EXAM 5- Glucocorticoids Flashcards
glucocorticoid secretion
hypothalamus => CRH
anterior pit=> ACTH
adrenal cortex =>glucocorticoids
body regulates glucocorticoid release via
stress and circadian rhythm (AM =peak)
glucocorticoids have effects via___
gene transcription ∴ onset is delayed
mineralocorticoid effects
=aldosterone binds and (+) Na+ reabsorption, and K+ depletion
=water retention and increased BP
-cortisol does not affect this receptor although it binds with high affinity
glucocorticoid effects
=metabolic effects- mobilize glucose via catabolic actions, metabolize bone and collagen ect…
= immunosuppression
=anti-inflammatory
=CNS effects
fludrcortisone
=mineralocorticoid
=Na+ retention!!
toxic effects of glucocorticoids
skeletal muscle atrophy osteoporosis hyperglycemia peptic ulcer (from immunosuppression) immunosuppression insomnia/mood disorders suppression of adrenal steroid secretion persistent months after treatment ... iatrogenic cushing's syndrome
toxic effects of mineralocorticoids
hypertension
water retention
keep glucocorticoid treatment under ___ days
14
terminate treatment ___
gradually to lessen adrenal suppression and avoid symptoms of adrenal suppression
patient populations that glucocorticoids would be problematic in=
- immunosuppressed
- diabetics (glucocort. increase glucose mobilization)
- pts with infections
- pts with peptic ulcers
- pts with cardiovascular conditions
- puts with osteoporosis (post-menopausal women)
deoxycorticosterone, fludrocortisone
greater mieralocorticoid action
cortisone, hydorcortisone
equal mineralocorticoid and glucocorticoid acitons
prednisone prednisolone triamcinolone benamethasone dexamethasone
greater glucocorticoid action
