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16 Cards in this Set
- Front
- Back
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Glucocorticoids, MOA
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bind to steroid recpetors that then dissociate from HSP90, dimerize, bind to GRE:
Synthesize Lipocortin: inhibits PLA2 reducing AA |
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Antiinflammatory effects of Glucocorticoids
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apoptosis of activated lymphocytes (dec. NF-kB)
decrease ICAM, selectins, integrins stabilize lysosomes reduce cap permeability Antagoize Histamine |
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Glucocorticoids SE
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catabolic: osteoporosis
mm wasting endocrine adrenal hypoplasia HTN lethargy N/V/ ulcers Inc. RBC, dec. WBC, inc N Headache, vertigo, EEg abnormalities, labile mood |
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Glucocorticoids withdrawal
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acute adrenal insufficiency
HPA suppression Fever, myalgia, arthalgia malaise |
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Glucocorticoids Uses
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RA, allergic symptoms, asthma,
ulcerative coliits enteritis of GI tract organ transplants replacement for adrenal cortical insufficiency |
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Glucocorticoids, MOA
|
bind to steroid recpetors that then dissociate from HSP90, dimerize, bind to GRE:
Synthesize Lipocortin: inhibits PLA2 reducing AA |
|
|
Antiinflammatory effects of Glucocorticoids
|
apoptosis of activated lymphocytes (dec. NF-kB)
decrease ICAM, selectins, integrins stabilize lysosomes reduce cap permeability Antagoize Histamine |
|
|
Glucocorticoids SE
|
catabolic: osteoporosis
mm wasting endocrine adrenal hypoplasia HTN lethargy N/V/ ulcers Inc. RBC, dec. WBC, inc N Headache, vertigo, EEg abnormalities, labile mood |
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Glucocorticoids withdrawal
|
acute adrenal insufficiency
HPA suppression Fever, myalgia, arthalgia malaise |
|
|
Glucocorticoids Uses
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RA, allergic symptoms, asthma,
ulcerative coliits enteritis of GI tract organ transplants replacement for adrenal cortical insufficiency |
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Test for Cushings
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Low dose Dexamethasone
should give <5mg/ml cortisol by morning normally |
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3 causes of Cushing's syndrome
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bilateral adrenal hyperplasia SECONDARY to ectopic ACTH
nodular hyperplasia of adrenal gland ectopic ACTH production elsewhere |
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Cushings disease is caused by
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Ectopic ACTH secreting primary adenoma (pituitary)
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Test for Cushings
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Low dose Dexamethasone overnight should NORMALLY lead to <5mg/ml cortisol in am.
Cushings Disease Px will reduce cortisol metabolites @ high doses |
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Steroid synthesis inhibitor
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Aminoglutethimide
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Steroid inhibitors Tx for Cushings (2)
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Metyrapone (INH 11B hydroxylation)
trilostane (INH 3B dehydrogenase) |
