2. Endocrine 2
Adrenal Glands
• Adrenal Medulla
– Responds to SNS
stimulation
– Secretes catecholamines –
epinephrine is the main
player from this gland
• Adrenal Cortex
– Produce three kinds of
steroids
– Glucocorticoids,
mineralocortcoids,
androgens
6. Endocrine 6
Glucocorticoids
• Influence ________
metabolism
• Major effects on the
metabolism of all organs
of the body
• Corticosteroids are
examples of this
substance given by health
care providers to
decrease inflammation,
and suppress allergic
reactions
7. Cortisol
http://geekymedics.com/2011/01/24/how-
the-adrenal-axis-works/
• Cortisol is a steroid hormone
(glucocorticoid)which is released
under stress & low steroid levels
It’s main function is to increase
blood glucose levels by promoting
gluconeogenesis Cortisol also
suppresses the immune system &
increases fat, protein & carb
metabolism Random Fact!
• You may recognise cortisol’s
pharmaceutical name which is
Hydrocortisone Hydrocortisone is
used to reduce inflammation
leveraging Cortisol’s
immunosuppresive effect
8. Endocrine 8
Mineralocorticoids-Aldosterone
• http://geekymedics.com/2011/01/24/how-the-
adrenal-axis-works/
• Aldosterone is also a steroid hormone
(mineralocorticoid) It’s main function is to
increase blood volume It causes reabsorption of
sodium and water as well as causing excretion of
potassium . Random Fact!
• Drugs that interfere with the secretion or action
of Aldosterone are in used as antihypertensives
An example is Spironolactone which blocks
Aldosterone receptors
10. Endocrine 10
Pheochromocytoma
• Tumor of the adrenal medulla
• Hereditary, high incidence of occurrence in
family members
• Symptoms:
– Headache, diaphoresis, and palpitations
– Hyperglycemia
– Hypertensive emergencies
11. Endocrine 11
Diagnostic findings
• 24 hour urine – will show elevated levels of
catecholamines
• Clonidine suppression test-will not stop
catecholamine levels from being excreted
13. Endocrine 13
Addison’s Disease
• Adrenocortical
insufficency
• Causes: autoimune,
surgical removal of the
adrenal glands, infection
– TB most common cause
• Chronic corticosteroid
therapy will suppress
adrenal function
18. Endocrine 18
Managment
Restore circulation
Fluid
Give corticosteroids
Solu-Cortef
D5NS fluids
Vasopressor amines
Treat underlying
cause
Lifelong replacement
is needed if the
adrenal gland does
not regain function
Supplement with
added salt during
times of stress
19. Care of the patient with Addison’s
Disease
• ADL’s
• Assessment
• Dietary needs
• Patient is total care
during the initial crisis
• Assess turgor, mucous
membranes, orthostatic
blood pressures will
signify need for more
fluids
• Six small feeding,
carbo’s, high protein
• Need to deal with stress
Endocrine 19
21. Endocrine 21
Things to remember
• Corticosteroids are
always tapered off
• Acute withdrawal will
precipitate an
addisonian crisis
related to adrenal
insufficency
