Term
| Adrenal output of cortisol? |
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Definition
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Term
| Levels of glucocorticoids during the day? |
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Definition
| Circadian rhythm, peak levels around 8am. Levels rise after meals |
|
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Term
| Glucorticoids numerous physiological effects |
|
Definition
effects:
intermdiary metabolism, cardiovascular function, growth and immunity |
|
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Term
| Glucocorticoids effects on inflammation |
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Definition
-induce expression of annexin--a protein which inhibits phospholipase A2 and thus decreasese the sythesis of eicosanoids, inlcuding PG's and LT's
-reduce release of proteases, eg collagenase and stromelysin
-suppress release of pro-inflamm cytokines,, eg IL1, IL6 and TNF from macrophages
-suppress events in lymphocyte activiation
-block IgE mediated release of histamine and LTC4 by basophils |
|
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Term
| Glucocorticoid pharmacokinetics |
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Definition
| well-absorbed, highly protein bound and eliminated primarily by liver |
|
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Term
| Major use of glucocorticoids |
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Definition
| replacement therapy and anti-inflammatory agents |
|
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Term
| glucocorticoid common indications |
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Definition
| asthma, allergic rhinitis, psoriasis, eczema and hypersensitivity dermatidies, vasculitis, coinnective tissue diseases, IBD, nephrotic syndrome, immunosuppreseive agent in organ transplant, promotion of fetal lung development |
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Term
| the synthetic corticosteroids |
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Definition
hydrocortisone (cortisol)
cortisone
prednisone
dexamethasone |
|
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Term
| Source of synthetic corticosteroids |
|
Definition
| synthesized with modifications to create steroids with special characterisitcs |
|
|
Term
| synthetic corticosteroids pharmacokinetics |
|
Definition
-similar to cortisol and other steroids
-may have different ratios of glucocorticoid potency to mineralocorticoid potency |
|
|
Term
| Hydrocortisone indications |
|
Definition
-allergic disorder
-disorder of endocrine system
-inflammatory disorder of the musculoskeletal system
-disorder of teh respiratory system
-disorder if the skin |
|
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Term
| Cortisone (cortone acetate)indications |
|
Definition
same as hydrocortisone plus
Adrenal insufficiency
-allergic disorder
-disorder of endocrine system
-inflammatory disorder of the musculoskeletal system
-disorder of teh respiratory system
-disorder if the skin |
|
|
Term
|
Definition
Same as cortisone plus:
Allergic disorders, intractable to adequate trials of conventional treatment
-asthma
-inflammatory disease of musculoskelatal system
-polyyositis
-rheum arthritis |
|
|
Term
| Dexamethasone (Decadron) indications |
|
Definition
same as hydrocortisone plus:
-cerebral edema--associated with primary or metastatic brain tumor craniotomyor head injury
-Cushing's sydrome diagnosis |
|
|
Term
| Clinical uses of adrenocorticosteroids |
|
Definition
-diagnosis and treatment of disturbed Adrenal function
-adrenocortical hypo- and hyperfunction
-diagnostic purposes
-stimulation of lung maturation in teh fetus
-corticosteroids and nonadrenal disorders |
|
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Term
| synthetic corticosteroid ACUTE toxicities |
|
Definition
| hypertension, hyperglycemia, mood disturbance, myopathy, psychosis, masked fever, fluid retention, hypokalemic metabolic alkalosis |
|
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Term
| synthetic corticosteroids SUB-ACUTE CHRONIC toxicity |
|
Definition
| moon facies, stria, delayed wound healing, acne, hirsutism, ecchymoses, ulcers and GI bleeding, gluacoma, cataracts, infection, osteopenia |
|
|
Term
| Stategies for minimizing synthetic toxicity |
|
Definition
-use drugs with low mineralocorticoid activity
-use of alternate day therapy
-topical administration reduces systemic effects |
|
|
Term
|
Definition
| aldosterone, deoxycorticosterone, fludrocortisone |
|
|
Term
|
Definition
-synthesized in teh zona glomerulosa of adrenal cortex
-action-promotes reabsorption of Na from distal convoluted and proximal collecting tubules |
|
|
Term
|
Definition
Indications: Addison's disease, adrenogenital disorder
-treatment of adrenocortical insufficiency associated with mineralocorticoid deficiencey. |
|
|
Term
|
Definition
-inhibits cholesterol side chain cleavage
-inhibit steroid synthesis only seen at high doeses
-anti fungal imidazole derivative
-potent and non-selective inhibition of adrenal and gonadol steroid synthesis |
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