Glucocorticoids

Question 1

what are glucocorticoids

Answer 1

steroid hormones that bind to the glucocorticoid rec.

Question 2

how does the adrenal cortex synth. glucocort.

Answer 2

steroid base - cholesterol - pregnenolone - corticosteroid

Question 3

Name the corticosteroid types

Answer 3

• glucocorticoids
• mineralocorticoids
• androgens

Question 4

What stimulates the prod of the corticosteroids and where is it produced

Answer 4

Acth ex pituitary gland (hypophysis)

Question 5

What percent of cortisol is bound to plasma protein

Answer 5

90%

Question 6

what are the main sites of peripheral cortisol met.

Answer 6

liver and kidney

Question 7

to which rec do the gc s bind

Answer 7

to the cytosolic glucocorticoid receptor

Question 8

how is the gc being bound to the rec.

Answer 8

as it is lipophilic it goes across the cell membrane where it is bound to the cytosolic glucocorticoid rec. and travels to the nucleus in bound form where it is either repressed (by HAT activated in inflam.) or activated and genes are transcribed

Question 9

What does the activation of gc lead to

Answer 9

encoding of antiinflam. mediators:
-ANNEXIN
- interleukin 10
…

Question 10

name the effects of gcs on carbohydrate met.

Answer 10

• stimulated gluconeogenesis, incr. glucogenolys.
• inhib. gluc transport into cells and incr. insulin resistance
• incr. blood sugar level

Question 11

effects of gcs on lipid met.

Answer 11

• incr. lipolysis, high levels of ffa

- incr. lipogenesis and redistr. of fat - leads to obesity

Question 12

protein met effects of gcs

Answer 12

anti anabolic, catabolic action

• decr. epithelium reg.
• decr. wound healing

Question 13

effects of gcs on water-electrolyte balance

Answer 13

• smaller doses - incr. diuresis

- larger doses - Na and water retention

Question 14

effects of gcs on bones

Answer 14

• anti vit d action

- incr. CA excr.

Question 15

effects of gcs on cv

Answer 15

incr. BP

Question 16

effects of gcs on blood cell formation

Answer 16

• slightly incr. red blood cell formation

- slightly incr. white blood cell form.

Question 17

anti inflam. action of gcs

Answer 17

• inhibit action of cox 2 and formation of prostaglandins
• induce synth. of lipocortins - mediate anti infl.
• stim. endogenous anti-infl. pathways
• syn. of eicosanoids decr.
• t-cell and phagocyte activity decr.

Question 18

name the types of gcs

Answer 18

• long acting
• med. acting
• short acting

Question 19

Name the short acting gcs

Answer 19

• Cortisol

- Cortisone (inactive needs liver activation)

Question 20

Name the med acting gcs

Answer 20

• prednisolone
• methylprednisolone
• triamcinolone

Question 21

name the long acting gcs

Answer 21

• dexamethasone
• betamethasone
• flumethasone

Question 22

Name all the ind. for gcs (10)

Answer 22

• anti infl.
• oedema
• shock
• allergy, anaphylaxis,
• asthma
• autoimmune disorder
• lymphoid tumor
• induction of praturition
• ketosis
• addisons disease

Question 23

Name the SE of gcs

Answer 23

• inhib. of wound healing
• neg. effect on nutrient and mineral met.
• immunosuppression
• • reactivation of preexisting cond.
• catabolic effect - diabetogenic, muscle wasting, osteoporosis

Question 24

name the contra ind.

Answer 24

• pre existing renal impairment, chf, liver disease
• diabetes
• pregnancy
• infection
• NSAID treatment (some combis exist)

Question 25

How to admin gcs

Answer 25

• single large dose
• depot
• chronic