Steroid hormones دکتر کلانتر Corticosteroids Glucocorticoids diffuse into the cell but...
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Transcript of Steroid hormones دکتر کلانتر Corticosteroids Glucocorticoids diffuse into the cell but...
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Steroid hormonesSteroid hormones کالنتر دکتر
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Cor
ticos
tero
ids
Cor
ticos
tero
ids
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Glucocorticoids diffuse into the cell but accessto the receptor may be prevented, for example inkidney, by the enzyme 11-beta hydroxysteroiddehydrogenase, which converts active cortisol intoinactive cortisone.
When activated, the receptors translocate to thenucleus where they can upregulate gene transcriptionby action on specific DNA response elements.
GlucocorticoidsGlucocorticoids
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Basal secretions
Group Hormone Daily secretions
Glucocorticoids • Cortisol• Corticosterone
5 – 30 mg
2 – 5 mg
Mineralocorticoids • Aldosterone• 11- deoxycorticosterone
5 – 150 μgTrace
Sex Hormones•Androgen•Progestogen•Oestrogen
• DHEA • Progesterone• Oestradiol
15 – 30 mg
0.4 – 0.8 mgTrace
From Essential of Pharmacotherapeutics, ed. FSK Barar. P.351
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mechanism of action
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Corticosteroids are Gene-Active
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Steroid Functions
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Actions: Anti-inflammatory
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•The anti-inflammatory actions of glucocorticoids are mediated by stimulation of synthesis of lipocortin, which inhibits pathways for production of prostaglandins, leuko- trienes, and platelet activating factor. These mediators would normally contribute to increased vascular permeability and subsequent changes including oedema, leucocyte migration, fibrin deposition.
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(+)(-)
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Anti-inflammatory actions of corticosteroids
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• Recruitment of WBC and monocyte- macrophage into affected area & elaboration of chemotactic substances
• Lipocortin
• ELAM1 and ICAM-1 in endothelial cells
• TNF from phagocytic cells
• IL1 from monocyte-macrophage
• Formation of Plasminogen Activator
• Action of MIF and fibroblastic activity
• Expression of COX II
Actions: Anti-inflammatory
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• Intestinal absorption
• Renal excretion
• Excessive loss of calcium from spongy bones (e.g., vertebrae, ribs, etc)
Actions: Calcium metabolism
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• Inhibit cell division or synthesis of DNA
• Delay the process of healing
• Retard the growth of children
Actions: Growth and Cell division
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RBC: Hb and RBC content
(erythrophagocytosis )
WBC: Lymphocytes, eosinophils, monocytes, basophils
Polymorphonucleocytes
Actions: Blood
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Aggravate peptic ulcer. May be due to:
– Acid and pepsin secretion
– immune response to H.Pylori
Actions: Stomach
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• Direct: – Mood– Behaviour– Brain excitability
• Indirect: – maintain glucose, circulation and electrolyte
balance
Actions: CNS
ICP (pseudotumor cerebri) - Rare
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Addison's disease: weakness and fatigue is due to
Prolonged use:
Actions: Skeletal MusclesNeeded for maintaining the normal function of Skeletal
muscle
inadequacy of circulatory system
Steroid myopathy
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• Restrict capillary permeability
• Maintain tone of arterioles
• Myocardial contractility
Actions: Cardiovascular system
Mineralocorticoid induced hypertension ??
Na+ sensitize blood vessels to the action of catecholamines & angiotensin
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Actions: Electrolyte and water balance
• Aldosterone is more important
• Act on DT and CD of kidney– Na+ reabsorption
– Urinary excretion of K+ and H+
• Addison’s disease ??
• Na+ loss• Shrinkage of ECF• Cellular hydration• Hypodynamic state of CVS• Circulatory collapse, renal failure, death
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• Redistribution of Fat• Buffalo hump• Moon face
• Promote adipokinetic agents activity(glucagon, growth hormone, adrenaline, thyroxine)
Actions: Lipid metabolism
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Actions: Carbohydrate and protein metabolism
• Gluconeogenesis– Peripheral actions (mobilize aas and glucose and
glycogen)
– Hepatic actions
• Peripheral utilization of glucose
• Glycogen deposition in liver(activation of hepatic glycogen synthase)
Negative nitrogen balance and hyperglycemia
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Good luck
Good luck