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Pharamacology > Steroids > Flashcards

Steroids Flashcards

1
Q

2 Types of steroid?

A 
Hormonal (corticosteroids and sex hormones)
Non hormonal (cholesterol)
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2
Q

Name the 4 zones of the adrenal gland (outer->inner)

A

Zona glomerulosa
Zona fasciculata
Zona reticularis
Adrenal medulla

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3
Q

Where are mineralocorticoids produced? eg?

A

In the zona glomerulosa of the adrenal gland

e.g. aldosterone

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4
Q

Where are glucocorticoids produced? eg?

A

In the zona fasciclata of the adrenal gland

e.g. cortisol

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5
Q

Where are androgens produced? eg?

A

in the zona reticularis of the adrenal gland

e.g. testosterone

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6
Q

What is produced int he adrenal medulla? eg?

A

Catecholamines (e.g. adrenaline)

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7
Q

What is formed in the zona reticularis of the adrenal gland?

A

Androgens (testosterone)

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8
Q

What is formed in the zona fasciculata?

A

Glucocorticoids (cortisol)

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9
Q

What is formed in the zona glomerulosa?

A

Mineralocorticoids (aldosterone)

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10
Q

What is cholesterol’s main function?

A

Regulates fluidity and function of phospholipid bilayer membranes
Makes membrane less deformable and less water permeable (so no cell wall needed)

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11
Q

What controls the rate of cholesterol production?

A

HMG CoA reductase (inhibited by statins)

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12
Q

What is the main glucocorticosteroid in humans?

A

Cortisol

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13
Q

What do glucocorticosteroids do?

A 
Prepare for starvation (catabolic)
-hyperglycaemia
-mobilisation of lipids
-breakdown of proteins
and anti inflammatory
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14
Q

Name two inhaled GCS drugs?

A

Fluticasone (for asthma)

Beclomethasone

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15
Q

Name two topical GCSs

A

Hydrocortisone

Betamethasone (for eczema)

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16
Q

Name two systemic GCS drugs

A

Prednisolone

Dexamethasone

17
Q

What are Prednisolone and Dexamethasone used for?

A

To treat systemic arthritis, inflammatory bowel disease, cerebral oedema, some types of leuekmia

18
Q

What is Beclomethasone?

A

Inhaled GCS to treat asthma

19
Q

How do GCS drugs work?

A

Bind to cytoplasmic GRs (glucocorticoid receptors) and modulate transcription of hundreds of inflammatory genes
(block transcription of pro-inflam and induce transcription of anti-inflam)
Activates Annexin-1 (phospholipidase-A2 inhibitor) so arachadonic acid can’t be formed-> no prostagladins of leukotrienes

20
Q

Give 3 examples of anti-inflammatory proteins

A

IL-10, Anexin-1 and Ribonucleases (break down inflam mRNAs)

21
Q

Give 5 examples of pro-inflammatory proteins

A

COX-2, cytokines, immunoglobulins (IgG, IgE), complements and adhesion molecules

22
Q

What is Cushing’s disease?

Give 9 effects on body

A

Syndrome caused by either overproduction of cortisol or overuse of synthetic GCS drugs
Cateracts, moon face, red cheeks, benign intercranial hypertension, euphoria, buffalo hump, thinning of skin (bruises and poor wound healing), osteoporosis and muscle wasting of arms and legs

23
Q

How can overproduction of cortisol be treated?

A

By Metyrapone

24
Q

How else to GCS affect the body?

A

Reduces proliferation, adhesion, migration, activation and survival of inflammatory leukocytes
Reduces oedema and impairs fibrosis and wound healing

25
Q

Why can’t GCS drugs be stopped suddenly?

A

-ve feedback occurs, causing atrophy of adrenal gland in the long term (anterior pituitary stops producing ACTH)
ACTH= adrenocroticotrophic hormone

26
Q

What is the series of events that causes production of cortisol?

A

Stress, shock, starvation, pain ->
Hypothalamus releases corticotrophin releasing factor ->
Anterior pituitary releases ACTH ->
Adrenal gland releases cortisol

27
Q

What is the main endogenous mineralocorticoid? And what triggers its release?

A

Aldosterone

Released from zona glomerulosa when low plasma Na+ and indirectly by renin-angiotensin sytem

28
Q

What are the actions of aldosterone?

A

Acts of MR (mineralocorticoid receptors) in cytoplasm of kidney tubule epithelial cells
Increases transcription of epithelial Na+ channels–> increased Na+ and water reabsorption into blood -> slat and water are conserved while K+ and H+ are excreted

29
Q

What is Fludrocortisone?

A

Mineralocorticoid receptor agonist

Used as replacement therapy in adrenal insufficiency (Addison’s disease)

30
Q

What drug is used to treat Addison’s Disease

A

Adrenal insufficiency so the MR agonist Fludrocortisone

31
Q

Name a diuretic that is also used in hyperaldosternism

A

Spironolactone, competitive MR antagonist

Reduces blood volume in hypertension while preventing hypokaleamia

32
Q

What is Fludrocortisone?

A

An MR agonist used to treat Addison’s disease

Increases volume of blood and may cause hypokalaemia

33
Q

What is Spironolactone?

A

MR antagonist -> diuretic that prevents hypokaleamia

Pharamacology (16 decks)

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