Cortisol has several important functions in the body. It acts as a permissive hormone that allows other hormones like glucagon and catecholamines to increase blood glucose levels. Cortisol also has metabolic effects like increasing blood sugar and breaking down fats and proteins. Additionally, cortisol has systemic roles in maintaining functions of the central nervous, cardiovascular, skeletal, and immune systems. Pharmacologically, cortisol acts as an anti-inflammatory, anti-allergic, anti-stress, and anti-immune hormone. Prolonged high levels of cortisol can lead to side effects like acne, weight gain, and striae.

1. Functions of Cortisol
Made by/mohammed nassar zaky nassar
Faculty of medicine , menoufia university

2. cortisol
functions
permissive
metabolic
systemic
pharmacological

3. Permissive function
1-Glycogenolysis : by Glucagon
2- Lipolysis : by Catecholamines & GH
3- Vasoconstriction of arterioles : by Catecholamines
& Angiotensin 2

4. Metabolic function
Net effectactionname
Hyperglycemic &
diabetogenic
1-Decrease glucose uptake & utilization by peripheral tissues
2-Increase gluconeogenesis & glycogenolysis by liverCHO
_1-In extrahepatic tissue(skeletal muscles & bones) Catabolic
2-In liver AnabolicProtein
Lipaemia
Ketonemia
1- lipolysis FFA in plasma
2- keton body formation keton bodies in bloodLipid
Weak mineralocorticoid effect
1- Sodium & water reabsorption & potassium & hydrogen excretion
2-H2O diuresis as it decreases ADH secretionElectrolyte

5. Systemic functions
FunctionSYSTEM
It is essential for sensations & higher functions such as memory &intellectual
performanceCNS
vascular reactivity to circulating catecholamines & other vasoconstrictor
agentsCVS
1-skeletal muscle : maintain muscular activity
2- Bone : renal excretion of calcium & phosphate
Skeletal
system
Lymphocyte , eosinophil & basophil count
RBCs , neutrophils & platelet count
Blood cells

6. Pharmacological action
Anti-
allergic
Anti-
inflammatory
Anti-
stress
Anti-
immunity

7. 2-Anti-immunity effect1-Anti-allergic effect
Causes atrophy of lymphoid tissue
Immunity
A-block release of histamine from
mast cells relief symptoms of
asthma & delayed hypersensitivity
reactions
B-It does not block antigen-antibody
reaction

8. 3-Anti-stress
effect
Hemorrhage
Hypotension
Hypoxia
Hypoglycemia
Mechanism
1- Increase mobilization of FFA and amino acids from their stores
That is used as a source of energy by vital tissues during stress
2-Help vasoconstriction of blood vessels to increase ABP

9. 3-Anti-inflammatory effect
1- local redness via VC of BVs blood flow to the inflamed area
2- local edema via capillary permeability & leakage of plasma to tissue
3- local hotness via release of IL 1 from macrophage
4- local pain via release of inflammatory mediators like PGs from the
damaged tissue &stabilization of lysosomal membrane

10. Common Clinical Indications for
Synthetic Glucocorticoids
DisordersField of Medicine
Asthma (moderate/severe), allergic rhinitis, anaphylaxis, urticaria, food/drug
allergies
Allergy & Pulmonology
Acute severe dermatitisDermatology
Adrenal insufficiencyEndocrinology
Crohn's Disease (IBD), ulcerative colitisGI Diseases
Leukemia/lymphomaHematologic Diseases
Uveitis (eye inflammation)Ophthalmology
Rheumatoid arthritis, systemic lupus erythematosus, vasculitis
Rheumatology/Immunol
ogy
Multiple sclerosis, organ transplant, nephrotic syndrome, cerebral edemaOther

11. Side effects of prolonged pharmacological
use (Cushing syndrome)
Acne & hirsutism
Moon face &
striae
Buffalo hump