CCSs Lecture Set 4

Term
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How do glucocorticoids maintain adequate serum glucose levels in the fasting state? (4)
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Terms in this set (34)
How do glucocorticoids maintain adequate serum glucose levels in the fasting state? (4)
1. increase serum glucose levels
2. inhibit glucose uptake by muscle
3. stimulate lipolysis
4. catabolic effect on muscle leading to release of amino acids
(release of new fuels getting turned into glucose)
Characterize the metabolic effects of glucocorticoids.
multiple, sometimes opposing effects (on protein, fat, carbohydrate metabolism)
Cortisol levels may spike _______-fold with surgery
5
How do CCSs affect leukocytes?
reduce leukocyte infiltration
How do CCs affect cytokines and chemokines?
suppress inflammatory cytokines and chemokines
How do CCSs affect immune cells?
decrease lymphocytes, monocytes, eosinophils, adn basophils
How do CCSs affect phospholipase? What is the effect?
inhibit phospholipase; decrease PGs, leukotrienes, and PAF
How do CCs affect cyclooxygenase? What is the effect?
Inhibit cyclooxygenase with subsequent decrease in PG synthesis
How do CCSs affect histamine release? What is the effect?
decrease histamine release; associated increase in capillary permeability
What is the only increase associated with immunosuppressive effects of CCSs?
increase in capillary permeability
What is the effect of tissue macrophage and lymphocyte inhibition from CCS?1. decreased phagocytosis 2. decreased production of tumor necrosis factor, IL-1 and other substances important in cellular immunityHow do CCSs inhibit the lipoxygenase pathway?indirectly by inhibiting phospholipase breaking out substrate (arachidonic acid) from cell membraneHow do CCSs inhibit the cyclooxygenase pathwaydirectly (COX 2 primarily, also some COX 1)What behavior changes are expected with GCC treatment?initial insomnia/euphoria, ultimately depression with high dosesWhat is a pseudotumor cerebri?benign intracranial HTN; Increased intracranial pressure with normal CSF and anatomy; However, could lead to optic nerve atrophy and blindnessWhat is the treatment for pseudotumor cerebri?1) Weight loss 2) Diamox (decreases the production of CSF therefore dec. ICP) 3) Lasix (Alternate for those who can't tolerate Diamox) 4) drain CSFWhat are the pituitary effects of GCCs?supression: decreased ACTH/GH/LH/TSHWhat is the gastric effect of GCCs? What is its cause?PUD; poss related to decreased immune response against H. pyloriWhat effects do GCCs have on fat redistribution?increased visceral, facial, nuchal, and supraclavicular fatWhat is the effect of GCCs on calcium?decreased vitamin D induced calcium absorptionWhat concentration of CCs are required for adequate renal function?physiologic concentrationsWhat do CCSs do for near-term fetuses?promote surfactant productionWhich COX enzyme is protective of the GI tract?COX-1Synthetic CCSs are produced from either: (2)1. bovine cholic acid 2. plant steroid sapogeninsWhich are the long-acting steroids? (2)betamethasone dexamethasoneWhat is not long acting?anything except betamethasone and dexamethasoneWhat is the HPA axis?hypothalamic-pituitary-adrenal axisEquivalent oral doses for prednisone, prednisolone, methylprednisolone, and meprednisone5,5,4,4What is the equivalent dosage for cortisone and cortisol (hydrocortisone)?25, 20Does methylprednisolone have any salt-retaining activity?NOprednisone is how many times more potent than hydrocortisone?4xmethylprednisolone is how many times more potent than hydrocortisone?5xdexamethasone is how much more potent than hydrocortisonemore than 20xbetamethasone is how much more potent than hydrocortisonealmost 40x