• Glucocorticoids - Effects on intermediary metabolism
• Major human one is cortisol
• Mineralcorticoids - Effects on salt retention
• Major one is aldosterone
• Androgenic or estrogenic activity
• Major human one is dehydroepiandrosterone sulfated form (DHEAS)

1. Affecting concentration, distribution and function of leukocytes.
2. Suppressive effects on infllammatory cytokines and chemokines.
3. Suppressive effects on other lipid and glucolipid mediators of inflammation.

• Inflammation is associated with extravasation and infiltration of leukocytes into affected tissue.
• Mediated by complex interactions of white cell adhesion molecules with those of endothelial cells.
• Glucocorticoids inhibit this.
• One injection of glucocorticoid decreases circulating numbers of lymphocytes, monocytes, eosinophils, and basophils.
• One injection increases circulating neutrophils.

Glucocorticoids

• These effects may cause osteoporosis in Cushing's syndrome.

Glucocorticoids.

• Growth hormone may be needed in children receiving glucocorticoid therapy.

• Short-acting:
• Cortisone (Cortone Acetate)
• Prednisone (Meticorten)
• Intermediate-acting:
• Triamcinolone (Aristocort, Kenacort)
• Long-acting:
• Dexamethasone (Decadron)

• Promotes reabsorption of sodium from the distal convoluted and cortical collecting renal tubules.
• Promotes sodium reabsorption in the sweat gland, slivary glands, GI mucosa, and across cell membranes in many tissues.

• A precursor for aldosterone with similar effects.
• Secreted in much smaller amounts than aldosterone

• A potent synthetic steroid with glucocorticoid and mineralocorticoid activity.

• Adrenocortical insufficiency.
• Potent salt-retain activity

• An adrenal androgen
• Converted to androstenedione, testosterone, and androsterone.
• Has been advocated for weight loss, tx of CV disease, aging and other conditions.
• Jury still out on efficacy.

• A synthesis inhibitor (antagonist of adrenocortical agents)
• Selective inhibitor of steroid synthesis (cortisol and corticosterone)
• Uses:
• Diagnostic use is to determine capacity of anterior pituitary to produce ACTH and to test adrenal fct.
• Rarely used to treat Cushing's disease.
• ADR: Salt and water retention. Hirsutism.

• Antagonist of adrenocortical agents: Synthesis inhibitor
• Blocks conversion of cholesterol to pregnenolone causing decrease in synthesis of all steroids.
• Uses: Has been used to reduce estrogen production in breast cancer.
• Replaced tamoxifen or aromatase inhibitors.

• Antagonist of Adrenocortical Agents: Synthesis inhibitor
• Potent, nonselective inhibitor of adrenal and gonadal steroid synthesis.
• Use: Has been used for tx of Cushing's Syndrome
• ADR: Hepatotoxicity.

• Antagonist of Adrenocortical Agents: Glucocorticoid antagonist
• Has strong antiprogestin activity.
• High affinity antagonist of glucocorticoid receptor.
• Use:
• Useful in treating Cushing's syndrome due to ectopic ACTH production or adrenal carcinoma.
• Used for contraception and postcoital contraception

• Mineralocorticoid antagonist
• Competes w/ aldosterone for binding sites on receptors.
• Uses:
• Used to treat primary aldosteronism.
• Also an androgen antagonist and can be used to treat hirsutism.
• Also used as a diuretic.
• ADR: Hyperkalemia, gynecomastia, sedation