Let’s do glucocorticoid in pharmacology.
Compared with cortisol, these synthetic derivatives
have better oral availability, longer half-life,
less mineralocorticoid activity... compared
We’re talking about synthetic derivatives
Examples: hydrocortisone, prednisone, prednisolone
These drugs you should be extremely familiar
with, these are synthetic pharmacologic glucocorticoids.
Adverse effects, we talked about iatrogenic
Why in the world are we talking about Cushing’s
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,
If that occurs and the patient gets into a
physiologic stressful situation such as shock,
the patient’s going to die of Addisonian