Anti-Inflammatory Corticosteroids Flashcards Preview

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Flashcards in Anti-Inflammatory Corticosteroids Deck (29):
1

Addison's disease requires _________.

cortisol supplementation

2

Cushing's disease results from _________.

excess endogenous cortisol

3

Once you administer glucocorticoids for a significant time, you need to __________.

continue administering it, because the exogenous glucocorticoids inhibits pituitary release of ACTH

4

ACTH (also called ________) is acts on the ________.

adrenocorticotropin hormone; adrenal glands to stimulate cortisol production

5

CRF (____________) is released by the ________ and acts on the ________.

corticotropin-releasing factor; hypothalamus; pituitary

6

ACTH inhibits _______.

CRF release from the hypothalamus

7

Pituitary release of ________ is inhibited by ________.

ACTH; glucocorticoids

8

What are the metabolic symptoms of Cushing's disease/excess glucocorticoids?

Diabetes (due to increased gluconeogenesis), obesity, muscle wasting (due to AA shuttle to liver), skin atrophy,

9

What are the mineralocorticoid effects of aldosterone?

Sodium retention (and consequent increased water reabsorption from the kidneys resulting in increased BP); metabolic alkalosis; hypokalemia

10

Immunologically, glucocorticoids ______.

suppress the immune response by decreasing lymphocyte activation and restricting vasodilation

11

Cortisol has a ______ backbone.

cholesterol

12

Prednisone and cortisone have to __________.

be metabolized in the liver to the active prednisolone and cortisol

13

________ inhibits the mineralocorticoid action while _______ stimulates it.

Dexamethasone; fludrocortisone

14

Aldosterone ______ potassium levels.

lowers (if you don't have enough aldosterone, such as in Addison's, you will be hyperkalemic)

15

In the kidneys, ______ converts cortisol to cortisone, thus ensuring that aldosterone is the primary glucocorticoid regulator in the kidneys.

11Beta-HSD2

16

The most potent anti-inflammatory is ______.

dexamethasone (Decadron)

17

Which two glucocorticoids have to go through the liver?

Cortisone and prednisone

18

______________ are released in concert with cortisol, but not aldosterone.

Adrenal androgens (such as dihydroandostenedione and androstenedione)

19

Endogenous and exogenous glucocorticoids negatively affect the ___________.

hypothalamus and pituitary (production of CRF and ACTH, respectively)

20

In the plasma, cortisol is ________.

bound to cortisol-binding globulin (CBG)

21

Once in the cell, cortisol ___________.

dimerizes with R, forming R-S complex that binds the response element on DNA

22

The half-life of cortisol is roughly ______.

60 - 90 minutes

23

Aldosterone works by ________.

activating transcription factors (in the nucleus) that produce protein for sodium and potassium resorption--leading to increased water retention

24

What are the two ways glucocorticoids antagonize inflammation?

They (1) inhibit the synthesis of IL-1 to IL-6, IL-8, GM-CSF, and TNF, and they (2) inhibit the production of arachidonic acid metabolites

25

The inactivating enzyme is _______, while the activating enzyme is _______.

11Beta-HSD2; 11Beta-HSD1

26

The alternate-day schedule __________.

lessens adverse effects, because the anti-inflammatory effects outlast the HPA effects

27

What do mineralocorticoids do to potassium levels?

Decrease

28

Excess aldosterone can lead to _______.

hypertension, increased blood volume, hypokalemia, and metabolic alkalosis

29

The glucocorticoid with the best topical activity is ________.

triamcinolone

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