Term
|
Definition
Synthetic ACTH
Test Integrity of HPA Axis
(determine if patient needs supplemental steroids)
Test: Measure cortisol --> give Cosyntropin --> measure cortisol in 30 and 60 minutes |
|
|
Term
| What are the effects of Glucocorticoids on Carbohydrate and Protein metabolism? |
|
Definition
Keep blood glucose elevated
(opposite effect of insulin)
Increase gluconeogenesis
Increase glycogenolysis
Increase proteolysis |
|
|
Term
| What are the effects of glucocorticoids on lipid metabolism? |
|
Definition
- Redistribution of body fat
- Permissive effect on GH and B-agonists to increase lipolysis |
|
|
Term
| What are the effects of Corticosteroids on the CNS? |
|
Definition
Euphoria, high motor activity, insomnia, restlessness
Addisons - apathy, depression, irritability
Cushings - neuroses and psychoses |
|
|
Term
| What are the effects of Corticosteroids on Blood Cells? |
|
Definition
Increase - Hg, RBCs, PMNs
Decrease - Lymphocytes, eosinophils
Addisons - increased lymphocytes |
|
|
Term
| In what form can corticosteroids enter cells? |
|
Definition
|
|
Term
| What two proteins account for corticosteroid binding? |
|
Definition
CBP - Corticosteroid Binding Protein
(increases during pregnancy and estrogen treatment)
Albumin |
|
|
Term
| What Glucocorticoid has a short half life? |
|
Definition
| Cortisol (Hydrocortisone) |
|
|
Term
| What is the long acting Glucocorticoids? |
|
Definition
Betamethasone
(the only one that can be given topically) |
|
|
Term
| What are the side effects of Glucocorticoid therapy? |
|
Definition
Suppression of ACTH and TSH production
Osteoporosis
Diabetes
Peptic Ulcer
CNS - arousal --> depression |
|
|
Term
| What are some side effects of Glucocorticoid therapy specifically seen in Men? |
|
Definition
Hypogonadism
Decreased gonadotroph secretion --> decreased testosterone
|
|
|
Term
| What are some side effects of Glucocorticoid therapy specifically seen in Women? |
|
Definition
No ovulation
Dysmenorrhea
Osteoporosis |
|
|
Term
| What are some side effects of Glucocorticoid therapy specifically seen in Children? |
|
Definition
Stunted Growth
Decreased GH --> decreased IGF-1
|
|
|
Term
| Why should Corticosteroid therapy not be stopped abruptly? |
|
Definition
Recovery from ACTH and TSH suppression may take a year or more
Doses should be tapered |
|
|
Term
| What drug is used to treat Acute Adrenal Insufficiency? |
|
Definition
Hydrocortisone - IV
(also used to treat glucocorticoid withdrawal) |
|
|
Term
| What drug is used to treat Skin Disease? |
|
Definition
|
|
Term
| What two mechanisms control Aldosterone secretion? |
|
Definition
1) Angiotensin II
2) Plasma K
(ACTH mediated release is secondary) |
|
|
Term
| What two drugs inhibit adrenocorticoid synthesis? |
|
Definition
Aminoglutethimide
Ketoconazole
(Cushing's Treatment)
|
|
|
Term
| What is the mechanism of Aminoglutethimide and Ketoconazole? |
|
Definition
| Inhibit CYP450 synthetic pathway of Cortisol production |
|
|
Term
| What drug is also an antifungal agent? |
|
Definition
Ketoconazole
(adrenocorticoid inhibitor) |
|
|
Term
| What is the mechanism of Glucocorticoid Anti-inflammatory and Immunosupressive action? |
|
Definition
| Blocks Phospholipase A2 --> inhibits release of arachadonic acid which is the building block of prostaglandins and leukotrienes |
|
|
Term
| What are two situations in which IV Hydrocortisone can be used? |
|
Definition
Acute Renal Failure
Glucocorticoid Withdrawal |
|
|
Term
| What drug is used to test the HPA Axis? |
|
Definition
Cosyntropin
(synthetic ACTH)
|
|
|
