monam84
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Guys/gals, im completely baffled, in adrenal hemorrhage due to meningococcemia, I keep reading that hydrocortisone is used, but isnt the more importnat hormone to regulate aldosterone? Why are we regulating cortisol and not alderstrone... i just dont get it. Ugg.. can sum1 please enlighten me. much thanx
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| silver
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perhaps because glucocorticoids are nonspecific cardiac stimulants that activate release of vasoactive sustances. lack of corticosteroids would lead to hypotension, shock, and death. furthermore, primary hormone of importance in acute adrenal crisis is cortisol, adrenal aldosterone production is relatively minor.
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| new_n_lost
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Aldosterone is not a Stress Hormone Cortisol is If we have adrenal hemorrhage of any cause the primary concern is to avoid shock n loss of the Gluco/mineralocorticoid deficiency which might occur. thats y we give Hydrocortisone
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| monam84
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I see what you mean by stress hormone, so esentialy we are avoiding the hypoglycemia that occurs as a result of the lack of cortisol (glucagon needs it to fxn) which may lead to coma... by giving the hydroxycortisol. Is this correct?
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| monam84
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on a side note: in sheehan's necrosis you also have to supply cortisol (among others) .. i guess there's a trend here 
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| silver
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it's not just the development of hypoglycemia that will lead to coma, but as mentioned in the above post, glucocorticoids are cardiac stimulants, so if a deficieny occurs, as in ad. insuff, then hypotension-->shock--death.
Glucocorticoids act as follows to:
Stimulate gluconeogenesis and decrease cellular glucose use
Mobilize amino acids and fatty acids
Inhibit the effects of insulin
Give rise to ketone bodies in metabolism (ketogenesis)
Elevate RBC and platelet levels
Exhibit anti-inflammatory effects, including the following:
Maintenance of normal vascular response to vasoconstrictors
Opposition to increases in capillary permeability
Inhibition of interleukin-2 (IL-2) production by macrophages
Stimulation of polymorphonuclear neutrophil (PMN) leukocytosis
Reduction of adherence of macrophages to endothelium
Depletion of circulating eosinophils and lymphocytes
Reduction of circulating lymphocytes (primarily T cells)
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| silver
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Sheehan syndrome (postpartum pituitary infarction) is pan-hypopituitarism. you have to treat the patient by managing ALL the hormone deficiencies that occur. the cardiovascular compromise that occurs in Sheehan is from the untreated associated hypothyroidism. death can result if hypothyroidism state is not diagnosed.
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| new_n_lost
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Monam84......... Plz go thru the physiology of Stress hormones that are Cortisol Glucagon Epinephrine. then u wil understand y the steroids r required in such cases.
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| monam84
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just went through endocrine so im still a bit shaky on it, thanx for the info.
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| monam84
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Ok i get it, i remembered cortisols permissive effects on glucagon, but i completely forget its permissive effects on catecholamines, thanks guys.. thats a big point i woulda missed
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| new_n_lost
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monam r u IMG or AMG ??
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| monam84
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why do u ask?
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| new_n_lost
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simple question buddy U know Curiousity !! Nothing Special
P.S Dont say Curiousity Kills the Cat
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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