Corticosteroids

hi everyone now the topic of discussion is on corticosteroids the important aspect in your important topic in your pharmacology so one of the important questions asked from your former calls you in your basics paper is this corticosteroids so let's discuss myself top society team MDS conquer so any essay question if it is asked as an essay question you have to write the content so the contents actually include the introduction the synthesis of the corticosteroids and also the diurnal variations the regulation and actions of the pharmacal the are the actions of the corticosteroids on the body and the classification of the drugs and adverse effects the uses and the adverse effects so all and the applied aspects at the last sign followed by conclusion and differences so these are the contents so as we discuss you can write the contents ok so coming to the synthesis so introduction you can write that the corticosteroids play a very important role in regulating the body functions like that any interactive thing or descriptive you want to put in you can write so followed by the synthesis so it is mainly synthesized by the adrenal glands so the cortex and the medulla so you have to write these zones and if possible draw this diagram ok you have to write the zones and the individual things you have to write which are being produced by the individual zones so that's important so next you have to write the regulation so if a person is in constant stress I'll the physiological or psychological or environmental then the hypothalamus produces this see Harris or corticotropin-releasing hormone which acts on the pituitary gland to produce ACTH that is Ellen o corticotropin hormone which again acts on the adrenal gland to produce the cortisol okay this is the HPA axis which you have to draw this diagram if you draw it will be really fetching and it will add your ad marks to your answer ok and if the cortisol levels are reduced then this it's the CRH it sends a signal by via biofeedback mechanism to the hypothalamus and again it produces this ER it's so it is like opposite again so increase in this which occur if the cortisol levels is low and reduction in the CRH occur if the cortisol levels are high it is how so if the cortisol is more produced and it sends a signal so the CRH will be will reduce and our being opposite is like if the cortisol levels are low it sends the signals over this so that the CRH is more produced by the hypothalamus okay this is the HPA axis which you need to draw annually you need to explain next the diurnal variation usually it is maximum in the morning hours that is between 6:00 a.m. to 9:00 p.m. so again for the night shift persons its opposite so again it's minimum in the evening covers so actions of these glucocorticoids so you have to write the individual actions so protein metabolism it is actually for the protein make down breakdown so for the retardation of the grow the thinning and this curve the skin and subcutaneous tissue so muscles gets wasted if Eddy the cortisol levels have to be in its own limit if then if it crosses the limit then it can cause more of protein big breakdown which causes a message of the muscles leading to the condition called as de steroid myopathy and also it can cause the thinning of the hair and for when will wound healing and also very important role in carbohydrate metabolism so this line you have to put forward for this that it promotes gluconeogenesis and prevents the glycolysis so this we have to write okay this is very important and then for the fat metabolism so it causes a redistribution of the fat at the expense of the extremities and centripetal distribution of the fat okay so because of which the extremities are thin and since if it crosses a limit it results in a condition which is called as a moon like phase Buffalo Hump okay and the rupture of the skin occurs due to stretching because of which the purple striae appears on the abdomen okay this are the important points you have to put forward for the fat metabolism of why the moon-like phases occur why the Buffalo Hump occurs and why this purple striae on the okay because it plays a very important role in redistribution of the fat X the at the expense of the extremities and centripetal distribution of the fat occurs at the reason all these features occur if the glucocorticoids are not within their limits okay next it also very helpful in maintaining the electrolyte and the water balance and in the blood plays a very important role as well okay so in the GI t it increases the gastric acid and the pepsin secretion it also decreases the gastric mucosal cell proliferation and which tha's producer peptic ulcer formation if it is not within its limit and on the CNS excess of glucocorticoids decrease the threshold of the excitation of the electrical stimulus of the brain because of which it can produce convulsions so these are the various pharmacological actions so you have to put forward and if you can draw this diagram of how it has the of how it shows anti-inflammatory and the immunosuppressive effects that will be really adding to your mark so draw this if you can okay so how it shows anti-inflammatory and the immunosuppressive effects so coming to the Mindel corticoids so aldosterone is the most important mineral corticoid which helps in preservation of the sodium and the but it maintains the water balance sodium and a water balance so it's decrease if there is a decrease in the aldosterone then it causes hypotension dehydration circulatory collapse and finally death that's the reason it is called as a life-saving hormone okay you can put all these points and you can highlight so it's mainly important for the sodium and water retention so that you can put forward so again if it is asked as the essay question so for aldosterone is better to write the when in angiotensin mechanism so renin-angiotensin mechanism you know if you can put forward this it's very good so angiotensinogen which is produced by the liver it's converted to angiotensin one in presence of renin which is produced by the kidney then angiotensin 1 is converted to angiotensin 2 by the presence of the enzyme that is angiotensin converting Zam that finally acts on the receptors and produces this aldosterone by the adrenal gland this aldosterone plays a very important role in retention of this water and sodium so that plays a very important role in regulating the blood pressure of the body so if you put forward all these points that will be really fetching for you okay so this is how you have to start with the answer and then you have to come for the classification of the drugs so the short acting drugs which in the glucocorticoids the short acting the intermediate acting and the long acting so these you have to write it's very important and the Mendel corticoids you have to write okay so you have already discussed the pharmacological actions so these are the various adverse effects so this is a mnemonic actually which if you can try to remember this mnemonic okay so the glucocorticoids a mnemonic hides itself has its answer so glaucoma the muscle atrophy the ulcers the Cushing's syndrome the osteoporosis the cataracts on systemic use and the osteonecrosis and it's contraindicated completely contraindicated in renal failure and also in contraindicated in tuberculosis and also contraindicated in congestive heart failure the impair wound healing the edema the infections and diabetes mellitus and also suppression of the HPA axis okay so how it suppresses is for example if the cortisol levels are much beyond the limit then as I said it sends a signal to the hypothalamus so since it's more than the limit so it sends a signal to the hypothalamus to us to stop the production of the CRH so there is a reduced production of the crs because of which the ACTH is also less produced that the reason there will be no signal that is to be released by the adrenal gland so signal from the pituitary gland will not be going to the adrenal gland that's the reason it ends up with adrenal insufficiency or adrenal crisis so that's very important so that you have to highlight so if the cot is all or if the dark drugs dosages if you give a more long-term usage of cortisol and if the dosage of the drug is not properly monitored then it results in adrenal crisis because it sends a signal to the hypothalamus followed to the pituitary gland followed to the adrenal gland so if the CRH is not produced then again ACTH is not produced and finally there in Erlang cannot produce its own cortisol so the person will completely be on the artificial corticosteroids that we give that's not important reliable so the body should also produce its own corticosteroids that's the reason when we prescribed corticosteroids after a particular dose it's time we give alternate day basis so that on the alternate day the natural simulation of the body occurs is a natural production of the corticosteroids occur so one day we give are those other day the body produces so this is how we have to maintain the HPA axis and to read this is how you have to prevent the adrenal crisis okay so Cushing syndrome see I have an idea of this picture and write the symptoms that's the entire symptoms from the head-to-toe see I have a look of this picture and you can write okay and if there is less number less corticosteroids or decrease or deficiency then it results in Addison's disease so have a look of this diagram and write the symptoms okay if it is more than it results in Cushing's syndrome if it is less or deficiency it results in Addison's disease okay so therapeutic uses in dentistry so every question pharmacologic aspect right their plight aspects so in especially in dentistry it is used in all these ways okay so especially for the Aptus ulcers and any autoimmune diseases like lichen planus or edema multiform a prime figures all these you can give steroids because it has its very good property of having anti-inflammatory action so for oral lesions you have to start with topical corticosteroids so topical steroids are very important so if it is asked in order medicine do mention these steroids along with the dosages the dosages are very important for the oral medicine students okay so you have to write this specific dosages especially for the times in alone and the club it is all these two are very important so do note so 0.14 the times point zero five four kilometers well propanoic okay and again adverse effects further topical steroids you need to write so it could be the local hyper lie like the bruising or derm electro for your hyperpigmentation delay in ruling a delay in wound healing and also fungal and bacterial infections so opportunity infections actually occur if there's a long-term usage of steroids but topical steroids will not cause much of systemic effects so the topical effects you can write so this is how you have to write your answer applied aspects oral medicine students they have to write more so if you can write the dosages of the drugs and individual autoimmune diseases so autoimmune diseases corticosteroids have the immunosuppressive action so because of which they can be used in autoimmune diseases like lichen planus mem figures SLE all these diseases you can write okay and apart from that the Absinthe ulcers you can give the time stone a stone i topically 0.1% so you have to elaborate your answer by writing your applied aspects so not only the headings you have to write individual description of that particular disease and how the corticosteroids act in that disease so like that you have to enhance and increase your answer that says so and differences you can give your pharmacological textbook the three party that's enough the main textbook you have to give that and work a textbook you can give so like the clinical aspects have taken from Burkett Kirk a you can give okay any articles if you can give you it's enough that's enough for this particular chapter of corticosteroids okay so main thing we're all diagrams are required and we're all flowcharts you can give if you can give those that's enough so the heart of the answer actually lies in the actions of the actions of the glucocorticoids and the mindell corticoids actions as well as the classification of the drugs and the important side effects the Cushing syndrome and the the Cushing syndrome the all those important side effects from the head to toe and as a synthesis so this is how we after start and end your answer and finally the applied aspects especially in dentistry so that's it okay and if it is for oral surgery students and it is again important to write for the stress management if you have to extract many multiple extractions on one day then who give corticosteroids as a prophylactic use to manage the stress so like that you can answer for the oral surgeon so we're all related to your own particular department if you write the applied aspects it's very useful for you that's it okay thank you