ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.
-
Upload
emil-price -
Category
Documents
-
view
215 -
download
0
Transcript of ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.
![Page 1: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/1.jpg)
ADRENOCORTICAL PHARMACOLOGYDR FATAI OLUYADI
USMLEINCLINED.COM 1
![Page 2: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/2.jpg)
ADRENAL CORTEX
ZONA GLOMERULOSA
ZONA FASCICULATA
ZONA RETICULARIS
USMLEINCLINED.COM 2
![Page 3: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/3.jpg)
ADRENAL CORTEX
USMLEINCLINED.COM 3
![Page 4: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/4.jpg)
ADRENAL CORTEX HORMONES
MINERALOCORTICOIDS (ALDOSTERONE)
GLUCOCORTICOIDS (CORTISOL)
ANDROGENS (ANDROSTENIDIONE, TESTOSTERONE)
USMLEINCLINED.COM 4
![Page 5: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/5.jpg)
ADRENAL HORMONE SYNTHESIS
USMLEINCLINED.COM 5
![Page 6: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/6.jpg)
GLUCOCORTICOIDS HYDROCORTISONE CORTISONE PREDNISONE PREDNISOLONE METHYLPREDNISOLONE TRIAMCINOLONE BETHAMETHASONE DEXAMETHAOSIONE
USMLEINCLINED.COM 6
![Page 7: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/7.jpg)
GLUCOCORTICOID FUNCTIONIncrease Blood PressureIncrease Insulin resistanceIncrease GluconeogenesisDecrease Fibroblast activityDecreased InflammationImmunosuppressionDecrease Bone formationWeak Mineralocorticoid effects
USMLEINCLINED.COM 7
![Page 8: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/8.jpg)
STEROID RESPONSE
USMLEINCLINED.COM 8
![Page 9: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/9.jpg)
ANTI-INFLAMMATORY EFFECTS OF GLUCOCORTICOIDS Inhibits production of leukotrienes and prostaglandins by blocking the Phospholipase A2 enzyme of the Arachidonic acid pathwayInhibits leukocyte AdhesionBlocks Mast cell degranulationReduces Eosinophil countBlocks Interleukin-2 productionInhibits the protein synthesis ( Decrease production of Cytokines and inflammatory mediators)
USMLEINCLINED.COM 9
![Page 10: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/10.jpg)
CLINICAL USES OF GLUCOCORTICOIDSManagement of Inflammatory disrorders – Asthma, Inflammatory bowel diseasesImmunosuppresants – Autoimmune diseasesCongenital defect in steroid synthesis – 21 Hydroxylase Deficiency Adrenal insufficiencyFetal Lung maturity
USMLEINCLINED.COM 10
![Page 11: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/11.jpg)
ANTI-INFLAMMATORY Glucocorticoids are used in the treatment of Inflammatory diseases e.g: AsthmaInflammatory Bowel diseaseGoutVasculitis e.g Temporal /Giant cell arteritis
*Glucocorticoids can reduce inflammatory responses mediating nervous tissue swelling therefore can be used in the treatment of trauma induced cerebral edema and spinal cord injury.
*Intra-articular steroids are used in the treatment of Inflammatory Joint Diseases
USMLEINCLINED.COM 11
![Page 12: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/12.jpg)
IMMUNOSUPPRESSANT
To Prevent Transplant rejectionTreatment of Automimmune disease: SLE, PolymyositisCancer treatment – for Cancers of White blood cells E.g Leukemia, Lymphoma
USMLEINCLINED.COM 12
![Page 13: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/13.jpg)
ADRENAL INSUFFICIENCY Glucocorticoids are given as replacement in patients with adrenal insufficiency
Adrenal insufficiency can be as a result of: Autoimmune destruction of the adrenal glands Hemorrhagic shock Infection – e.g Adrenal Tuberculosis Metastatic disease e.g Lung cancer Hypothalamic or Pituitary insufficiency
USMLEINCLINED.COM 13
![Page 14: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/14.jpg)
FETAL LUNG MATURATION
Glucocorticoids e.g DEXAMETHASONE, BETHAMETHASONE, HYDROCORTISONE induces surfactant synthesis in the fetus promoting fetal lung maturity and is usually given to prevent Neonatal respiratory distress.
USMLEINCLINED.COM 14
![Page 15: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/15.jpg)
ADVERSE EFFECTS OF GLUCOCORTICOIDSHyperglycemiaHigh Blood PressureTruncal obesityMoon faciesAbdominal striaeImmunosuppresssionOsteoporosisEasy bruising Adrenal cortical atrophy – Reason why glucocorticoids should be tapered slowly
USMLEINCLINED.COM 15
![Page 16: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/16.jpg)
CUSHINGNOID SIDE EFFECTS OF GLUCOCORTICOIDS
USMLEINCLINED.COM 16
![Page 17: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/17.jpg)
MINERALOCORTICOIDS
Aldosterone is the main endogenous mineralocorticoid.
Release of Aldosterone is regulated by Angiotensin II via the Renin-Angiotensin System in the regulation of Blood Pressure.
The most common clinically used Mineralocorticoid is FLUDROCORTISONE.
USMLEINCLINED.COM 17
![Page 18: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/18.jpg)
MINERALOCORTICOID FUNCTIONS
Mineralocorticoid functions include
1.Increase Sodium (Na) Reabsorption - to drive Increased Water reabsorption ultimately to increase Blood Volume, Venous return, Cardiac Output and Blood Pressure.
2.Increase Potassium (K) excretion
3.Increase Hydrogen (H) excretion.
USMLEINCLINED.COM 18
![Page 19: ADRENOCORTICAL PHARMACOLOGY DR FATAI OLUYADI USMLEINCLINED.COM 1.](https://reader036.fdocuments.us/reader036/viewer/2022062805/5697bfda1a28abf838cb0156/html5/thumbnails/19.jpg)
CLINICAL USES OF MINERALOCORTICOIDS
FLUDROCORTISONE
Adrenal Insufficiency : Low Cortisol, Aldosterone and Androgens
Adverse effects: Hypertension
USMLEINCLINED.COM 19