Steroids, Hormones, and Vitamins

Steroids

Compounds with CPPP; metabolites of mevalonate pathways

Sterols

Cholesterol - animals

Ergosterol - fungi

Phytosterol - plants

Primary bile acids

directly from cholesterol (liver)

cholic acid, chenodeoxycholic acid

Secondary bile acids

Fermentation of primary bile acids by intestinal flora

Deoxycholic acid, lithocholic acid

Steroid hormones

Produce in adrenal cortex

STEROID HORMONES

Glucocorticoids

Mineralocorticoids

Sex Hormones

Mineralocorticoids

Produce in the zona glomerulosa

Eg. aldosterone - promote Na and water retention, K excretion, electrolyte and water balance

Glucocorticoids

produced in the zona fasciculata

produce cortisol which is responsible for long term control of stress: Increase gluconeogenesis and immunomodulation

Sex hormones

Produced in the zona reticularis

In males: Dihydrotestorene by 5-alpha reductase

In females: Estrogen by aromatase

Hormones

substances excreted by the endocrine gland

Posterior pituitary hormone

Antidiuretic hormone

Oxytocin

Antidiuretic Hormone (ADH)

helps maintain water balance by decreasing water loss in urine

Vasopressin

Injection anti-diuretic hormone

Treatment for diabetes insipidus

Oxytocin

uterine contraction during child birth, promotes lactation, maternal behavior, social bonding, and sexual arousal.

Thyroid conditions

Hypothyroidism

Cretinism

Myxedema

Hypothyroidism

Low production of thyroid hormone. Thyroid damage caused by autoimmune disease is the most common cause of hypothyroidism

Cretinism

Congenital hypothyroidism at birth, which results in growth retardation, developmental delay, and other abnormal features

Myxedema

condition resulting from advanced hypothyroidism, or deficiency of thyroxine; it is the adult form.

Thyroid gland hormones

Thyroxine (T4)

Triiodothyronine (T3)

Levothyroxine

Thyroxine (T4) used for replacement therapy

Liothyronine

Triiodothyronine (T3), same use with T4 but have better GI absorption, more rapid onset of action and shorter duration of action.

Liotrix

4:1 combination of T3 and T4

Adrenal glands hormones

Epinephrine

Norepinephrine

Dopamine

Epinephrine

vasoconstrictor and vasopressor

Norepinephrine

strong peripheral vasoconstrictor and useful in restoration of blood pressure (acute hypotension)

Dopamine

administered in IV infusion

Used to treat cardiac decompensation (a sudden worsening in symptoms associated with heart failure) and patients with acute hypotension

Anterior pituitary hormone

Adrenocorticotropin (ACTH)

Growth Hormone

Luteinizing

Follicle stimulating

Prolactin

Thyroid stimulating

Adrenocorticotropin (ACTH)

stimulates the adrenal glands to produce the stress hormone cortisol

Adrenocorticotropin (ACTH)

Can be used in rheumatoid arthritis and acute rheumatic fever, collagen (component of connective tissue) disease, systemic autoimmune disease

Injection is a sterile preparation of the pituitary of mammals.

Pancreatic hormones

Glucagon

Insulin

Glucagon

secreted by the a- cell

increase blood sugar

glycogenolysis

Insulin

secreted by the b-cells

decrease blood sugar

glycogenesis

Hormones for calcium regulation

Parathyrin

Calcitonin

Parathyrin

Parathyroid hormone

control calcium metabolism

Increase blood calcium

Increase bone resorption and calcium release

Parathyroid Injection used for blood-calcium maintenance in case of tetany or uncontrollable muscle

Calcitonin

decrease blood calcium

Treatment for Paget’s disease (deterioration of bone tissue) and postmenopausal osteoporosis and control hypercalcemia

IM Injection

GI Hormones

Cholecystokinin

Secretin

Pengastrin/Gastrin

Cholescystokinin

Diagnostic aid in cholecystography and cholangiography

stimulates the secretion of pancreatic digestive enzymes, flow of bile and contraction of gall bladder

Secretin

diagnose gastrinoma and pancreatitis

increase the bicarbonate content and volume of secretion from the pancreas

Pengastrin/Gastrin

For diagnostic purposes, gastric secretion function

Increases GI motility and stimulates the secretion of gastric acid, pepsin and intrinsic factor

Vitamins

Organic substances, not synthesized within the body, that are essential in small amounts for the maintenance of normal metabolic functions.

Lipid soluble vitamins

Vitamin A, D, E, K

Vitamin A

vitamin associated with night blindness

Vitamin A

Retinol

most toxic vitamin

most stable vitamin

good vision, growth, tissue, differentiation

Tretinoin

Retin-A: All-trans retinoic acid

treat acne vulgaris

Isotretinoin

Accutane: 13-cis retinoic acid

For cystic acne

Fish liver oils

sources of vitamin A

B-carotene

Solatene

Precursor converted in small intestine

Deficiency of vitamin A

Xeropthalmia

Hyperkeratosis

Nyctalopia

Vitamin D

Sunshine vitamin

Ca and PO4 absorption

Source:

Fish liver oils

Vitamin D2

Ergocalciferol

Calciferol

Vitamin D3

Vitamin D Deficiency

Rickets

Osteomalacia

Vitamin E

α-tocopherol

Antioxidant

Sources

green veggies, whole grains, yolk, meat

Test for vitamin E

Further-Meyer Synergistic with Selenium

Vitamin E deficiency

rare neurologic dysfunctions

Vitamin K

2-methyl-1,4- naphthoquinone

Synthesis of blood coagulation factor

Sources:

leafy veggies, dairy

Vitamin K1

phytonadione

Vitamin K2

menaquinone

Vitamin K3

menadione

Vitamin K4

menadiol, acetomenaphthone

Vitamin K deficiency

hemorrhage and capillary fragility

Vitamin K

Prolonged oral antibiotic therapy may result in the deficiency of what vitamin?

Pyridoxine or Vitamin B6

Use to supplement dietary intake and to treat deficiency states, congenital metabolic dysfunctions and poisoning cause by cycloserine and isoniazid

Pellagra

Classic niacin deficiency can lead to what condition

Thiamine

Vitamin B1

Decarboxylation (CHO, AA)

Vitamin B1 deficiency

Beriberi

Wernicke-Korsakoff

Riboflavin

Vitamin B2

Redox coenzyme, FAD

Vitamin B2 deficiency

Stomatitis

Cheilitis

Glossitis

SE: yellow urine

Niacin

Nicotinic acid, Niacinamide

Vitamin B3

Redox coenzyme

NAD

Vitamin B3 deficiency

Pellagra = Dementia + Dermatitis + Diarrhea

Pantothenic acid

Vitamin B5

“chick anti-dermatitis factor”

Acetyl CoA

Secretion of hormones (cortisone)

Vitamin B5 deficiency

Paresthesias of the extremities or “burning foot” syndrome

Pyridoxine

Vitamin B6

Transamination, Decarboxylation (CHO, AA), RBC metabolism

Pyridoxol

pyridoxine from plants

Pyridoxal

Pyridoxamine

pyridoxine from animals

Pyridoxine antagonists

Chloramphenicol

Cycloserine

Hydralazine

Isoniazid

Oral contraceptives

Vitamin B6 deficiency

Peripheral neuropathy

RBC fragility

Hypochromatic microcytic anemia

Folic acid

Vitamin B9

Pteroylglutamic acid

Folate -> FH2 to Tetrahydrofolic acid (liver & plasma)

Vitamin B9 deficiency

Megaloblastic anemia

Macrocytic anemia

Cobalamin

Vitamin B12

Cyanocobalamin, Hydroxocobalamin

RBC synthesis; metabolism of folic acid

Cyanocobalamin

most active vitamin B12

Vitamin B12 deficiency

Pernicious anemia

Rapidly dividing cells of the hematopoietic system and irreversible neurologic damage

Biotin

Vitamin H

Carboxylation (gluconeogenesis and FA synthesis)

Vitamin H Deficiency

Impaired fat and CHO metabolism

Dermatitis

Avidin

usual cause of vitamin H deficiency

Cevitamic acid

Vitamin C

Hydroxylation of pro and lysine (collagen synthesis)

Anti-oxidant

Enhances Fe absorption

Vitamin C deficiency

Scurvy

impaired wound healing, loss of dental cement, SQ hemorrhage