Glucocorticoids

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Today I made up a mnemonic for remembering the effects of excessive glucocorticoids: 

"Grossly Fat Pigs Can Never Ice-skate Harmlessly"

Cows however.... 


  • Grossly  Glucose - reduced glucose uptake by cells and increased gluconeogenesis leads to relatively high blood glucose, which leads to increased insulin secretion and glycogen production. This may cause diabetes. 
  • Fat - Fat - Fat is redistributed to the abdomen and face (moon face) and the back of the neck (buffalo hump)
  • Pigs - Protein - there is increased protein breakdown and decreased buildup leading to muscle wasting. 
  • Can - Calcium - increased osteoclastic activity and reduced osteoblast activity leads to osteoporosis. There is also reduced absorption in the gut and increased secretion by the kidneys. 
  • Never - Negative feedback - causes negative feedback on ACTH(unless increased ACTH is the primary cause) - synthetic glucocorticoids may lead to a reduced production of endogenous glucocorticoids 
  • Ice Skate - Inflammation supression - reduces both acute and chronic inflammation and scarring. Also affects blood vessesls. 
  • Harmlessly- Healing - this also affects healing- patients have poor wound healing, thin skin, easy bruising and may have avascular necrosis of the femoral head due to its effects on blood vessels. 
  • Other side effects of synthetic glucocorticoids include hypertension, euphoria or depression, cataracts, benign intracranial hypertension, hypercoagulability, menstural disorders, and oral thrush.. I haven't figured out how to include these in yet. 
Also cushing's syndrome refers to the symptoms seen in patients with prolonged exposure to excessive corticosteroids (may be endogenous or exogenous and caused by problems of the pituitary or the adrenal gland itself), whereas cushing's disease refers to disease of the pituitary gland leading to excessive adenocorticotrophic hormone production causing excessive cortisol. 

References:
http://www.patient.co.uk/doctor/cushings-syndrome
Kumar and Clark's clinical medicine

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