Corticosteroids Flashcards
What is the role of the hypothalamus?
It produces hormones including the Corticotropin releasing hormone
Maintains homeostasis through regulating body temperature, controlling appetite, managing sexual behavior, managing emotional responses
What hormones are released from the posterior pituitary?
Oxytocin & ADH (antidiuretic hormone)
What hormones are released from the anterior pituitary?
Leutinizing hormone, Folicular stimulating hormone, growth hormone, adrenocorticotropic hormone, thyroid stimulating hormone, prolactin
Where is cortisol released from?
zona fasiculata in the adrenal cortex
Where is aldosterone released from?
zona glomerulosa in the adrenal cortex
What is released from the adrenal medulla?
epinephrine and norepinephrine
The zona reticularis releases
sex hormones
What is the role of cortisol (hydrocortisone)?
Increases carbohydrate & protein metabolism
suppress immune system
suppression of pro-inflammatory cytokines
mobilization of free fatty acids
inhibits insulin from shuttling into cells
When does cortisol peak?
8 am
When is cortisol at its lowest concentration?
midnight
What is the normal production of cortisol?
15-30 mg/day
What causes release of cortisol?
ACTH
What are cortisol levels in response to minor procedures?
up to 50 mg/day
return to baseline within 24 hours
ex. hernia repair
What are cortisol levels in response to moderate procedures?
up to 75-100 mg/day
return to baseline by 5 days
ex. colectomy
What are cortisol levels in response to major procedures?
up to 200 mg/day
usually returns to baseline by 5 days
ex. major trauma
What is Cushing’s Sydnrome?
Too much cortisol typically due to increase of corticosteroids
What are reasons Cushing’s disease can occur?
Tumor on pituitary gland resulting in increased release of cortisol
What are the signs and symptoms of Cushing’s Disease?
moon face, hunch back, thin skin, osteoporosis, amennorhea, Na & fluid and retention, males develop breasts
When do we see clinical manifestations of Addison’s Disease?
When 90% of cortical zones are destroyed
What is the most common cause of Addison’s disease?
autoimmune destruction
What are reasons for secondary adrenal insufficiency?
problems w/ hypothalamus or anterior pituitary
TBI
Chronic glucocorticoid treatment (3-4 weeks)
Topical administration such as aersols for asthma and COPD or creams used for skin problems
Ischemic/hemorrhagic lessons of hypothalamic-pituitary axis