Corticosteroids Flashcards Preview

Pharmacology Test #5 > Corticosteroids > Flashcards

Flashcards in Corticosteroids Deck (53)
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1

Cortex of the adrenal glands secretes

glucocorticoids, mineralcorticoids, and androgens

2

Medulla of the adrenal gland secretes

Epinephrine and Norepinephrine

3

Glucocorticoids

stress hormones; increase circulating glucose concentrations; potent anti-inflammatory effects

4

Mineralocorticoids

Na+ retention; increase blood volume; increase blood pressure

5

What controls the synthesis of mineralocorticoids

Renin-angiotensin-aldosterone system

6

Transport of steroids

transported in plasma by plasma transport proteins

7

Corticoid-binding globulin (transcortin) transports

glucocorticoids and progesterone

8

Sex hormone binding globulin (SHBG) transports

testosterone and estradiol

9

Metabolism of steroids

metabolized in the liver (oxidation, sulfation, and glucuronidation)

10

Excretion of steroids

excreted in bile (estrogen) or in the urine (progesterone, androge, and glucocorticoids)

11

Glucocorticoids up-regulate enzymes for

gluconeogenesis and anti-inflammatory proteins

12

Phosphoenolpyruvate carboxykinase (PEPCK) catalyzes

the rate-limiting step in gluconeogenesis

13

Lipocortin I suppresses

phospholipase A2, which has a critical role in eicosanoid synthesis

14

Mechanism of immunosuppression by glucocorticoids

activated glucocorticoid receptor (GR) binds to NFkB and prevents binding of NFkB to its response element; transcription of cytokine genes are repressed

15

Physiologic effects of glucocorticoids on the liver

Increase gluconeogenesis and glycogen storage

16

Physiologic effects of glucocorticoids on the muscle

Promote protein degradation; decrease protein synthesis and decrease sensitivity to insulin

17

Physiologic effects of glucocorticoids on adipose tissue

promote lipolysis and decrease sensitivity to insulin

18

Physiologic effects of glucocorticoids on the immune system

Block the synthesis of cytokines and inhibits the production of eicosanoids

19

Addison's disease

hypoadrenalism; decreased secretion of steroid hormones by the adrenal cortex

20

Causes of Addison's disease

1. destruction of the cortex by TB or atropy
2. decreased secretion of ACTH due to disease of anterior pituitary

21

Symptoms of Addison's disease

Extreme weakness, anorexia, anemia, nausea, vomiting, low blood pressure, hyperpigmentation, mental depression

22

Cushing's disease

Hyperadrenalism

23

Causes of Cushing's disease

1. tumors in the adrenal cortex
2. increased production of ACTH due to pituitary carcinoma
3. ectopic production of ACTH due to non-pituitary carcinoma

24

Symptoms of Cushing's disease

Increased protein catabolism (easy bruising, delayed wound healing, muscle wasting), increased glucose levels, osteoporosis and opportunistic infections

25

What is Ketoconazole?

antifungal at lower concentration (block the synthesis of ergosterol)

26

Ketoconazole inhibits

P450scc; 17alpha-hydroxylase, and 11beta-hydroxylase

27

Ketoconazole can treat

hyperglucocorticoid states (Cushing's syndrome)

28

Therapeutic uses of corticosteroids

1. Primary adrenal insufficiency caused by atrophy of adrenal cortex
2. Allergic reactions
3. Inflammation and autoimmune diseases
4. Asthma
5. Immunosuppressive
6. Anti-cancer

29

What is required for GC activity in glucocorticoids?

4,5-double bond
C3 ketone
11-beta hydroxyl
C17 hydroxyl

30

What is required for MC activity in mineralcorticoids?

4,5-double bond
C3 ketone