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22 Cards in this Set
- Front
- Back
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What is Addisons Disease?
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Loss of adrenocortical function. low cortisol and aldosterone
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What is Cushings Syndrome?
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high ACTH leading to high cortisol
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Cortisol mechanism of action
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enters cell nucleus, binds to GRE (glucocorticoid receptor element) to up-regulate transcription
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Effects of cortisol
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gluconeogenesis, lipolysis/lipogenesis, muscle breakdown
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Cortisol has what effect on insulin secretion
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increases it. cortisol increases blood glucose levels = compensatory insulin release
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Why is osteoporosis a side effect of cortisol?
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cortisol stimulates the breakdown of tissues to use the monomers for gluconeogenesis, including bone breakdown
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How is cortisol an anti-inflammatory agent?
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inhibits phospholipase A2, decreases COX2 mRNA, decreases IL2 and IL3 and platelet activating factor
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Peak cortisol levels are at what time?
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morning
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Cortisol is normally absorbed poorly across skin. Why do many cortisol creams work well?
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cortisol is absorbed very well through inflamed skin, just not through normal skin
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Strongest glucocorticoid available ...
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dexamethasone
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Beclomethasone and budesonide are glucocorticoids specialized for which organ?
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lungs (airway mucosa); used in asthma to reduce inflammation
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Fetal lung maturation is stimulated in pregnant women by which glucocorticoid
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Betamethasone
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Why do we taper off cortisol doses?
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to give the adrenal cortex time to recover normal function after being suppressed by the exogenous cortisol. there is a strong feedback loop with cortisol and ACTH
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Aldosterone comes from where?
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adrenal cortex (zona glomerulosa)
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What causes aldosterone release?
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angiotensin 2 mainly (RAAS system), and also ACTH a little bit
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Fludrocortisone is what type of steroid drug
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mineralocorticoid, with glucocorticoid activity
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Fludrocortisone is given under what conditions?
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long half life, so it is given after adrenalectomy
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What are eplerenone and spirinolactone?
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aldosterone antagonist diuretics
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What is Mifepristone?
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competitive inhibitor of glucocorticoids at the receptor; used in Cushing's treatment
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Function of ketoconazole?
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inhibit adrenal steroid synthesis (inhibits p450 enzymes used in synthesis)
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Function of aminoglutethimide?
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block steroid synthesis and conversion of cholesterol into pregnenolone
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Function of metyrapone?
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inhibit cortisol formation, but not cortisol precursor formation; used in diagnostic tests for cortisol levels
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