13.1. ADRENOCORTICOSTEROIDS
Endocrine disorders are treated with the following drugs:
• natural hormone drugs;
• synthetic hormone analogs;
• hormone substitutes (substances with hormone-like action);
• hormone antagonists (hormone-specific receptor blockers, antihormones).
General principles for use of hormone-active drugs go as follows.
• Substitution therapy means administration of an exogenous hormone drug or its analog [insulin therapy in diabetes, maintenance doses of glucocorticoids (GCs) for induced adrenal cortex atrophy]. Substitution therapy is used to treat insufficient endogenous hormone production.
• Stimulation of peripheral gland function means administration of drugs containing tropic hormones of the anterior pituitary (corticotrophin for adrenal cortex atrophy); use of specific receptor blockers of the pi-tuitary-hypothalamic system (Clomiphene foranovulation infertility). A block of central endocrine gland receptors leads to activation of releasing hormone production by the hypothalamus, and tropic hormones production by the anterior pituitary.
• Inhibition of peripheral gland function is suppression of hormone synthesis directly in the gland in case of its hyperfunction (Thiamazole for hyperthyroidism); inhibition of the endocrine gland function in case of tumor growth (androgen receptor antagonist Flutamide), stimulation of specific receptors of the pituitary-hypothalamic system (combined oral contraceptives). Stimulation of receptors in central endocrine glands leads to inhibition of releasing hormone production by the hypothalamus and tropic hormones production by the anterior pituitary.
Steroid hormones include adrenocortical hormones (GCs and mineralocorticoids) as well as female and male sex hormones. All these hormones are physiologically active substances, derivatives of cyclopentanoperhy-drophenanthrene. The precursor of all steroid hormones in the human body is pregnenolone synthetized from cholesterol. The adrenal glands are paired organs located atthe upper pole of each kidney and consisting of the outer cortex and inner medulla which produces