Unit 2 - Pharmacology Guiding Questions ch. 29 Flashcards
primary glucocorticoid released in humans
cortisol
negative feedback control of glucocorticoid synthesis
hypothalamus > CRH > anterior pituitary > ACTH > adrenal cortex > cortisol > target tissues
role of glucocorticoids in normal function
responsible for the circadian rhythm
also released in response to stressful stimuli
glucocorticoids effect on glucose, protein, and lipid metabolism
-Muscle cell: ↓ glucose uptake, ↑ protein breakdown > amino acids
-Fat cell: ↓ glucose uptake, ↑ fat breakdown > free fatty acids
-Liver cell: use amino acids and free fatty acids > gluconeogenesis > glucose > glycogen
anti-inflammatory effects of glucocorticoids
attenuate the heat, erythema, swelling, and tenderness
ways that glucocorticoids act as anti-inflammatories
-inhibit the chemical signals and the concentration of cells that compromise the inflammatory response
-inhibit the transcription and expression of adhesion molecules which diminishes the ability of leukocytes to find and enter inflames tissues
-inhibit the production of other chemo-attractive chemicals
-reduce vascular permeability by suppressing the local release of vasoactive substances such as histamine, kinins, and other chemicals that cause increased capillary permeability
-inhibit the production of proinflammatory substances such a prostaglandins and leukotrienes
how do glucocorticoids act as immunosupressants
suppress the ability of immune cells to synthesize or respond to chemical mediators such as the cytokines that promote autoimmune responses
other effects of glucocorticoids
-affect renal function by enhancing sodium and water reabsorption and by impairing the ability of the kidneys to excrete a water load
-they can alter CNS function producing changes in behavior and mood
-alter formed elements in blood
-adequate amounts are needed for normal cardiac and skeletal muscle function
primary uses of glucocorticoids
-to evaluate and treat endocrine disorders
-help resolve symptoms of various nonendocrine problems
what is drug-induced Cushing syndrome
-symptoms: roundness and puffiness in the face, fat deposition and obesity in the trunk region, muscle wasting in the extremities, hypertension, osteoporosis, increased body hair, and glucose intolerance
-adrenocortical hypersecretion
what additional tissues can be affected by glucocorticoids
-bone, ligaments, tendons, and skin
-glucocorticoids appear to weaken supporting tissues by inhibiting the genes responsible for production of collagen and other tissue components and by increasing the expression of substances that promote breakdown
one of the most common side effects of prolonged, systemic glucocorticoids
loss of bone strength
what must be considered when treating a pt that is taking glucocorticoids
-the potential for tissue breakdown
(Should be careful to avoid overstressing tissues that are weakened)
-bone loss and risk of osteoporosis should be evaluated periodically
adverse effects of glucocorticoids
-peptic ulcer can develop
(Breakdown of supporting proteins in the stomach wall or direct mucosal irritation)
-increased susceptibility to infection
-may slow growth in children through inhibitory effect on growth plates in developing bone
-may cause glaucoma by impairing normal drainage
-mood changes
-may cause hypertension because of sodium and water retention
-alter glucose metabolism
(in people with diabetes will increase risk of hyperglycemia, insulin resistance, and decrease control of blood glucose levels)
what is the principle mineralocorticoid and its primary function
aldosterone: maintaining fluid and electrolyte balance in the body. worked on kidney to increase sodium and water reabsorption and potassium excretion
