29 Questions
What is the key property of the acetal group in budesonide that leads to prolonged residence in lung tissue?
It increases the hydrophobic nature of the compound
How does the systemic glucocorticoid activity of budesonide compare to fluticasone propionate?
It is 4-7 times lower
What is the key mechanism of action for ciclesonide's prolonged duration of action in lung tissue?
It is directly activated in the lungs
What is the primary disadvantage of lipophilicity for inhaled glucocorticoids?
It facilitates their transport away from lung tissues via mucociliary clearance
How does beclometasone dipropionate represent a breakthrough in asthma treatment?
It is currently used as an inhaler
What is the key advantage of non-halogenated glucocorticoids like budesonide compared to halogenated ones?
They have a lower systemic glucocorticoid activity
Which modification to the steroid structure increased glucocorticoid activity by 10-fold?
Introduction of a 9α-fluoro substituent
What effect did the introduction of a double bond at the Δ1 position have on steroid activity?
Increased glucocorticoid activity fourfold without increasing mineralocorticoid activity
How does the change in geometry of ring A caused by the introduction of the C1==C2 function affect glucocorticoid receptor (GR) affinity and pharmacokinetics?
It increases GR affinity and alters metabolism
What is the bioavailability of prednisone and prednisolone when orally administered?
Greater than 80%
Which enzyme is responsible for the interconversion of prednisone and prednisolone in the liver?
11β-hydroxysteroid dehydrogenase
Why are smaller doses of prednisone or prednisolone required compared to hydrocortisone in the treatment of rheumatoid arthritis?
They have higher glucocorticoid activity
What determines the extent of absorption of topical adrenocorticoids?
The type of cream or ointment, the condition of the skin, and the use of occlusive dressings
What percentage of halobetasol propionate was systemically absorbed after topical application in previous studies?
Approximately 6%
Why does the acetonide group in triamcinolone acetonide contribute to its increased activity compared to triamcinolone?
It reduces the polarity of the molecule, leading to better skin absorption
What is the purpose of esterifying one or more alcohol groups in topical glucocorticoids?
To achieve good skin absorption by increasing the lipophilicity of the molecule
What type of esters were found to be less active as topical anti-inflammatories, according to the text?
Phosphate esters
What is the primary factor that determines the activity of topically applied anti-inflammatory agents, according to the information provided?
The lipophilicity of the molecule
What is the main reason for the negligible activity of a certain substance elsewhere in the body?
Rapid metabolism by cytochrome P450 enzymes
Which group of steroids is primarily used for the treatment of Addison disease?
Mineralocorticoids
What is a characteristic shared by mometasone furoate, fluocinolone acetonide, and flunisolide?
High topical anti-inflammatory activity
Why are semisynthetic analogs used instead of naturally occurring aldosterone in treating Addison disease?
Cost-effectiveness
What modification greatly enhances both salt retention and anti-inflammatory activity of hydrocortisone?
Addition of a 9-fluoro group
Which structural difference distinguishes aldosterone from cortisol?
Absence of a 17a-hydroxyl group
What is the core structure of adrenocorticoids?
Pregnane skeleton
What are the undesired side effects of endogenous glucocorticoids?
Oedema and increased susceptibility to infection
Why are glucocorticoids best used as topical anti-inflammatory agents?
They are more effective when applied directly to the affected area.
What was the significance of the discovery that cortisone could relieve the symptoms of rheumatoid arthritis?
It revealed that the effects of cortisone were actually due to its conversion to cortisol.
What is the importance of the functional groups in the structure of cortisol?
All the functional groups are important, and the removal of any reduces or eliminates activity.
Test your knowledge on endogenous glucocorticoids, their structure, and their effects on metabolism and enzyme activity. Learn about the mineralocorticoid and immunosuppressant effects of glucocorticoids and how they can impact the body.
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