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Glucocorticoids in Pharmacology – Adrenal Insufficiency

by Carlo Raj, MD
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    Let’s do glucocorticoid in pharmacology. Compared with cortisol, these synthetic derivatives have better oral availability, longer half-life, less mineralocorticoid activity... compared with cortisol. We’re talking about synthetic derivatives of cortisol. Examples: hydrocortisone, prednisone, prednisolone and betamethasone. These drugs you should be extremely familiar with, these are synthetic pharmacologic glucocorticoids. Adverse effects, we talked about iatrogenic Cushing’s. Why in the world are we talking about Cushing’s here? Only because on the outside, the patient looks like a typical Cushing’s patient; on the inside, what is actually happening? The adrenals are undergoing atrophy. Remember secondary adrenal insufficiency. The adrenals are atrophic. What else is happening when you give glucocorticoid? This is a nice little summary of adverse effects. Suppression of skeletal growth in children, decreased wound healing, suppression of immune system, varied central nervous system effects. The suppression of ACTH, in fact, once again will cause secondary adrenal insufficiency. You will never abruptly stop this patient from taking glucocorticoid-glucocorticoid, never. If that occurs and the patient gets into a physiologic stressful situation such as shock, the patient’s going to die of Addisonian crisis....

    About the Lecture

    The lecture Glucocorticoids in Pharmacology – Adrenal Insufficiency by Carlo Raj, MD is from the course Adrenal Gland Disorders.


    Included Quiz Questions

    1. Do not cause Cushing's syndrome
    2. Have better oral availability than cortisol
    3. Are synthetic derivatives of cortisol
    4. Have a longer half life than cortisol
    5. Have less mineralocorticoid activity than cortisol
    1. Chronic glucocorticoid therapy is stopped abruptly
    2. Synthetic cortisol is given to patients with adrenal insufficiency
    3. Cushings's syndrome progresses
    4. Immune system response to an infection
    5. Patient on glucocorticoid therapy increases dose

    Author of lecture Glucocorticoids in Pharmacology – Adrenal Insufficiency

     Carlo Raj, MD

    Carlo Raj, MD


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