Unit 2: Steroid drugs Flashcards Preview

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Flashcards in Unit 2: Steroid drugs Deck (15)
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1

2 parts of adrenal gland and what they produce

Adrenal Cortex:
Mineralocorticoids
Glucocorticoids
Adrenal androgens

Adrenal Medulla: epinephrine (adrenaline)

2

3 layers of the adrenal cortex

produces 3 steroid hormones (adrenocorticosteroids)
1. Outer layer (zona glomerulosa)
-Produce mineralocorticoids
-->Aldosterone
2. Middle layer (zona faciculata)
-Produce glucocorticoids
-->Cortisol (hydrocortisone)
3. Inner layer (zona reticularis)
-Produce adrenal androgens
-->Dehydroepiandrosterone (DHEA)

3

synthesis of endogenous corticosteroids

1. stress or hypoglycemia -->CRH from hypothalamus
2. CRH binds in anterior pituitary--> ACTH release
3. ACTH binds in adrenal cortex--> corticosteroids for effect on tissues, cortisol=feedback inhibition to hypothaalamus, inhibits CRH & ACTH

4

one major mineralcorticoid

fludrocortisone

5

one major adrenal androgen

DHEA

6

synthesis of aldosterone

Adrenal cortex is stimulated by angiotensin II to release aldosterone
(K+ levels and ACTH can affect the release of aldosterone but to a smaller extent than angiotensin II)

7

synthesis of endogenous mineralcorticosteroid: MOA

Aldosterone binds to mineralocorticoid receptor, activates the receptor and affects gene transcription
Action similar to glucocorticoid receptors but affects different genes

8

3 things that aldosterone acts on

1. sweat and salivary glands
2. Mucosal cells of the intestine
**3.active reabsorption of Na+ and associated passive reabsorption of H2O in the distal convoluted tubule of kidney

9

what is the replacement drug for pt's with addison's disease?

fludrocortisone: more salt-retaining potency than anti-inflammatory potency
Addisons: body doesn't produce sufficient adrenal hormones (low cortisol and aldosterone)
Don’t replace with aldosterone due to electrolyte disturbances

10

mineralcorticoids role in CV system, activation of RAAS system causes...

...increased levels of aldosterone
which cause
-fibrosis in heart and blood vessels
-Vascular remodeling
-Development of congestive heart failure

11

what do you use to prevent damage from RAAS system?

Use mineralocorticoid receptor antagonist to prevent damage from RAAS system, esp. in systolic heart failure patients

12

MOA for glucocorticoids

steroid binds to Intracellular glucocorticoid receptor-->gene transcription--> decrease inflamm. Ctks & increase Annexin A1 (endothelium)
-takes hours to days

13

pattern of cortisol release

from adrenal cortex in circadian diurnal pattern. Highest levels release early in the morning (peaking around 8am)
Lowest levels released between 12 to 4 am
*GREATLY increased in response to stress.
(Carbohydrate and Protein Metabolism
Lipid Metabolism
Decrease bone formation
Anti-inflammatory
Immunosuppressive)

14

carb and protein metabolism of glucose

1. inc. glucose formation
2. reduce glucose uptake & utilization by peripheral tissues (cortisol antagonizes effect of insulin)
3. inc. protein breakdown (catabolic effect)
4. activate lypolysis (provides fatty acids for glucose formation) inc. free fatty acids = insulin resistance

15

outcomes of carb and protein metabolism of glucose

Outcomes from these effects:
Decreased muscle mass
Thinning of the skin
Hyperglycemia
Worsening of diabetes