{"id":6646,"date":"2024-11-18T20:56:32","date_gmt":"2024-11-18T20:56:32","guid":{"rendered":"https:\/\/workhouse.sweetdishy.com\/?p=6646"},"modified":"2024-11-18T20:56:32","modified_gmt":"2024-11-18T20:56:32","slug":"adrencortccal-hormones","status":"publish","type":"post","link":"https:\/\/workhouse.sweetdishy.com\/index.php\/2024\/11\/18\/adrencortccal-hormones\/","title":{"rendered":"ADRENCORTCCAL HORMONES"},"content":{"rendered":"\n<p>Adenocortical hormones control the metabolism of carbohydrate (CHO), protein, fat and water<br>\/electrolytes<br>Adencortical hormones are classified into:<br>a) Glucocorticoid &#8211; Cortisone<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hydrocortisone (Cortisol)<br>b) Mineralocorticoid &#8211; Aldosterone<\/li>\n\n\n\n<li>Desoxycorticosterone<br>c) Sex Hormone &#8211; Estrogen<\/li>\n\n\n\n<li>Androgen<br><strong>Glucocorticoids<\/strong><br>The important glucorticoid secreted in man is hydrocortisone. It posseses some<br>mineralocorticoid activity as well. Cortisone is less potent and is converted to hydrocortisone by<br>liver.<br>They are classified as<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Short acting e.g cortisone, hydrocortisone<\/li>\n\n\n\n<li>Intermediate acting e.g predinsolone, triamcinolone<\/li>\n\n\n\n<li>Long acting e.g dexamethasone, betamethasone)<br>139<br>Dexamethasone and betamethasone have got a high glucorticoid activity while cortisone and<br>hydrocortisone have high mineralocorticoid action. Therapeutic activity in inflammatory disorder<br>is proportional to the glucocorticoid activity.<br>Actions on CHO metabolism:<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>antinsulinic effect<\/li>\n\n\n\n<li>decreases Peripheral utilization of glucose,<\/li>\n\n\n\n<li>increases gluconeogenesis<\/li>\n\n\n\n<li>promote glycogen storage<br>Protein metabolism:<\/li>\n\n\n\n<li>Inhibit protein synthesis,<\/li>\n\n\n\n<li>Increases catabolism<br>Fat metabolism:<\/li>\n\n\n\n<li>Interferes with fat storage causing deposits with characteristic distribution (neck,<br>supraclavicular area, and face<br>Electrolyte and H2O metabolism<\/li>\n\n\n\n<li>Sodium and water retention<\/li>\n\n\n\n<li>Hypokalmia<br>Suppression of pitutary adenocortical system<br>CNS: Euphoria and stimulation<br>CVS: Restore vascular reactivity<br>GIT: Increase gastric acid secretion<br>Blood: Increase number of RBC, Hypercoagulability<br>Uric acid: Increased excretion<br>Calcium metabolism: increased Ca++excretion, interfere with Ca++ absorption<br>Antinflammatory: Inhibit exudation, capillary dilatation, migration of phagocyte, fibroblast, inhibit<br>fibrous tissue formation<br>Antiallergic: through inhibition of antibody production suppress tissue inflammatory response.<br>Absorption and fate: It has fair absorption, bound to \u03b1 -globuin (transcortin).And in the liver,<br>cortisone is converted into hydrocortisone.<br><br>Therapeutic use<br>1) Replacement therapy: In Addisons disease and Addisonian crisis<br>2) Antinflammatory: in conditions like Collagen disease (rheumatoid carditis, arthritis),<br>3) Hypersensitivity reactions: (Bronchial Asthma, status asthmatic), Blood disease due to<br>circulating antibodies (autoimmune disease), Skin disease (eczema), Eye disease (allergic<br>inflammation of the eye), Nephrotic syndrome, Acute gout.<br>4) Immunosuppression: In tissue \/ organ transplantation.<br>Precautions<\/li>\n\n\n\n<li>Check weight for fluid retention<\/li>\n\n\n\n<li>Test urine for sugar<\/li>\n\n\n\n<li>Follow blood pressure through measurement and check bones by X-ray for osteoporosis<\/li>\n\n\n\n<li>Doses should be tapered slowly (Don\u2019t stop abruptly)<\/li>\n\n\n\n<li>Increase dose in surgery, infection<\/li>\n\n\n\n<li>Encourage diet rich in K+<br>, protein and adequate calcium, low Nacl<\/li>\n\n\n\n<li>Rule- out infection before initiation of treatment<br>Side effects:<\/li>\n\n\n\n<li>Due to prolonged use: Weight gain and edema hypokalmia, hyperglycemia, osteoporosis,<br>psychiatric disturbance, susceptibility to infection (like TB), peptic ulceration, cushing<br>syndrome, retarded growth<\/li>\n\n\n\n<li>Complication with rapid withdrawal results in adrenacortical insufficiency due to depression of<br>adrenocortical activity<br>Contraindication:<br>They are contraindicated in patients with peptic ulcer disease, acute infection like active<br>tuberculosis, diabetes mellitus, psychosis, pregnancy<br><strong>Mineralocorticoid<\/strong><br>Aldosterone<br>It is the main mineralocorticoid of adrenal cortex. It increases absorption of Na at distal tubule<br>and increases K+<br>excretion. They are not widely used in therapeutics rather its antagonists are<br>of value in cases of edema.<br><strong>Thyroid and Antithyroid Drugs<\/strong><br>They inhibit the function of the thyroid gland and used in hyperthyroidism.<br>141<br>Antithyroid drugs include:<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Thiourea compounds, e.g. , propylthiouracil, methimazole, carbimazole<\/li>\n\n\n\n<li>Ionic inhibitors, e.g. , potassium percholate, potassium thiocyanate<\/li>\n\n\n\n<li>Iodide, e.g. , Lugol\u2019s iodine, potassium iodide<\/li>\n\n\n\n<li>Radioactive iodine (131I)<br>Thiourea Compounds<br>Inhibit the formation of throid hormone through inhibiting the oxidation of iodide to iodine<br>by peroxidase enzyme and blocking the coupling of iodothryosines to form<br>iodothyronines.<br>They are contraindicated in pregnant and lactating women.<br>Toxicities include drug fever, skin rashes, increased size and vascularity of the thyroid<br>gland, and agranulocytosis.<br>Ionic Inhibitors<br>Potassium percholate prevents the synthesis of thyroid hormones through inhibition of<br>uptake and concentration of iodide by the gland. It has the risk of aplastic anemia,<br>therefore no longer used in the treatment of hyperthyroidism.<br>Iodides:<br>Improve manifestations of hyperthyroidism by decreasing the size and vascularity of the<br>gland so they are required for preoperative preparation of the patient for partial<br>thyroidectomy.<br>Iodides act through inhibition of the \u201cprotease\u201d enzyme which releases T3 and T4 from<br>thyroglobulin, and organification.<br>Radioactive Iodine:<br>It is used in hyperthyroidism as sodium 131I orally. It is trapped and concentrated as<br>ordinary iodine, which emits beta rays that act on parenchymal cells of the gland.<br>It is contraindicated in pregnancy and lactation as it affects thyroid gland in the fetus and<br>the infant. Its important toxicity is hypothyroidism.<br>Propranolol<br>This is an important drug which controls the peripheral manifestations of hyperthyroidism<br>(tachycardia, tremor). In addition, it decreases the peripheral conversion of T4 to T3.<br><br><strong>Thryoid Storm (Crisis)<\/strong><br>This is a sudden acute exacerbation of all the symptoms of thyrotoxic which rarely occur<br>after thyroidectomy. Manifestations include hyperpyrexia, gastrointestinal symptoms,<br>dehydration, tachycardia, arrhythmia, restlessness, etc. which may progress to shock<br>and death.<br>Management: It consists of infusion of intravenous fluids, supportive management, and<br>also administration of propylthiouracil, sodium iodide, hydrocortisone, and propranolol.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Adenocortical hormones control the metabolism of carbohydrate (CHO), protein, fat and water\/electrolytesAdencortical hormones are classified into:a) Glucocorticoid &#8211; Cortisone<\/p>\n","protected":false},"author":1,"featured_media":6510,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[683],"tags":[],"class_list":["post-6646","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocrine-drugs"],"jetpack_featured_media_url":"https:\/\/workhouse.sweetdishy.com\/wp-content\/uploads\/2024\/11\/18179857.png","_links":{"self":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6646","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/comments?post=6646"}],"version-history":[{"count":1,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6646\/revisions"}],"predecessor-version":[{"id":6647,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/posts\/6646\/revisions\/6647"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media\/6510"}],"wp:attachment":[{"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/media?parent=6646"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/categories?post=6646"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/workhouse.sweetdishy.com\/index.php\/wp-json\/wp\/v2\/tags?post=6646"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}