Glucocorticosteroid Pharm

Question 1

Cholesterol response to stress

Answer 1

Increase in cholesterol

Question 2

How many carbons does cortisol have

Answer 2

21

Question 3

Adrenal medulla

Answer 3

Stress gland. Makes epi, norepi, sympathetic system.

Question 4

Adrenal cortex and compartments and cyps

Answer 4

Makes aldosterone (Zona glomerulosa), cortisol (cyp11b1 and cyp17 in zona fasciculata), dehydroeriandrosterone (cyp17 in reticularis)

Question 5

How does cortisol affect transcription

Answer 5

Binds to GR which displaces hsp90. Dimerizes. Sits on DNA to initiate transactivation or transrepression

Question 6

Effect of epinephrine, glucagon, insulin and cortisol on PEP

Answer 6

Insulin inhibits, other three stimulate. Drives gluconeogenesis

Question 7

Describe plasma glucose response to cortisol, glucagon, epinephrine. Mechanism?

Answer 7

All three raise blood glucose but there is a synergistic response to all three. Stimulate PEP

Question 8

GCs effect on immunity

Answer 8

Transactivatiom of anti inflammatories (annexin A1) and transrepression of PGs and other pro inflammatories

Question 9

Annexin A1

Answer 9

Increased by GCs. Decreases phospholipase A2, blocking conversion of phospholipids to arachidonic acid. No downstream PGs, leukotrienes, inflammation

Question 10

How does transrepression work

Answer 10

Prevents dimerixation of GR

Question 11

Cause of Addisonian crisises

Answer 11

Mineralcorticoid deficiency

Question 12

difference b/w prednisone and methylprednisalone

Answer 12

prednisone is a prodrug, methylprednisolone is active drug

Question 13

Hypothalamic pituitary adrenocortical axis

Answer 13

CRH from hypothal, ACTH from ant pit, cortisol from adrenal cortex. Cortisol inhibits CRH and ACTH

Question 14

Cushings syndrome: causes

Answer 14

tumors or drugs producing excess cortisol.