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24 Cards in this Set
- Front
- Back
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What's the function of Zona glomerulosa? |
produces mineralocorticoids Under the control of angiotensin II and K |
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What is the function of Zona fasciculata? |
produces cortisol regualated by ACTH |
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What is the function of Zona reticularis? |
responsible for producing sex steroids regulated by the ACTH |
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How is cortisol produced? |
Produced on demand Follows ACTH levels |
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How is cortisol regulated? |
negative feedback stress response diurnal rhythm: In response to sleep-wake cycles ACTH peaks early AM Cortisol peaks 8am breif burst during the day increase with caffeine and exercise stress can override this regulation |
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What is the function of StAR? |
transports cholesterol from outer membrane of the mitochondrion to the inner membrane. |
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What happens if StAR is mutated? |
severely compromised steroid synthesis. |
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How is StAR regulated? |
up regulated by ACTH down regulated by Cortisol |
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What are the functions of cortisol? |
1. Carb and protein metabolism 2. Lipid redistrubution 3. CV and respiratory 4. Bone and skin 5. CNS 6. ANTI-INFLAMMATORY- important for asthma and COPD. |
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How is inflammation accelerated? |
recruit immune cells to inflammation site enhance immune cell proliferation Increase production of damaging agents. |
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How do glucocortioids work in a physiological and cellular level? |
1. Attenuate leukocyte traffiking (less adherence to endothelium) 2. Inh neutophil apoptosis? 3. Promote Eosinophils apoptosis 4. Diminish monocytes and macrophages 5. Diminish degranulations of mast cells 6. Diminish dendritic cells and T-cells 7. diminish eicosanoids and Up regulate ACE which degrade bradykinin. |
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How do glucocorticoids work in a molecular level? |
1. direct activation of gene expression via dna binding target genes 2.. Direct repression of gene expression via DNA binding 3. Direct blocking of NFkB transcription by histone deacetylation |
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What receptor is induced by glucocorticoid that helps bronchodilation? |
beta 2 receptors |
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What gene is induced by glucocorticoid that attenuates inflammation? |
annexin A1 |
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How does annexin A1 work? |
decreases leukocyte adhesion decreases leukocyte transmigration increase leukocyte apoptosis |
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What pro-inflammatory gene is supressed by glucorticoids? |
IL-1beta |
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What's IL-1beta function? |
important mediator of the inflammatory response |
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What are the corticosteroids for acute treatment? |
prednisone methylprednisolone prednisolone |
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Why taper GC treatment? |
HPA supression symptoms rebound |
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When to taper GCs? |
high dose (40 mg/ day) for >5 days lower chronic use (7.5 mg/day) |
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What are the inhalational corticosteroids? |
beclovent pulmicort aerobid flovent azmacort asmanex Alvesco |
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What are SE of ICs? |
adrenal suppression dysphonia oropharyngeal candidiasis Make sure rinse after inhalation |
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What is the role of ICs in asthma treatment? |
1st line treatment for persistent asthma (eosinophilic asthma) not affective in non-eosinophilic asthma. |
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What is the role of ICs in COPD? |
Not monotherapy. Usually combo with LABA. |
