Hormones in Action: Corticosteroids, Sex Hormones & Oral Contraceptives

 

Hormones in Action: Corticosteroids, Sex Hormones & Oral Contraceptives
Let the Body’s Chemistry Tell a Story

ACTH – The Master Commander

Story Visual: Picture the pituitary gland as a general in a control room, releasing ACTH (Adrenocorticotropic Hormone) to activate the adrenal cortex, the “hormone factory.”

Function of ACTH:

• Stimulates adrenal cortex to release glucocorticoids (mainly cortisol)
• Minor stimulation of mineralocorticoids and androgens
• Maintains adrenal gland size and function

Memory Tip:
ACTH = Adrenal Cortex Triggers Hormones

Classification of Corticosteroids

Table Visual: Corticosteroids as Superheroes with different powers

• Glucocorticoids – control glucose & stress (♂️ Cortisol, Prednisolone)
• Mineralocorticoids – manage minerals & BP (♀️ Aldosterone, Fludrocortisone)

Classification:

1. Short-acting: Hydrocortisone
2. Intermediate-acting: Prednisolone, Triamcinolone
3. Long-acting: Dexamethasone, Betamethasone
4. Mineralocorticoid: Fludrocortisone

Mechanism of Action – Corticosteroids

A hormone key unlocking nuclear DNA

• Enter cells → bind to cytoplasmic glucocorticoid receptor
• Complex enters nucleus → alters gene transcription
• Suppresses inflammation & immune response
• Promotes gluconeogenesis, inhibits protein synthesis

Mnemonic: “I-GEN”
I – Immune suppression
G – Gluconeogenesis ↑
E – Enzyme induction
N – Nuclear receptor action

Therapeutic Uses of Corticosteroids

 Story: "Corticosteroid is the crisis manager"

 Indications:

• Autoimmune: RA, SLE
• Asthma, COPD
• Cerebral edema
• Adrenal insufficiency
• Allergies
• Transplant rejection
• Fetal lung maturation (Betamethasone)

Mnemonic: "4 A's + 2 E's + F"
Autoimmune, Allergy, Adrenal, Asthma
Edema, Emesis
Fetal Lungs

Adverse Effects of Corticosteroids

Cartoon Visual: A superhero on steroids turning into a villain

Side Effects:

• Cataracts
• Osteoporosis
• Retention of Na+/fluid → HTN
• Thin skin, muscle wasting
• Immunosuppression
• Sugar ↑ → Diabetes
• Obesity (central)
• Loss of K+ (hypokalemia)

Mnemonic: "CORTISOL"

Drug Interactions of Corticosteroids

Visual: Pills clashing like swords

Interactions:

• ↑ Hypokalemia with diuretics
• ↑ GI bleed with NSAIDs
• ↓ Effect of vaccines
• CYP450 inducers ↓ steroid levels (e.g., rifampin, phenytoin)
• CYP450 inhibitors ↑ toxicity (e.g., ketoconazole)

Androgens and Anabolic Steroids

 Visual Story: A man building muscles in the gym under hormonal influence

Examples: Testosterone, Methyltestosterone
Uses:

• Hypogonadism
• Delayed puberty
• Anemia
• Wasting syndromes
• Bodybuilding (abuse)

Adverse Effects:

• Liver toxicity, acne, testicular atrophy, infertility, aggression

Estrogens and Progesterone

 Hormonal symphony during the menstrual cycle

Estrogens: Estradiol, Ethinylestradiol
Progesterone: Natural + synthetic (Norethisterone, Medroxyprogesterone)

Uses:

• HRT (menopause)
• Contraceptives
• Dysfunctional uterine bleeding
• Prostate cancer

 Adverse Effects:

• ↑ Breast cancer risk
• Thromboembolism
• Nausea, weight gain

Oral Contraceptives – The Daily Shield

Woman protected by a hormonal shield

Types:

1. Combined pills (COCs) – Estrogen + Progestin
2. Mini pill – Progestin only

MOA:

• Inhibit ovulation (no LH surge)
• Thicken cervical mucus
• Thin endometrium

Side Effects:

• Nausea, weight gain, mood change
• DVT risk ↑ in smokers
• Liver enzyme interaction (rifampin ↓ efficacy)

Mnemonic: “OCP = Ovulation Ceased Permanently (temporarily)”

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