1. Mineralocorticoids such as aldosterone act on minerals like sodium and potassium, regulating their levels in the body. 2. Aldosterone is synthesized in and released from the zona glomerulosa of the adrenal cortex, regulated by factors like angiotensin. 3. It increases sodium reabsorption and potassium excretion, maintaining fluid volume and blood pressure levels. Imbalances can cause issues like hypokalemia or hypertension.

1. RIDA BATOOL
SHEHZADI SANA
IRAM HAROON
AYESHA SADIQQA
Basic and Clinical Pharmacology Katzung 13E
Lippincott Illustrated Reviews, Pharmacology
Reference:

2. CORTICOSTEROIDS
MINERALOCORTICOIDS

3. GENERAL REVIEW OF CORTICOSTEROIDS
• Hormones of adrenal cortex are called
corticosteroids or corticoids.
• CORTICO – related to adrenal cortex
• STEROIDS – related to steroidal nucleus.

4. ANATOMY OF ADRENAL GLANDS

5. FUNCTIONAL ANATOMY OF ADRENAL GLANDS
• Body has 2 adrenal glands , also called
SUPRARENAL GLANDS.
• These have 2 Parts
- Adrenal cortex
- Adrenal medulla
CORTICOSTEROIDS are related to Adrenal
CORTEX

6. ANATOMY OF ADRENAL CORTEX

7. HORMONES OF ADRENAL CORTEX
Adrenal cortex hormones are classified into three groups.
Mineralocorticoids
-cortisol
–corticosterone
–cortisone
Glucocorticoids
-aldosterone
-deoxycorticosterone
Androgens
-dehydroepiandrosterone (DHEA)
-androstenedione
-testosterone

8. HORMONES OF ADRENAL CORTEX

10. INTRODUCTION
• Mineralocorticoids are the corticosteroids that act
on MINERALS(electrolytes) ,particularly
* SODIUM (Na+ )
*POTASSIUM ( K+ )

11. SYNTHESIS and REGULATION
SYNTHESIS
Aldosterone is
synthesized
and release from
zona glomerulosa
of adrenal cortex

12. SYNTHESIS and REGULATION
REGULATION OF SECRETION
Aldosterone secretion is regulated by 4 main factors

13. ACTH plays
insufficient role in
regulating the
aldosterone
secretion.
Other factors like ,
Angiotensin are
able to maintain or
regulate its
secretion.
(ref. BC Pharmacology by
Katzung pg. 708 and
Lippincott Pharmacology)

15. MECHANASIM OF ACTION
• Aldosterone acts through mRNA mechanism
• Its receptors are cytoplasmic.
• It binds to its specific receptors , Hsp90 releases
• Receptor-steroid complex forms dimer and
enters the nucleus
• Binds to response element (MRE) and regulate
transcription and translation
• Synthesized protein are in the form of enzymes
i.e. Sodium/Potassium ATPase and increase
expression of epithelial sodium channel (ENaC).

16. MECHANASIM OF ACTION

17. PHARMACOKINETICS
• Synthesized in body and injected in tracer
quantities.
• Binds to albumin in Plasma
• Half life is 15-20 minutes
• Degraded by liver and conjugated to form
glucoronides
• Excretion via urine

18. PHARMACODYANMICS
• ALDOSTERONE Has following actions
• LIFE SAVING HORMONE
-maintains osmolarity and volume of ECF
-without it, death occurs within weeks
- has 3 important function
*reabsorption of sodium
*excretion of potassium
* secretion of hydrogen ions

19. PHARMACODYANMICS
• Effect on sodium ion :
Increases sodium reabsorption , during
hyper secretion of aldosterone , the
loss of sodium is less but in hypo
secretion , excretion of sodium
increases and resulting in
hypernatriuria

20. PHARMACODYANMICS
• Effect on ECF:
Along with sodium ion , 2 molecules of water
are reabsorbed which result in an increase in
ECF volume.
But still mild hypernatremia occurs
It induces thirst, leading to intake of water
again.. IT will lead to increase ECF and blood
volume.

21. PHARMACODYANMICS
• Effect on blood pressure:

22. PHARMACODYANMICS
• Effect on Potassium ions:
Aldosterone results in excretion of potassium
from body , it will result in HYPOKALEMIA
and muscle weakness
HYPERKALEMIA is also very dangerous
condition, may lead to cardiac Toxicity ……
arrhythmias….. Cardiac collapse and then
DEATH .

24. PHARMACODYANMICS
• EFFECT ON HYDROGEN IONS:
In order to keep electrolyte imbalance ,
aldosterone causes tubular secretion of
hydrogen ions ,
Excreted in exchange of Sodium ions
Helps to maintain acid-base balance in body
In hyper secretion, causes alkalosis and in
hypo secretion , causes acidosis

25. PHARMACODYANMICS
• EFFECT ON OTHER ORGANS :
• Prevents sodium loss via salivary and sweat
glands
• Prevent loss of sodium through feces.
• Hypo secretion of aldosterone may lead to
diarrhea with sodium and water loss

26. CLINICAL INDICATION
MINERALOCORTICOIDS clinical indications are:
 Aldosterone and DOC (precursor of aldosterone)
help to maintain acid-base balance and use in
acidosis.
 Use to treat hypotension
 FLUDROCORTISONE, a potent steroid has potent
salt retaining activity and used to treat
adrenocortical insufficiency related to
mineralocorticoid deficiency
 Use in a treatment of hyperkalemia

27. ADVERSE EFFECTS
HYPERSECRETION :
 Hyperaldosteronism : Primary
hyperaldosteronism or Conn syndrome…..
Occurs due to tumor on zona glomerulosa
Secondary hyperaldosteronism occurs due to
.. CHF, Nephrosis and toxemia of pregnancy
 HYPOKALEMIA: hypokalemia
 will lead to muscle weakness

28. ADVERSE EFFECTS
 HYPERTENSION: Occurs due to increase in ECF ,Blood
volume, cardiac output ..
Cardiac output IS directly
proportional to BP
 ALKALOSIS
 ADDISON Disease
 PERIPHERAL EDEMA

29. ADVERSE EFFECTS
• HYPOSECRETION :
 Hyperkalemia
 Acidosis
 Hypotension
 Electrolyte imbalance
 Cardiac arrhythmias

30. ANTAGONISTS
Ref: BC Pharmacology 12E (chapter 15)

31. ANTAGONISTS

32. THE END