Adrenocorticoids

Ms. Anna

Adrenal Cortex Extreme temperature

Cholesterol Food and H2O deprivation
Glucocorticoids Psychologic stress
Cortisol, Corticosterone
Glucose metabolism Glucocorticosteroid MOA
Dealing with bodys stress Alter protein synthesis
Inflammation Glucose in blood
Suppress immune system Liver glycogen
Mineralocorticoids Inhibit uptake of glucose and muscle and fat
Aldosterone Anti-inflammatory
Fluid and electrolyte balance Prevent lysosomal rupture
Others Immunosuppression
Androgens Na, H20 reabsorption
Estrogens
Progestins Adverse Effects
Adrenocortical suppression
Purpose Body will no longer produce cortisol
Evaluate and treat endocrine disorders Drug-induced Cushings Syndrome
Hormonal deficiencies Catabolism
Physiological dose - equivalent Peptic ulcer
to normal dose Susceptibility to infection
Pharmacologic dose - larger Glaucoma
dose to capitalize particular Cataracts
beneficial effect Mood changes
Resolve symptoms non-endocrine Psychosis
Hypotension
Glucocorticoids
Cortisol (Hydrocortisone) Drugs that Inhibit Adrenocortical Hormone Synthesis
Controls release of CRH, ACTH Aminoglutethimide
Synthesis and secretion Inhibits first step in adrenal corticoid
Hypothalamus - CRH synthesis
Ant. Pituitary - ACTH Blocks the conversion of cholesterol to
Adrenal Glands - Glucocorticoids subsequent hormone precursors
Metyrapone
Cortisol Inhibits the hydroxylation reaction of
Early morning - peaks at 8 AM several intermediate compounds in the
Circadian rhythm adrenal corticoid pathway
Stress
Trauma
Infection
Hemorrhage
Mineralocorticoids
Aldosterone
Fluid, electrolyte balance
Stimulant - Angiotensin II
Mechanism
Kidneys
Hormone-receptor-complex

Therapeutic Use
Aldosterone Antagonist
Replacement therapy
Fludrocortisone
Impaired natural production
Addisons Disease
Adrenalectomy
Hypo fxn of adrenal cortex
Adverse Effects
HTN, peripheral edema
Weight gain, Hypocalemia
Aldosterone Antagonist
Spironolactone
Binds to receptor but doesnt
activate it
Potassium sparing diuretic: HTN
Prevents hypokalemia
Hyperaldosteronism Diagnosis

Rehab Concerns
MS, RA
Catabolic - muscle wasting
Inactivity - poor nutrition and aging,
osteoporosis
Strengthening - Weight bearing act
Mobility and ambulation
HTN, Immunosuppression
Toxicity - Mood changes, psychosis