Glucocorticoid drugs D(1 Effects on metabolisms o a carbohydrate: blood glucose t: gluconeogenesis t, glycolysis_, glucose utilization) o b)Protein: synthesis +, degradation t n c)Lipid: long term use: plasma cholesterol t, fat redistribution (central obesity: moon face, buffalo hump) d) Water and electrolytic:Na’ excretion↓, K+excretion↑, Caz+excretiontand absorption)
(1) Effects on metabolisms a) Carbohydrate: blood glucose ↑: gluconeogenesis ↑, glycolysis↓, glucose utilization↓ b) Protein: synthesis ↓, degradation ↑ c) Lipid: long term use: plasma cholesterol ↑, fat redistribution (central obesity: moon face, buffalo hump) d) Water and electrolytic: Na+ excretion ↓, K+ excretion ↑, Ca2+ excretion↑and absorption↓ Glucocorticoid drugs
Glucocorticoid drugs o(2)Permissive action o Potentiating the effects of catecholamines and glucagon(胰高血糖素) D 3) Anti-inflammatory effects D Acute: inhibiting microvascular leakage leukocyte infiltration o Chronic: inhibiting fibroblast proliferation deposition of collagen cicatrization(瘢痕形成)
(2) Permissive action Potentiating the effects of catecholamines and glucagon (胰高血糖素) (3) Anti-inflammatory effects Acute: inhibiting microvascular leakage leukocyte infiltration Chronic: inhibiting fibroblast proliferation deposition of collagen cicatrization (瘢痕形成) Glucocorticoid drugs
Glucocorticoid drugs o a) Inhibiting inflammation related proteins or enzymes o inducing lipocortin, inhibiting phospholipase A2 activity decreasing mediators: PGs, LTS, PAF o inhibiting the expression of PLA2, coX-2, inducible Nos, etc o inducing ACE, degrade brady kinin
a) Inhibiting inflammation related proteins or enzymes inducing lipocortin, inhibiting phospholipase A2 activity, decreasing mediators: PGs, LTs, PAF inhibiting the expression of PLA2 , COX-2, inducible NOS, etc. inducing ACE, degrade bradykinin. Glucocorticoid drugs
Phospholipid I( rom cell membran Bradykinin ngiotensin Phospholipase A2 日日日日日日日·日·日·日日日日日 Arachidonic acid Cyclooxygenas Lipid-derived NSAIDs mm>o autocoids and elated drugs PGG g Prostacyclin(PGl2) Hydro- peroxidase PGE PG c 5-Lipoxygenase Thromboxane Dipyridamole 5-HPETE see Chapter 20 Leukotrienes
PAF Lipid -derived autocoids and related drugs
Glucocorticoid drugs a)Inhibiting inflammation related proteins or enzymes inducing lipocortin, inhibiting phospholipase A2 activity, decreasing mediators: PGs, LTS, PAF inhibiting the expression of COX-2, inducible Nos, etc. inducing ACE, degrade bradykinin. b)Inhibiting cytokines: TNFa, IL-1, IL-2, IL-5, IL-6,IL-8,etc c) nhibiting adhesion molecules(黏附分子) d) Inducing the apoptosis of inflammatory cells
a) Inhibiting inflammation related proteins or enzymes inducing lipocortin, inhibiting phospholipase A2 activity, decreasing mediators: PGs, LTs, PAF inhibiting the expression of COX-2, inducible NOS, etc. inducing ACE, degrade bradykinin. b) Inhibiting cytokines: TNF, IL-1, IL-2, IL-5, IL-6, IL-8, etc. c) Inhibiting adhesion molecules (黏附分子) d) Inducing the apoptosis of inflammatory cells Glucocorticoid drugs