Corticosteroids

Question 1

Cortisol Metabolic Functions

Answer 1

Provide Energy for stress state

• Gluconeogenesis
• Glycogenolysis (indirectly by Glucagon)
• Lipolysis

Blood glucose increase, Insulin
- Lipogenesis, Net fat deposition increases

Question 2

Cortisol Regulation

Answer 2

Axis - Negative feedback: Cortisol to Hypothalamus

Inflammation - Pro-inflammatory cytokines TNFa, IL1, IL6

Question 3

Cortisol Catabolic Functions

Answer 3

Proteolysis (for gluconeogenesis)
Lipolysis (but Insulin then encourages lipogenesis)

Reduce Calcium Absorption;
Reduce Bone formation

Question 4

Cortisol Inflammatory Functions

Answer 4

Decrease expression of pro-inflammatory cytokines, chemokines:

• Limit adhesion molecules
• Decrease IL2Receptors, TCR
• Decrease enzymes - COX, 5-LOX, PLA2

Increase other targets
- B2 receptors, for bronchodilation

Overall decrease T cell, B cell, M, E , B; just increase neutrophils, promote resolution of inflammation; decrease type IV hypersensitivity rxn, hence Immunosuppressant for transplants;

Question 5

Miscellaneous Cortisol Functions

Answer 5

• Increase surfactant production in lungs

Question 6

Hydrocortisone (Cortisol)
Cortisone

Which is prodrug

Answer 6

Cortisone is prodrug

Question 7

Prednisolone
Prednisone

Which is prodrug

Answer 7

Prednisone is prodrug

Question 8

Whats the deal with Methylprednisolone, Triamcinolone, Dexamethasone and Betamethasone

Answer 8

Increasing glucocorticoid effect
NO water retention effect (aldosterone)
Beta and Dexa 1-3 days MOA, increase potency;

Question 9

Side effects

Answer 9

Cushing’s Syndrome:
Hyperglycaemia
Obesity
Muscle Wasting
Growth Retardation
Delayed Wound Healing, Skin thinning (limited ECM and collagen production)
Water retention, Edema, Hypertension, CHF

Oesteoporosis
GI bleeding

Must taper dose off or else insufficiency;