Allergic Rhinitis Rheumatoid Arthritis Asthma Multiple Sclerosis Carpal Tun Powerpoint Presentation

Allergic Rhinitis Rheumatoid Arthritis Asthma Multiple Sclerosis Carpal Tun

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Slide 1 :

6/16/2009 MEDC 603 Steroids 1 Adrenocorticoids An inner medulla, which is a source of the catecholamines epinephrine and norepinephrine. An outer cortex, which secretes several classes of steroid hormones (glucocorticoids and mineralocorticoids, plus a few others). Steroidal hormones synthesized by the adrenal glands

Slide 2 :

6/16/2009 MEDC 603 Steroids 2 Hydrocortisone (11b,17a,21-trihydroxy- pregn-4-ene-3,20-dione) Aldosterone (11b,21-dihydroxy- pregn-4-ene-3,18,20-trione) Adrenocorticoids

Slide 3 :

6/16/2009 MEDC 603 Steroids 3 Opened form hemi-acetal form Aldosterone Overall Equilibrium in Aldosterone

Slide 4 :

6/16/2009 MEDC 603 Steroids 4 Adrenocorticoids ? Biological Activities 1. Glucocorticoid Activity 1.1 Effects on Metabolism 1.1.1 Stimulation of gluconeogenesis, particularly in the liver 1.1.2 Mobilization of amino acids from extrahepatic tissues 1.1.3 Inhibition of glucose uptake in muscle and adipose tissue 1.1.4 Stimulation of fat breakdown in adipose tissue 1.2 Effects on Inflammation and Immune Function 1.2.1 Anti-inflammatory properties 1.2.2 Immunosuppressive properties 1.3 Other Effects of Glucocorticoids 1.3.1 Multiple effects on fetal development (promote maturation of the lung) 1.3.2 Miscellaneous effects (Excessive glucocorticoid levels affect many systems, e.g., inhibition of bone formation, suppression of calcium absorption and delayed wound healing.) 2. Mineralocorticoid Activity 2.1 Effect on Electrolytes 2.1.1 Increased re-absorption of sodium 2.1.2 Increased renal excretion of potassium 2.2 Effect on Water 2.2.1 Increased re-absorption of water

Slide 5 :

6/16/2009 MEDC 603 Steroids 5 Adrenocorticoids ? Disease States ? Addison's disease: Affects about 1 in 100,000 people; caused by adrenal in-sufficiency (90%); typical by auto-immune disorders; both cortisol and aldostertone hormones are lacking. ? Cushing's disease: Affects about 10 to 15 million people / yr; caused by adrenal hyper-activity (cortisol); typical because of tumor growth exposure to prednisone for asthma, rheumatoid arthritis, lupus or other inflammatory diseases ? Conn's syndrome: May affect 15% of patients with high blood pressure; caused by hyper production of aldosterone; inability of adrenal cortex to carry out 17a-hydroxylation; hypertension, loss of potassium in the urine, muscle weakness and passing of large volumes of urine (polyuria)

Slide 6 :

6/16/2009 MEDC 603 Steroids 6 Glucocorticoids Allergic Rhinitis Rheumatoid Arthritis Asthma Multiple Sclerosis Carpal Tunnel Syndrome Dermatitis COPD Osteoarthritis Cystic Fibrosis Temporal Arteritis Gout Psoriasis Herniated Disc Shingles Inflammatory Bowel Disease Tennis Elbow Sinusitis Lupus Erythematosus ? Selected Indications

Slide 7 :

6/16/2009 MEDC 603 Steroids 7 Biochemical Mechanism of Action Cortisol Aldosterone Receptor Receptor Lipocortin Aldosterone- induced protein Regulates Na+-K+-ATPase Pump Na+ Influx Anti-inflammatory Action Mineralocorticoid Action

Slide 8 :

6/16/2009 MEDC 603 Steroids 8 Biosynthesis of Adrenocorticoids Corticosterone

Slide 9 :

6/16/2009 MEDC 603 Steroids 9 Metabolism of Adrenocorticoids

Slide 10 :

6/16/2009 MEDC 603 Steroids 10 Structure-Activity Relationships Hydrocortisone 1 1 120 m Anti- Salt- Plasma inflammatory retaining half activity activity life Cortisone 0.8 0.8 30 m

Slide 11 :

6/16/2009 MEDC 603 Steroids 11 Structure-Activity Relationships Prednisone 4 1 60 m Anti- Salt- Plasma inflammatory retaining half activity activity life Prednisolone 4 0.6 115-212 m

Slide 12 :

6/16/2009 MEDC 603 Steroids 12 Structure-Activity Relationships 6a-methyl 4 0 78-188 m prednisolone Anti- Salt- Plasma inflammatory retaining half activity activity life Triamcinolone 5 0 200+ m

Slide 13 :

6/16/2009 MEDC 603 Steroids 13 Structure-Activity Relationships Dexamethasone 30 0 110-210 m Anti- Salt- Plasma inflammatory retaining half activity activity life Betamethasone 35 0 300+ m

Slide 14 :

6/16/2009 MEDC 603 Steroids 14 Structure-Activity Relationships Aldosterone 0.2 800 30 m Anti- Salt- Plasma inflammatory retaining half activity activity life 11-deoxy 0 40 60 m corticosterone Fludrocortisone 10 800 300+ m

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HOSSAM HI\OSNI, favourited this 3 Years ago.

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Allergic Rhinitis Rheumatoid Arthritis Asthma Multiple Sclerosis Carpal Tunnel Syndrome Dermatitis more Allergic Rhinitis Rheumatoid Arthritis Asthma Multiple Sclerosis Carpal Tunnel Syndrome Dermatitis COPD Osteoarthritis Cystic Fibrosis Temporal Arteritis less