Glucocorticoids Flashcards
What are the 2 short acting glucocorticoids
Cortisone and hydrocortisone
What are the 4 intermediate acting glucocorticoids
Prednisone, Prednisolone, Triamcinolone, and Methylprednisolone
What are the 2 Long acting glucocorticoids
Betamethasone and Dexamethasone
What is the source of the endogenous glucocorticoid hormones
Adrenal glands
Where is the production of cortisol
Zona Fasciculata of the adrenal cortex
What is the precursor of glucocorticoids
Cholesterol
How are Cortisol and Dexamethasone similar
they both inhibit the HPA axis
What other effects do glucocorticoids have on other hormones
reduces TSH and increases GH production
How do cortisol levels vary time-wise
Cortisol levels are low at night and peak in the morning when activity is needed
What kind of receptor is the glucocorticoid receptor
Cytosolic receptor
what is the effect on metabolism from glucocorticoids
increase blood glucose, increase glycogen stores, increase blood fatty acids and blood amino acids
what do elevated glucose levels do
provide energy required to combat stress
how do glucocorticoids alter levels of circulating blood cells
Decrease eosinophils, basophils, mono, and lymphocytes and increase levels of hemoglobin, platelets and erythrocytes
What is the mechanism of glucocorticoids in the anti-inflammatory response
Inhibits phospholipase A2, by activation of Lipocortin and removing cells from circulation
What is the effect of glucocorticoids in the liver vs extra hepatic tissues
Liver: anabolic
Extrahepatic tissue: stimulates protein catabolism to provide energy needed for glucose synthesis
What percent of cortisol is bound to plasma proteins
90%
Synthetic corticosteroids are bound primarily by _____
albumin
Glucocorticoid therapy should be monitored in individuals with _____-
Hepatic dysfunction
Why is the plasma half life shorter than the biological half life
The effects persist due to the ligand receptor complex sticking around vs plasma membrane receptor desensitization
Large doses of glucocorticoids over an extended period of time can cause _____ of the HPA axis
suppression
A regimen of this type of therapy is useful allowing the HPA axis to recover
Alternate day therapy
What type of anti-inflammatory can glucocorticoids be administered for
Eczema and dermatitis, arthritis, bursitis, Crohn’s Disease, Asthma, and COPD
How can glucocorticoids be used in pregnant mothers
Pregnant mothers with threatened premature delivery prior to 34 weeks are given glucocorticoids which can cross the placental barrier and stimulate the production of surfactant in the lungs
What are some adverse effects of glucocorticoids
Osteoporosis, Cataracts, hyperglycemia, hypertension, peptic ulcer disease, addison’s disease (adrenal suppression)
