lecture 2 Flashcards
cortisol affinity for GC and MC?
equal
cortisone affinity for GC and MC?
low affinity for MC
cortisol converted to cortisone where?
kidney, salivary gland, and colon
mechanism of action of glucocorticoids?
increased synthesis of phospholipase A2 inhibitor, increased synthesis of NF-Kb inhibitor, decreased synthesis of adhesion factors
what is lipocortin?
inhibitor of phospholipase A2
immunosuppresive effects of GC?
Inhibition of macrophage activity Inhibition of cytokine secretion by macrophages and T cells Interleukins 1-6,8 TNFα Cell adhesion factors Inhibition of T and B cell replication Decreased IgG production
advantages of synthetic steroids?
longer half life, and more selective
dexamethasone and prednisone are selective for what?
GC
fludrocortisone is selective for what?
MC
three reasons to use GC?
replacement therapy, anti inflammatory, and immunosuppressant effects
if someone has acute adrenal insufficiency, what do you give?
high doses of hydrocortisone
if someone has chronic adrenal insufficiency, what do you give?
physiologic doses of hydrocortisone and fludrocortisone
stress, illness, surgery and co administration of CYP450 all reason for what?
to increase GC
is prolonged treatment of GC safe?
no
abrupt termination of what can cause life threatening problems?
GC
3 important adverse effects of gc?
infection, impaired wound healing, and osetoporosis
what is cushing syndrome?
too much GC, from tumor of pituitary or adrenal
ways to reduce risk of GC toxicity?
local administration, avoid prolonged use, taper withdrawal.
why would you want to use slow release capsules with high first pass effect of GC?
IBD
what is cyclosporine?
immunosuppressant, prevent organ rejection, causes gingival hyperplasia, inhibits cyp450’s
what is a calcinuerin inhibitor? leading to blocking T cell signaling for growth
cyclosporine
abatacept approved for what?
RA
IgG1 like protein that binds to Antigen-Presenting Cell (APC) and prevents T cell activation
abatacept
Abatacept inhibits the binding of ____ (CD80/CD86) to CD28 and T cell activation
B7
