balance
• glucocorticoids -> zone fasciculata (middle), affecting metabolism, fights infection, prevents fluid loss, neurochemistry effects

Question 5

What type of corticosteroid is cortisol?

Answer 5

Glucocorticoid

Question 6

How does the concentration of cortisol change at different times?

Answer 6

• cicadian rhythm:

highest in the morning when we wake up and then decreases throughout the day until the evening where it is at its lowest

Question 7

What is the purpose of the cicadian rhythms?

Answer 7

Allows you to be more active during the day, better response to stress and greater immune protection in the morning when you need it vs the evening when you are mostly in a protected environment
Natural homeostatic mechanism

Question 8

What are the side effects of high glucocorticoids?

Answer 8

Oedema, weight gain, hypertension, osteoporosis, avascular necrosis, hyperglycemia, glaucoma, jaundice, peptic ulcers, cushing’s if there is high cortisol

Question 9

Why may you have high glucocorticoid levels?

Answer 9

From stress

excess administration

Question 10

What is the use of glucocorticoids?

Answer 10

Hypersensitivity (asthma, dermatitis)
Arthritis
MS
Adrenal deficiencies
Chron's

Question 11

What are the glucocorticoid receptors?

Answer 11

• 2 forms: alpha and beta

- lipids so can enter the cell membrane meaning they are found in the nucleus and the cytoplasm

Question 12

What is the role of the beta glucocorticoid receptor?

Answer 12

Does not bind to the steroid

Increased in steroid resistant patients

Question 13

How do glucocorticoids work on receptors?

Answer 13

Through genomic activities (slow acting) and non-genomic activities (fast acting)

Question 14

How do genomic activities occur?

Answer 14

Transactivation and transrepression

Question 15

What is transactivation?

Answer 15

Glucocorticoids bind to alpha receptors, the receptor gets translocated to nucleus where it regulates gene expression

Question 16

What is transrepression?

Answer 16

Glucocorticoid bind to the DNA directly where pro-inflammatory transcription factors prevent gene expression

Question 17

How do non-genomic activities work?

Answer 17

Activated glucocorticoid binds to proteins on the membrane and cytoplasm causing an immediate effect through activating cascades

Question 18

What are the synthetic forms of glucocorticoids?

Answer 18

Dexamethasone
Betamethasone
Prednisone
Prednisolone