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30 Cards in this Set
- Front
- Back
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what are adrenocorticosteroids?
what are the two main types? |
steroids produced by adrenal cortex
glucocorticoids & mineralocorticoids |
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where are glucocorticoids & mineralocorticoids produced?
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the adrenal cortex
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what is the precursor to glucocorticoids & mineralocorticoids?
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cholesterol
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what is the path of synthesis for glucocorticoids?
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hypothalamus>CRH>ant pituitary>ACTH>adrenal cortex>cortisol>target tissue
cortisol also goes to hypothalamus and ant pituitary as (-) FB loop |
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when is cortisol generally released
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highest when waking and d/t stress
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what is the primary glucocorticoid
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cortisol (aka hydrocortisone)
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what is cortisol's primary function?
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control of glucose metabolism & controls bodies ability to deal c stress
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what is cortisol's secondary function?
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decrease inflammation
suppress immune function |
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What else does cortisol effect?
(other effects) |
renal, CNS, blood, cardiac, & skeletal muscle
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what type of receptors do glucocorticoids use?
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intra-cellular
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what are prescription uses of glucocorticoids?
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replacement
help Dx endocrine condition Anti-inflammatory Immune suppressant Antilymphotic (for cancer) |
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What are ways to administer glucocorticoids?
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-orally (systemic)
-intra-articular injection -epidural injection -region/organ specific (nasal, topical opthalmic) |
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What are two examples of glucocorticoids?
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dexamethasone (Dexasone)
prednisone |
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What are adverse effects of glucocorticoids?
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-adrenal cortical suppression
-drug induced Cushing syndrome -break down of tissue -others (HTN, glacoma, ect) |
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what are PT considerations for a pt on glucocorticoids in relation to their side effects?
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-inc risk of overuse injury (d/t muscle/bone wasting)
-pressure ulcers -possible fx's -endurance issues -glucose problems |
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What is the primary mineralcorticoid?
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aldosterone
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What is aldosterone's primary function?
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maintain fluid and electrolyte levels
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What are the adverse effects of mineralcorticoids?
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cardiac and vascular changes (hypertrophy and fibrosis)
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What stimulate the secretion of mineralcorticoids?
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-increased angiotensin II
-increased plasma K -increased ACTH |
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What does angiotensin regulate?
How? |
maintains BP by peripheral vessel constriction or by stimulating aldosterone for long term change
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what is the difference b/w the nuclear and non-nuclear effects?
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the nuclear effect is slower and involves a change in protein synthesis
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what is the mechanism of action for aldosterone
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intra-cellular receptor> nucleus> inc protein synthesis> inc membrane permeability to Na> Na enters cell from lumen and leaves cell into blood stream> Na back into systemic system
in addition K enters lumen and is excreted |
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What are the uses for mineralcorticoid drugs?
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replacement therapy (Addison Dz, post-adrenalectomy)
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What are adverse effects of mineralcorticoids?
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cardiac and vascular changes (hypertrophy and fibrosis)
HTN peripheral edema wt gain hypokalcemia |
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what are 2 examples of aldosterone antagonists?
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spironolactone (Aldactone)
eplerone (Inspra) |
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what is the result of taking aldosterone antagonists?
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increases Na and water excretion and K retention
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what is another name for aldosterone antagonists?
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K sparing diuretics
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what are some adverse effects of aldosterone antagonists?
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-hyperkalemia
-GI disturbances Spironolactone may -interfere c sex hormones -have CNS effects |
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what are two possible mechanisms of action for aldosterone antagonists?
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-block a specific enzyme in the synthesis pathway
-directly suppress the adrenal gland |
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What are the primary and secondary adverse effects of adrenal steroids?
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Primary
-break down of supporting tissues Secondary -water and Na retention -immune suppression -Toxicity |
