wk1 corticosteroids Flashcards
What are the 3 divisions of the adrenal cortex and what do they synthesize
- zona glomerulosa- mineral corticoids ( aldosterone)
- zona fasiculata- glucocpticoids ( cortisol)
- zona raticularis- Sex steroids ( DHEA, Testosterone, estrogen and progeterone)
what is the principal glucocorticoid hormone .
cortisol
what do glucocorticoids do?
regulate metabolism of proteins, carbohydrate, and lipids
what do glucocorticoids promote in the liver?
they promote gluconeogenisis (increase blood glucose)
how is cortisol synthesized?
cortisol is sythesiszed from progesterone( precursor of all steroid hormones), it takes place in the zone fasciculata. Cortisol is the mainhormon produced by the adrenal gland. it is released durng times of stress adn when serum glucose levels drop.
Cortison increases blood glucose via gluconeogenesis and glycogenolysis
Hydrocortisone is the name for cortisol when it is used as a drug
what is the effect of glucocorticoids?
- by raising the plasma glucose levels, glucocorticoids provide the body with energy required to respond to stressors ( trauma, infection, disease)
- cause a mild increase in blood pressure, thought to be due to enhancing the vasoconstrictive effects of adrenergic stimuli on small blood vessels
what is the relationship between cortisol and insulin
cortisol counteracts insulin and contributes to hyperglycemia by stimulating increase causing hepatic gluconeogenisis while also impairing the peripheral utilization of glucose thereby causing increase in insulin resistance
What are some of the effects of glucocorticods on the immune system
increaase circulating neutrophils
- decrease circulating lymphocytes ( including t cells), eosinophils, basophils, monocytes and macrophages
how do glucocorticoids effect auto immune disease
- redistribution of WBC can severely hamper the bodys ability to fight off infection
- at the same time it can be extremely useful in treating condiions which have an auto immune basis or condiions in which WBC counts and certain WBC lines are markedly elevated ( i.e leukemia)
Glucocorticoids also increase hemoglobin levels and red blood cell count
How do glucocorticoids behave on a molecular level
They form complexed with specific receptors to migrate to the nuleus where they interact with selective regulatory sites w/in DNA
- resulting in positive and negative modulation of several genes inolved in inflammatory and immune responses, RBC and WBC production and Cytokine production
how do glucocorticids effect WBC
they inhibit the access of leukocytes to inflammatory sites, interfere with the functions of leukocytes, endothelial cellsm and fibroblasts, and suppress rhe production and effects of multiple factors involved in the body’s inflammatory response
what do pharmacologic doese of glucoorticoids produce
they dramatically inhibit the accumulation of leukocytes as well as inhibit cell signaling for multiple chemotactic agents at site of inflammation
what are glucocorticoids indicated for?
- inflammatory and allergic conditions
- reactive airways disease
- allergies
- Arthritis
- Auto-immune conditions
- Replacement therapy for Addison disease (rx needed for patient survival;)
Inhaled steroids
- primarily used to treat people with asthma, but also with emphysema and chronic bronchitis
- favored over steroid pills because they act directly on the airwys
- enhances their effectiveness and lowers the risk and extent of side effects.
nasal inhaled glucocorticoids
- allergic rhinitis
- non-allergic (vasomotor) rhinitis
- nasal polyps
