Mineralocorticoids and Glucocorticoids – Adrenal Pharmacology

by Pravin Shukle, MD

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    Let's move on to the zona glomerulosa and mineralocorticoid function. Now remember that when we are talking about mineralocorticoids or even corticosteroids, we are talking about using a steroid receptor. If you remember from your pharmacology lectures way back at the beginning, when we were looking at receptors, there are five major types of receptors. Steroid receptors are intracellular receptors and so the drug, because it's lipophilic can cross the membrane easily and that's how the medications or the hormones work. Now, if the steroid binds to the receptor inside the cell, it has to send a message into the nucleus. It does so through something called an MRE or mineralocorticoid response element. This MRE is part of the DNA molecule. The MRE exerts its effects through DNA and you have production of certain enzymes. Now the aldosterone agonists are part of the renin angiotensin system, and they have a very strong salt retaining activity just like androgynous mineralocorticoids. So, aldosterone agonists are also considered mineralocorticoids as well as diuretics. A good example of a mineralocorticoid is Florinef or fludrocortisone. Structurally it's very similar to cortisol. It has moderate glucocorticoid activity and very strong mineralocorticoid activity. It is involved and can be treating cerebral salt wasting syndrome, it can be used in Addison's disease, it can be used in this disease called POTS or paroxysmal orthostatic tachycardia syndrome. And it's also sometimes used in geriatric orthostatic hypotensive syncope. So, what we're doing here is we're retaining salt so that the blood pressures are a little bit higher and it prevents the drop in blood pressure that geriatric patients have when they stand up. Spironolactone is a diuretic, we discussed it already in the hypertension section of pharmacology, but we also use it as its mineralocorticoid function to treat hirsutism. So,...

    About the Lecture

    The lecture Mineralocorticoids and Glucocorticoids – Adrenal Pharmacology by Pravin Shukle, MD is from the course Endocrine Pharmacology. It contains the following chapters:

    • Steroid Binding is Intracellular
    • Mineralcorticoids
    • Glucocorticoids

    Included Quiz Questions

    1. These steroid hormones bind to intracellular receptors.
    2. These steroid hormones bind directly to an intranuclear receptor.
    3. These steroid hormones bind to a membrane receptor on the outside of the cell called tyrosine kinase.
    4. These steroid hormones bind to a transmembrane receptor on the cell called JAK STAT.
    5. There steroid hormones bind to a GPCR.
    1. Increased gluconeogenesis, lipolysis, abnormal lipid deposition, immune dysfunction.
    2. Decrease of blood pressure, slight drop in sodium, increased urine output.
    3. Immune dysfunction, especially T cell function.
    4. Inhibit COX-2 to decrease platelet activity.
    5. Increase glycogenolysis and lipolysis.
    1. Dexamethasone is more potent and lasts longer compared to prednisone.
    2. Dexamethasone is topical only while prednisone can be taken orally or via IV.
    3. Prednisone comes with multiple warnings associated with it while dexamethasone has a very mild side effect profile.
    4. Prednisone binds to a steroid receptor in the cell while dexamethasone binds to a receptor on the cell membrane.
    5. Prednisone is not recommended for children under 9 years while dexamethasone is not recommended for adults over 65 years of age.
    1. Treatment for hypertension
    2. Anti fungal
    3. Treatment for hirsutism
    4. Treatment for adrenal adenoma
    5. Breast cancer therapy

    Author of lecture Mineralocorticoids and Glucocorticoids – Adrenal Pharmacology

     Pravin Shukle, MD

    Pravin Shukle, MD

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