_

_
(ALDO INCREASES
EC FLUID VOLUME)

( physioweb.med.uvm.edu)

THE ADRENAL GLAND: CORTISOL

CORTISOL

Glukokortikoid
Biosintesis kortisol
ACTH
ACTH +R mengaktifkan adenil
siklase AMP intrasel
mengaktifkan protein kinase A
fosforilasi kolestril ester hidrolase
menjadi kolesterol bebas

Efek Glukokortikoid
Efek fisiologik

Efek Farmakologik

$ Efek Metabolik
- Glukoneogenesis
- proteolisis
- lipolisis
$ Efek Permisif

$ Efek antiinflamasi

(Fisiologi
ganong,,,Fisiologi
sheerwood)

Glukokortikoid
Efek:
Merangsag glukoneogenesis hati
kadar glukosa darah
Menghambat penyerapan &
penggunaan glukosa olh bnyk jar, kec
otak
Merangsang penguraian protein
lipolisis di jar adiposa as lemak
darah
jmlh eosinofil dlm darah dg
sekuestrasinya di limpa & paru

 hitung limfosit dlm darah dg

menghambat aktivitas mitosis limfosit

Mekanisme kerja:
Glukokortikoid + R transkripsi DNA
translasi mRNA sintesis enzim yg
menubah fungsi sel

CORTISOL AND
FOODSTUFF METABOLISM

Physioweb.med.uv
m.edu

Efek yang LAin

Target Sistem

Spesific Target

Physiologic
Function

S. Imun

Monosit

Menghambat
proliferasi

Skin n
Connective
Tissue
Cardivascular

Antiproliferatif
for fibroblast
Heart

Increased
Contractility
(Basic n Clinical
endrocrinology

CORTISOL
EFFECTS OF DEFICIT.
1. Cells/Organs/Systems cannot respond to external signals/stresses.
Examples: cardiovascular system cannot respond to exercise; kidney
cannot respond to a water load or dehydration; liver cannot respond to
epinephrine. Any major stress to the body can lead to death.
EFFECTS OF EXCESS.
1. Suppression of Immune and inflammatory reactions.
2. Breakdown of Connective Tissue and Bone.
3. Metabolism (see below): increased incidence of Diabetes Mellitus.
4. Excess can have mineralocorticoid effects on electrolytes (due to
structural similarities between cortisol and aldosterone).
EFFECTS ON FOODSTUFF METABOLISM.
Carbohydrate
Increased gluconeogenesis from protein
Reduced glucose uptake by muscle
Increased appetite

Fat
Peripheral mobilizatoion
Central (axial) deposition
(Buffalo Hump)
Increased appetite: body weight/
Fat increases

Protein
Increased muscle protein breakdown: muscle wasting
Increased synthesis of liver gluconeogenic enzymes
(e.g. transaminases)
Overall
Unmasking of Diabetes Mellitus

www.medicalstu
dent.com

Pengaturan sekresi
Glukokortikoid
Stress

Irama diurnal

(-) Hipotalamus
(CRH)
(-) H. Anterior
(ACTH)

Glukosa drh

As.amino drh
Korteks Adrenal
Kortisol
As.lmk drh

Fisiologi Sheerwood

DAILY SECRETION: CORTISOL

Pulsatile signals from pituitary
Diurnal changes in the feedback SET POINT

www.medicalstudent.c
om
Physioweb.med.uvm.e

MECHANISM OF ACTION: CORTISOL