What are the physiologic effects of glucocorticoids relative to adrenal crisis?

Updated: Oct 11, 2018
  • Author: Kevin M Klauer, DO, EJD, FACEP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Glucocorticoids are nonspecific cardiac stimulants that activate release of vasoactive substances. In the absence of corticosteroids, stress results in hypotension, shock, and death. Glucocorticoids act as follows to:

  • Stimulate gluconeogenesis and decrease cellular glucose use

  • Mobilize amino acids and fatty acids

  • Inhibit the effects of insulin

  • Give rise to ketone bodies in metabolism (ketogenesis)

  • Elevate RBC and platelet levels

  • Exhibit anti-inflammatory effects, including the following:

    • Maintenance of normal vascular response to vasoconstrictors

    • Opposition to increases in capillary permeability

    • Inhibition of interleukin-2 (IL-2) production by macrophages

    • Stimulation of polymorphonuclear neutrophil (PMN) leukocytosis

    • Reduction of adherence of macrophages to endothelium

    • Depletion of circulating eosinophils and lymphocytes

    • Reduction of circulating lymphocytes (primarily T cells)


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