Adrenocorticosteroids

Adrenocorticosteroids and Adrenocortical Antagonists Ma. Victoria M. Villarica, M.D. Fatima College of Medicine

Objectives ,[object Object],[object Object],[object Object]

Types of steroid hormones ,[object Object],[object Object],[object Object],[object Object],[object Object]

Adrenal Gland ,[object Object],[object Object]

Adrenal Cortex ,[object Object],[object Object],[object Object],[object Object]

ACTH ,[object Object],[object Object],[object Object],[object Object]

ACTH ,[object Object],[object Object]

Regulation of ACTH secretion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Control of Endocrine Activity ,[object Object],[object Object]

[object Object],[object Object],Steroid hormones

cholesterol Extracellular lipoprotein Cholesterol pool LH ATP cAMP PKA+ Pregnenolone Progesterone Androstenedione TESTOSTERONE 3  HSD P450c17 17  HSD acetate

Steroid hormone production ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Steroidogenic Enzymes Common name "Old" name Current name Side-chain cleavage enzyme; desmolase P450 SCC CYP11A1 3 beta-hydroxysteroid dehydrogenase 3 beta-HSD 3 beta-HSD 17 alpha-hydroxylase/17,20 lyase P450 C17 CYP17 21-hydroxylase P450 C21 CYP21A2 11 beta-hydroxylase P450 C11 CYP11B1 Aldosterone synthase P450 C11AS CYP11B2 Aromatase P450 aro CYP19

Adrenocorticosteroids ,[object Object],[object Object],[object Object],[object Object]

A. Mineralocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object]

B. Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CBG (transcortin) ,[object Object],[object Object]

C. Adrenal Androgens ,[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object]

Physiologic effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Physiologic effects (cont.): ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Physiologic effects (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Physiologic effects (cont.): ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Synthetic Steroids ,[object Object],[object Object],[object Object],[object Object]

Classification of Glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

II. Intermediate-acting glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],IV. Mineralocorticoids

Uses: ,[object Object],[object Object]

Therapeutic Uses : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

1. Adrenal Insufficiency (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Therapeutic Uses (cont.) 2. Adrenocortical hypofunctioning and hyperfunctioning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Therapeutic Uses 2. Adrenocortical hypofunctioning and hyperfunctioning (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

B. Stimulation of fetal lung maturation – betamethasone 12mg ffed by 12mg 18-24 hrs. later ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object]

C. Non- Adrenal Diseases (cont.) ,[object Object],[object Object]

C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object]

C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

C. Non-Adrenal Diseases (cont.) ,[object Object],[object Object],[object Object]

D. Diagnostic Application – dexamethasone: suppress production of ACTH ,[object Object],[object Object],[object Object],[object Object],[object Object]

Toxicity: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Supplemental measures: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Antagonists of Adrenocortical Agents ,[object Object],[object Object],[object Object],[object Object]

Synthetic inhibitors and glucocorticoid antagonists (cont.) ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Synthetic inhibitors and glucocorticoid antagonists (cont.)

[object Object],[object Object],[object Object],Synthetic inhibitors and glucocorticoid antagonists (cont.)

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of topical corticosteroids based on their potencies ,[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of topical corticosteroids based on their potencies (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object]

Common side effects of topical corticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Summary of adrenocortical agonists and antagonists…… ,[object Object],[object Object],[object Object]

Adrenocorticosteroids

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