Stress and Steroids Flashcards
homeostasis
ideal set point where body’s balance is achieved
allostasis
dynamic process that helps the body go back to the set point –>back to homeostasis
- process of attaining and maintaining stability through change when leads to adaptations
- altering multiple physiological variables to match demands
stress
internal or external alterations in our environment that produces tension
- prolonged stress can cause physical and physiological problems
- physical, psychological, chemical
eustress
positive rxn from the body
- makes us feel motivated and inc conc
distress
negative rxn that causes anxiety
- dec conc/performance long term or short term
stressor
actual fore exerted
- taking exam
- infection
coping mechanisms
ways in which stress is managed or our bodies are adapted to
- allow ind to withstand stressor
- helps to resolve the situation and feelings associated
influences of stress
- genetics
- culture
- prior experiences/env
- pre existing health status
- allostatic state
- ability to manage stress
general adaptation syndrome
body’s natural response to a stressor that involves
- alarm
- resistance
- exhaustion
alarm
initial state of arousal that is the body’s initial defense system
- fight or flight response
alarm fight or flight response
sympathetic nervous system
- adrenergic response
hypothalamic pituitary adrenal axis
adrenergic response
hypothalamus releasing CRH activates SNS which stimulates release of epi and norepi
HPA axis
CRH stimulates ant pituitary to secrete ACTH which stimulates adrenal cortex to release glucocorticoids
- glucocorticoid is cortisol
catecholamines
norepinephrine
epinephrine
norepinephrine
constricts smooth muscles
dilates pupils
dec gastric secretion
inc glucose (pancreas)
epinephrine
inc heart contractibility
inc venous return
inc cardiac output
relaxes smooth muscle (in lungs)
dilates airways
inc glucose and dec insulin
glucocorticoid
cortisol
- inc blood pressure, cardiac output
- dec reproductive hormones
- inc amino acids
- atrophy of lymph tissue
- limited inc in WBC
mineralcorticoids
aldosterone
- works on kidneys
- absorbs Na –> promotes water excretion
- excrete K and H
glucocorticoids promote
synthesis of epinephrine
catecholamines and glucocortiocds work…
together in the brain to develop memory
- teaches brain how to respond to stress
resistance
continued hormone and catecholamine release
- continued counteracting of effects of continued stress
- limited supply
- when stressor is removed, cholinergic response takes over and body relaxes (parasympathetic)
exhaustion
chronic state of stress that has negative impacts on physical and mental well being
- immunosuppression from cortisol, dec WBC, atrophy of thalamus, dec T cells
- excessive catecholamine response
allostasis, allostatic load and overload
allostasis: short term adaptation to stressor, survival
allostatic load: chronic stress, long term dysregulation
allostatic overload: exhaustion, stress induced disease or disorder
allostatic overload results in
- hair loss
- tension
- mouth sores
- asthma
- palpations
- tics
- digestive orders
- irritable bowel
- acne
- irregular periods
- impotence
- sleep disturbances
sleep deprivation
- irritability and moodiness
- apathy
- impaired memory
- poor judgement
- hallucinations
stress can lead to what diseases
- coronary artery disease
- HTN
- stroke
- tension headaches
- rheumatoid arthritis
- autoimmune disease
- IBS
- ulcers
- sexual disorders
- TII DM
overproduction of stress hormones
- affects memory
- major depressive disorder
- immunosuppression (inc risk of infection, autoimmune, dec healing, prolong infection)
cortisol effects on carb and glucose metabolism
- opposite of insulin
- glucose to the brain
- gluconeogenesis
- dec peripheral glucose utilization
- inhibit glucose uptake by muscles and adipose
- promote glucose storage
cortisol and protein metabolism
muscle wasting
break down of muscle, adipose tissue, skin and bones
cortisol and fat redistribution
lipolysis of extremities
lipogenesis of face and trunk
in exhaustion the body can never
achieve homeostasis
- hypertrophy of the adrenal cortex
- atrophy of lymphatic tissue
- bleeding ulcers
replacement of steroids can be
actual or pseudo insufficient
steroids have
anti inflammatory properties and are immunosuppressive
steroids used to treat
allergies
asthma
COPD exacerbation
chronic inflammatory bowel
rheumatoid arthrisis
post transplant
steroid replacement general
mimic physiological levels
- glucocort are essential
- must inc dose in times of stress
steroid replacement glucocort
alternate day therapy and give before 9 am
- mimics burst at 9 am
- traditional dosing is multiple and small
steroids replacement mineralcort
once per day dosing
frequently do not need to replace
