Steroids Flashcards
where is the adrenal gland located?
sits on the renal gland (kidney!)
what is destruction of adrenal tissue better known as?
Addison’s disease
what is excess adrenal action known as?
Cushing’s Disease/syndrome
what medications can cause suppression of adrenal action?
therapeutic corticosteroids
what are the three regions of the adrenal gland?
- zona glomerulosa
- zona fasicularis
- zona reticularis
what region of the adrenal gland is aldosterone released from?
zona glomerulosa
what region of the adrenal gland is cortisol released from?
zona fasicularis
what region of the adrenal gland is adrenal androgens released from?
zona reticularis
explain how cortisol is released from the adrenal cortex:
- hypothalamus releases corticotrophic releasing hormone
- this stimulates the anterior pituitary to secrete adrenocorticotrophic hormone
- this acts on the adrenal gland and stimulates it to release cortisol
what occurs when cortisol levels are too high?
cortisol will feedback to both the anterior pituitary and the hypothalamus to reduce its secretion (negative feedback)
what hormone is involved in salt & water regulation?
aldosterone
- enhances sodium reabsorption and potassium loss
what medications can inhibit the action fo aldosterone?
- ACE inhibitors
- AT2 blockers
what is cortisol?
a natural glucocorticoid
what is the result of high cortisol levels in the body?
- antagonist to insulin
- lowers immune reactivity
- raises blood pressure (enhances salt & water reabsorption)
- inhibits bone synthesis (osteoporosis)
what effects are seen as a result of taking therapeutic steroids?
- enhanced glucocorticoid effect (immunosuppressive and reduced inflammatory response)
- enhanced mineralcorticoid effect (salt & water retention and hypertension)
what are some common adverse side effects of therapeutic steroids?
- hypertension
- type 2 diabetes
- osteoporosis
- increased infection risk
what conditions can hyperfunction of the adrenal gland cause?
- Cushing’s Syndrome (glucocorticoids)
- Conn’s Syndrome (aldosterone)
what conditions can hypofunction of the adrenal gland cause?
- Addison’s disease
- Pituitary failure
what are the symptoms of Cushing’s disease?
- diabetes mellitus features (tiredness, thirst, excess urine)
- poor resistance to infection
- osteoporotic changes
- psychiatric disorders
- skin and mucosal pigmentation
what are the signs of cushing’s syndrome?
- centripetal obesity (moon face and buffalo hump)
- hypertension
- thin skin and purpura
- muscle weakness
- osteoporotic changes and fractures
what is cushing’s disease?
a pituitary tumour makes ACTH
what effects can high ACTH levels have on the skin and mucosa?
high ACTH levels will stimulate pigment cells:
- pigmentation of the skin = especially over joints
- pigmentation of the mucosa = patchy brown pigment on gingiva
what may cause adrenal hypofunction?
- gland failure (autoimmunity, infection, infarction)
- pituitary failure (lack of ACTH production)
what syndrome is associated with failure of ALL pituitary hormones?
Sheehan’s syndrome
