Glucocorticoids Flashcards

(36 cards)

1
Q

How/when are glucocorticoids released?

A

Diurnal rhythm in response to sleep/wake cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is glucocorticoid release regulated?

A

negative feedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

______ use of ______ can suppress the HPA axis and result in adrenal atrophy and insufficient adrenal response to environmental stressors (adrenal crisis).

A

Chronic; pharmacologic doses of glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chronic use of pharmacologic doses of glucocorticoids can suppress the _____ and result in adrenal atrophy and insufficient adrenal response to environmental stressors (adrenal crisis).

A

HPA axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chronic use of pharmacologic doses of glucocorticoids can suppress the HPA axis and result in _____ and insufficient adrenal response to environmental stressors (_____).

A

adrenal atrophy; adrenal crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

_____ is present in plasma bound to cortisol-binding globulin (CBG).

A

Cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cortisol is present in plasma bound to _____.

A

cortisol-binding globulin (CBG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the normal half life of cortisol?

A

60-90 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What organ eliminates cortisol?

A

the liver via reduction, then the kidney via conjugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can mineralcorticoid activity be separated from glucocorticoid activity?

A

by synthesizing structural changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the overall metabolic goal of glucocorticoids?

A

maintain glucose supply to the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why can excessive glucocorticoid use lead to a diabetes-like state?

A

bc it stimulates gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why can excessive glucocorticoid use lead to muscle wasting and atrophy?

A

bc protein synthesis is decreased- can lead to catabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why can excessive glucocorticoid use lead to centripetal obesity?

A

bc it stimulates lipogenesis in the central tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the permissive effects of glucocorticoids?

A

vasoconstriction, bronchodilation with catecholamines; lipolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the mineralocorticoid effects?

A

aldosterone-like actions

17
Q

Why can excessive glucocorticoid use lead to increased sodium and fluid retention?

A

bc it induces Na+ reabsorption from renal distal tubules and increased secretion of H+ and K+

18
Q

What are the major glucocorticoid effects?

A

anti-inflammatory, suppress the immune system, reduced vasodilation, decrease cell activation

19
Q

How do glucocorticoids reduce inflammation?

A

reduce leukotrienes by inhibiting phospholipase A2; decrease prostaglandins by blocking COX-2

20
Q

When using these agents in _____ replacement regimens (e.g., Addison’s disease), it is necessary to use an agent with both glucocorticoid and mineralocorticoid activity such as cortisol.

21
Q

When using these agents in physiologic replacement regimens (e.g., _____), it is necessary to use an agent with both glucocorticoid and mineralocorticoid activity such as _____.

A

Addison’s disease; cortisol

22
Q

When using these agents in physiologic replacement regimens (e.g., Addison’s disease), it is necessary to use an agent with both _____ and ______ activity such as cortisol.

A

glucocorticoid; mineralocorticoid

23
Q

When using these agents in _____ doses for their anti-inflammatory or immunosuppressive actions, it is desirable to select an agent with minimal or no mineralocorticoid activity (e.g., dexamethasone).

A

pharmacologic

24
Q

When using these agents in pharmacologic doses for their _____ or _____ actions, it is desirable to select an agent with minimal or no mineralocorticoid activity (e.g., dexamethasone).

A

anti-inflammatory; immunosuppressive

25
When using these agents in pharmacologic doses for their anti-inflammatory or immunosuppressive actions, it is desirable to select an agent with _____ (e.g., _____).
minimal or no mineralocorticoid activity; dexamethasone
26
Mineralocorticoid activity refers to _____ at the kidney.
salt (Na+)-retaining actions
27
______ activity refers to salt (Na+)-retaining actions at the kidney.
Mineralocorticoid
28
Glucocorticoid activity refers to _____ effects as well as _____ actions.
metabolic; anti-inflammatory
29
______ activity refers to metabolic effects as well as anti-inflammatory actions.
Glucocorticoid
30
What is the natural glucocorticoid molecule?
cortisol
31
What is the natural mineralocorticoid molecule?
aldosterone
32
11-hydroxy glucocorticoids are _____.
physiologically active
33
_____ are physiologically active.
11-hydroxy glucocorticoids
34
11-keto glucocorticoids are prodrugs that must be ____.
activated
35
What does 11β hydroxysteroid dehydrogenase I do?
activates 11-keto glucocorticoids
36
_____ are prodrugs that must be activated.
11-keto glucocorticoids