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CORTICOSTEROIDS & ANTAGONISTS   BY DR.UMA KADAM   M.B.B.S. MD ASSOCIATE PROFESSOR PHARMACOLOGY SKNMC
Adrenal hormones
The Adrenal Gland
[object Object],[object Object],[object Object],[object Object],[object Object],Adrenal cortex
 
Stressors
 
 
 
Therapeutic uses ACTH ,[object Object],[object Object],[object Object]
ACTH release ,[object Object],[object Object],[object Object]
 
CRF release ,[object Object],[object Object],[object Object],[object Object]
Terms  ,[object Object],[object Object]
Continued  ,[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object]
Corticosteroids ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
Adrenal Cortex: Steroid Hormone Production Cholesterol Pregnenolone Progesterone 17- α - Hydroxy pregnenolone 17- Hydroxy progesterone Dehydro-epi androsterone Andro-stenedione Estrone  Estriol  TESTOSTERONE ESTRADIOL Aromatase  Aromatase  Corticosterone  Corticosteroids  Aldosterone
Control of Cortisol Secretion: Feedback Loops ,[object Object],[object Object],[object Object],[object Object],[object Object],The control pathway for cortisol
Corticosteroids  ,[object Object],[object Object],[object Object]
 
Circadian rhythm of cortisol secretion
[object Object],[object Object],[object Object],Mechanism of action:
 
 
Effects of Glucocorticoids
Effects of Glucocorticoids  [ moon facies and  buffalo hump ]
[object Object],[object Object],[object Object],[object Object],Effects of Glucocorticoids
Corticosteroids  : Actions Involution of lymphoid tissue (species dependent) Decrease in peripheral lymphocytes, monocytes, eosinophils Increase in peripheral neutrophils, platelets, RBCs Decreased Clotting Time Decreased phagocyte competence Hematopoietic system Decreased calcium and iron absorption Facilitation of fat absorption Increased acid, pepsin, and trypsin Structural alteration of mucin Gastrointestinal Tract Required for normal sensitivity of adrenergic receptors Autonomic Nervous System Euphoria and behavioral changes Maintenance of alpha rhythm Lower Seizure Threshold Central Nervous System Parturition induced during the latter part of pregnancy in ruminants and horses Less reliable in dogs and cats Teratogenesis during early pregnancy.  Reproductive Tract
Increased reabsorption of  water, sodium, chloride Increased excretion of potassium , calcium Increased extracellular fluid Kidneys Positive inotropic effect Increased blood pressure (increased blood volume) Cardiovascular system Atrophy and thinning (chronic excess) Calcinosis Cutis Skin Weakness (excess and deficiency) Muscle atrophy (chronic excess ) Skeletal Muscle "Stabilization" of liposomal membranes Inhibition of macrophage response to migration inhibition factor Lymphocyte sensitization blocked Cellular response to inflammatory mediators blocked Inhibition of fibroblast proliferation  Cells   Inhibition of collagen synthesis by fibroblasts Acceleration of Bone resorption Antagonism of Vitamin D  Bone
Continued  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Important Drugs   ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
Therapeutic Uses   ,[object Object],[object Object],[object Object],[object Object],[object Object]
B. Pharmacotherapy   ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Therapeutic Uses:
Deflazacort   ,[object Object],[object Object],[object Object],[object Object]
The adverse effects ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object]
 
Precautions  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindication  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications after abrupt corticosteroid withdrawal : ,[object Object],[object Object]
Methods of withdrawal: ,[object Object],[object Object],[object Object]
Mineralo-corticosteroids : ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object]
Corticosteroid Antagonists   ,[object Object],[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object],[object Object]
Continued  ,[object Object],[object Object]
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Corticosteroids(2&3)

  • 1. CORTICOSTEROIDS & ANTAGONISTS BY DR.UMA KADAM M.B.B.S. MD ASSOCIATE PROFESSOR PHARMACOLOGY SKNMC
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  • 19. Adrenal Cortex: Steroid Hormone Production Cholesterol Pregnenolone Progesterone 17- α - Hydroxy pregnenolone 17- Hydroxy progesterone Dehydro-epi androsterone Andro-stenedione Estrone Estriol TESTOSTERONE ESTRADIOL Aromatase Aromatase Corticosterone Corticosteroids Aldosterone
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  • 23. Circadian rhythm of cortisol secretion
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  • 28. Effects of Glucocorticoids [ moon facies and buffalo hump ]
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  • 30. Corticosteroids : Actions Involution of lymphoid tissue (species dependent) Decrease in peripheral lymphocytes, monocytes, eosinophils Increase in peripheral neutrophils, platelets, RBCs Decreased Clotting Time Decreased phagocyte competence Hematopoietic system Decreased calcium and iron absorption Facilitation of fat absorption Increased acid, pepsin, and trypsin Structural alteration of mucin Gastrointestinal Tract Required for normal sensitivity of adrenergic receptors Autonomic Nervous System Euphoria and behavioral changes Maintenance of alpha rhythm Lower Seizure Threshold Central Nervous System Parturition induced during the latter part of pregnancy in ruminants and horses Less reliable in dogs and cats Teratogenesis during early pregnancy. Reproductive Tract
  • 31. Increased reabsorption of water, sodium, chloride Increased excretion of potassium , calcium Increased extracellular fluid Kidneys Positive inotropic effect Increased blood pressure (increased blood volume) Cardiovascular system Atrophy and thinning (chronic excess) Calcinosis Cutis Skin Weakness (excess and deficiency) Muscle atrophy (chronic excess ) Skeletal Muscle "Stabilization" of liposomal membranes Inhibition of macrophage response to migration inhibition factor Lymphocyte sensitization blocked Cellular response to inflammatory mediators blocked Inhibition of fibroblast proliferation Cells Inhibition of collagen synthesis by fibroblasts Acceleration of Bone resorption Antagonism of Vitamin D Bone
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  • 59. Next Class on … FEMALE SEX HORMONES: ESTROGENS