Adrenocorticoids are steroid hormones produced by the adrenal cortex. They include glucocorticoids and mineralocorticoids, each having essential roles in metabolism, stress response, electrolyte balance, and inflammation control.
Adrenal Cortex – Zones & Hormones
The adrenal cortex has three layers, each producing different hormones:
- Zona Glomerulosa – mineralocorticoids (aldosterone)
- Zona Fasciculata – glucocorticoids (cortisol)
- Zona Reticularis – androgens
1. Glucocorticoids
Main Natural Hormone
- Cortisol (Hydrocortisone)
Functions
- Increase glucose production (gluconeogenesis)
- Cause protein breakdown and fat redistribution
- Anti-inflammatory and immunosuppressive actions
- Help the body respond to stress
- Maintain blood pressure
Mechanism of Action
Glucocorticoids bind intracellular receptors → move to the nucleus → alter gene transcription → produce metabolic and anti-inflammatory effects.
Synthetic Glucocorticoids
- Prednisolone
- Dexamethasone
- Betamethasone
- Triamcinolone
- Methylprednisolone
Therapeutic Uses
- Inflammatory diseases (arthritis, asthma)
- Autoimmune disorders
- Skin diseases
- Allergic reactions
- Cerebral edema
- Replacement therapy in adrenal insufficiency
Adverse Effects
- Weight gain and fat deposition
- Hyperglycemia and diabetes
- Muscle wasting
- Osteoporosis
- Peptic ulcers
- Hypertension
- Suppression of HPA axis
2. Mineralocorticoids
Main Natural Hormone
- Aldosterone
Functions
- Increases sodium and water reabsorption in the kidney
- Promotes excretion of potassium and hydrogen ions
- Helps regulate blood pressure and fluid balance
Synthetic Mineralocorticoids
- Fludrocortisone – most commonly used
Uses
- Addison’s disease (adrenal insufficiency)
- Salt-losing conditions
Side Effects
- Sodium and water retention
- Hypertension
- Hypokalemia
Regulation of Adrenocorticoids
Glucocorticoids
Controlled by the HPA axis:
- Hypothalamus → CRH
- Pituitary → ACTH
- Adrenal cortex → Cortisol
Cortisol inhibits CRH and ACTH via negative feedback.
Mineralocorticoids
Controlled by the Renin–Angiotensin–Aldosterone System (RAAS) and serum potassium levels.
Clinical Conditions Related to Adrenocorticoids
1. Addison’s Disease
Low glucocorticoids and mineralocorticoids.
- Symptoms: Weakness, weight loss, low BP, hyperpigmentation
- Treatment: Hydrocortisone + Fludrocortisone
2. Cushing’s Syndrome
Excess glucocorticoids.
- Symptoms: Moon face, buffalo hump, obesity, hypertension
- Causes: Pituitary tumor, steroid overuse
3. Hyperaldosteronism
Excess aldosterone secretion.
- Causes severe hypertension and hypokalemia
Medicinal Chemistry (Short Notes)
Glucocorticoid Chemistry
- Cortisol is the natural prototype
- Modifications improve anti-inflammatory potency
- Dexamethasone and betamethasone have long duration
- Prednisolone has greater anti-inflammatory effect than cortisol
Mineralocorticoid Chemistry
- Fludrocortisone has a fluorine substitution → strong mineralocorticoid action
Detailed Notes:
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