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Summary Unlocking pharmacology - Glucocorticosteroids R80,33
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  3. University Of The Witwatersrand (wits)
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Summary Unlocking pharmacology - Glucocorticosteroids
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Welcome to the ultimate resource for mastering pharmacology! Our comprehensive pharmacology notes are specifically designed to help university students excel in their studies and achieve academic success. Whether you're a pre-med student, nursing student, pharmacy student, or studying any healthcar...

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  • March 22, 2024
  • 9
  • 2023/2024
  • Summary

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Glucocorticosteroi
ds
Introduction to GS function
 Endogenous and exogenous glucoticosteroids
 Normal: 10-20mg/day
 Treatment – not curative
 MOA:
- Binds cytoplasmic glucocorticoid receptor.
- Affect gene expression.
- Via glucocorticoid response elements (GRE’s)
- Either induce or inhibit gene expression




Examples of affected genes
Transcription stimulation Transcription inhibition
Lipocortin (annexin-1) Cytokines: IL-1, IL-2, TNF-a, y-

, interferon, IL-6
Gluconeogenic pathway enzymes Phospholipase A2
Interleukin-2 receptor
Cyclooxygenase-2
Hypothalamic-pituitary-adrenal axis




CS induced Acute Adrenal crisis.
 Cause: adrenal insufficiency (CS use>14 days)
 Dose tapering-when use exceed 14 days.
 Suppression of HPA axis by exogenous GS
- Triggers: stress, surgery, trauma, infection
- Symptoms:
Mild: myalgias, malaise, anorexia, weakness
Severe: vomiting fever, hypotension, shock
 Management: parenteral hydrocortisone
 Preserve HPA axis -alternate day dosing or morning dose.
Physiological response and adverse effects
Inflammatory response Susceptibility to
infections
Cancer

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