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14 Cards in this Set
- Front
- Back
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ADRENOCORTICOSTEROIDS
INTRODUCTION • PRODUCED IN ?• REGULATED BY ? • SYNTHESIZED ? |
INTRODUCTION
• PRODUCED IN ADRENAL CORTEX • REGULATED BY ACTH • SYNTHESIZED FROM CHOLESTEROL |
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ADRENOCORTICOSTEROIDS
MINERALOCORTICOID use? |
– Electrolyte homeostasis (e.g. aldosterone)
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ADRENOCORTICOSTEROIDS
• GLUCOCORTICOID – USe? – example: ? |
• GLUCOCORTICOID
– Carbohydrate, fat, & protein metabolism – example: cortisol |
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ADRENOCORTICOSTEROIDSDISEASE STATES
2 |
DISEASE STATES
• Cushing’s Disease – High output of adrenocorticosteroids – Hypertension – Fat Redistribution • Addison’s Disease – Low production of adrenocorticosteroids – Requires therapy with mineralocorticoids and glucocorticoids |
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ADRENOCORTICOSTEROIDS
PHARMACOLOGY 2 + 3 |
PHARMACOLOGY
• CARBOHYDRATE METABOLISM – Protection under physical stress – Protect glucose dependent brain function • gluconeogenesis • reduce peripheral glucose utilization • insensitivity to insulin |
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ADRENOCORTICOSTEROIDS
PHARMACOLOGY • LIPID METABOLISM 2 |
– Lipogenesis and Lipolysis
– Fat redistribution: buffalo hump, moon face |
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ADRENOCORTICOSTEROIDS
• ELECTROLYTE BALANCE 4 |
– Sodium and Water Retention
– Increased Blood Pressure – Potassium Loss – Addison’s: opposite effect-hyperkalemia and circulatory collapse |
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ADRENOCORTICOSTEROIDS
PHARMACOLOGY - CNS • Corticosteroids cause? |
– Depression
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ADRENOCORTICOSTEROIDS
PHARMACOLOGY - CNS • Addison’s Disease 2 |
– Apathy
– Psychosis |
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ADRENOCORTICOSTEROIDS
PHARMACOLOGY 4 |
• HEMATOLOGIC
– Decrease WBC (specifically lymphocytes) • DECREASE IMMUNE RESPONSE • ANTI INFLAMMATORY RESPONSE • RETARD GROWTH INCHILDREN (ß bone growth) |
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CORTICOSTEROID WITHDRAWAL
• Acute adrenal insufficiency ADRENOCORTICOSTEROIDS |
fever
– myalgia – arthralgia – malaise |
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CONSEQUENCES OF PROLONGED THERAPY
6 ADRENOCORTICOSTEROIDS |
• Adrenal Suppression
• Fluid and Electrolyte Imbalance • Peptic Ulceration • Depression • Cataracts • Osteoporosis |
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CLINICAL USE
7 ADRENOCORTICOSTEROIDS |
CLINICAL USE
• Adrenal Insufficiency – administer both mineralo and gluco-corticoids • Rheumatoid Arthritis • Allergic Disorder - not anaphylactic • Asthma • Ocular Disease - avoid if viral infection • Skin Disorder • Lymphocytic leukemia |
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Other Agents
2 ADRENOCORTICOSTEROIDS |
• Aminoglutethimide
– Decreases production of sterol including sex hormones • Mitotane – Adrenocorticolytic |
