Chapter 36

Adrenocortical Agents
*adrenal glands
Medulla
NE, epinephrine; SNS
Cortex
 CRHACTHad cortex
 Diurnal rhythm: high production of CRH
@mnpeak response of ACTH and
adrenocorticoid hormones @ am
 Stress, sns activation: inc blood vol, glucose
release, immune response blocking,
Androgens
Sex hormones
Glucocorticoids
Inc glucose levels
Inc chon breakdown, dec formation
Lipogenesis
Mineralocorticoids
Aldosterone—not only affected by
ACTH; also with serum K levels
Hydrocortisone
Cortisone

*Adrenal insufficiency
**Long term exogenous hormones negate
effect of ACTHunstimulated
adrenalsadrenal atrophy
*adrenal crisis

Glucocorticoids
Beclomethasone (Beclovent)
Respi inhalant, nasal spray; block
inflam locally
Betamethasone (Celestone, etc)
Long acting
Parenteral; oral (short term);
topical
Budesonide (Rhinocort, Entocort EC)
Intranasal-- rhinitis; oral—Crohn’s
Cortisone (Cortone Acetate)
Oral, parenteral
Tx adrenal insufficiency, acute
inflam
Dexamethasone (Decadron, etc)
Many different ROA
Rapid peak action, up to 2-3 days
Flunisolide (AeroBid, Nasalide)
Respi inhalant; intranasal
Hydrocortisone (Cortef, etc)
Powerful; both gluco and
mineralocc
Tx adrenal insuffiency
Replaced for other uses because of
its mineralocc props
Topical; ophthalmic
Methylprednisolone (Medrol)
little mineralocc props
Tx for immune DO
Many ROA, including retension
enemas
Prednisolone (Delta-Cortef, etc)
Intermediate acting ccsteroid
Effects w/in a day or so
Intralesional; intra-articular; oral;
topical
Prednisone (Deltasone, etc)
Oral only
Tx adrenal insufficiency, acute
inflam