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PHYSIOLOGY
Anatomy
Adrenal Cortex
Adrenal Medulla
phenylethanolamine-N-
methyltransferase
Norepinephrine Epinephrine
Steroidogenesis
Steroidogenesis
Steroidogenesis
Steroidogenesis
Steroidogenesis
Transport Proteins
Corticosteroid-binding globulin
(CBG)
Albumin
Transport & Metabolism
Cortisol Aldosterone
80% bound to CBG 60% bound to albumin
15% bound to albumin
5% free 40% free
t½ 90 mins t ½ 30 mins
Serum levels:
10-25μg/dl 2-10 ng/dl
Transport & Metabolism
Regulation - Glucocorticoids
Hypothalamus
CRH
Pituitary
ACTH
Adrenal Cortex
CORTISOL
Regulation - Glucocorticoids
Regulation - Glucocorticoids
Regulation-Glucocorticoids
Regulation-Glucocorticoids
Mechanism of Action-Glucocorticoids
Biologic Actions-Glucocorticoids
Biologic Actions-Glucocorticoids
long-term starvation
ketogenesis
Biologic Actions-Glucocorticoids
Physiologic Effects
1. hepatic glucose production
2. protein catabolism
3. fat catabolism
4. increased bone resorption
5. altered mood
6. increased gastric acidity
7. PNMT synthesis
Biologic Actions-Glucocorticoids
Therapeutic Effects
1. prevents vascular collapse during stress
2. anti-inflammatory effect
Capillary dilation; prostaglandin/leukotriene
production; Leukocyte migration; stabilzation of
lysosomal membrane
3. invoking immunosuppression
- T cell proliferation; complement synthesis;
β cell killing
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Pathophysiology
Pathophysiology
Pathophysiology
Pathophysiology
Pathophysiology
Pathophysiology
Regulation-Mineralocorticoids
Regulation-Mineralocorticoids
Actions of Angiotensin II
2. Direct arteriolar vasoconstrictor
3. Stimulus to aldosterone secretion
Regulation-Mineralocorticoids
Biologic Actions-Mineralocorticoids
Aldosterone
MOA: transcription of enzymes and
proteins
Hypersecretion of Aldosterone
SXS: hypertension
hypokalemia
metabolic alkalosis
Pathophysiology
Primary Hyperaldosteronism
ECF volume
Aldosterone Na retention + Renin
Renal perfusion
pressure
Secondary Hyperaldosteronism
Na retention
Renal perfusion Renin Aldosterone +
pressure ECF volume
Pathophysiology
Hyposecretion of Aldosterone
SXS: hypovolemia
hyponatremia
hyperkalemia
Happy
New
Year!!
!
Anatomy
Anatomy
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Transport & Metabolism
Epinephrine Norepinephrine
levels
20-50ng/ml 100-350 ng/ml
Transport & Metabolism
Regulation
Agonists Antagonists
Parkinson’s disease hypertension
clinical depression hyperthyroidism
shock cardiac arrhythmia
asthma angina pectoris
allergic reactions
nasal congestion
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