Glucocorticosteroids in sport

Glucose toxicity occurs when insulin secretion is reduced by prolonged hyperglycemia. Prolonged hyperglycemia can occur due to a number of causes. The prolonged and high-dose therapeutic use of glucocorticosteroids can induce diabetes mellitus. The use of exogenous progestogens can lead to growth hormone excess. Progestogens also have an affinity for glucocorticosteroid receptors. In obese dogs, tissue receptors have decreased insulin sensitivity. This leads to a greater demand for insulin, which can result in exhaustion of the islets of Langerhans.

Glucocorticoids are potent anti-inflammatories, regardless of the inflammation's cause; their primary anti-inflammatory mechanism is lipocortin-1 (annexin-1) synthesis. Lipocortin-1 both suppresses phospholipase A2 , thereby blocking eicosanoid production, and inhibits various leukocyte inflammatory events ( epithelial adhesion , emigration , chemotaxis , phagocytosis , respiratory burst , etc.). In other words, glucocorticoids not only suppress immune response, but also inhibit the two main products of inflammation, prostaglandins and leukotrienes . They inhibit prostaglandin synthesis at the level of phospholipase A2 as well as at the level of cyclooxygenase /PGE isomerase (COX-1 and COX-2), [29] the latter effect being much like that of NSAIDs , potentiating the anti-inflammatory effect.

Two similarly-designed, randomized, double-blind, placebo-controlled studies were conducted in a total of 970 adult patients with active, mild to moderate ulcerative colitis (UC) which was defined as an Ulcerative Colitis Disease Activity Index (UCDAI of ≥ 4 and ≤ 10). Eight-hundred ninety-nine of these patients had histology consistent with active UC; this was considered the primary analysis population. UCDAI is a four-component scale (total score of 0 to 12) that encompasses the clinical assessments of stool frequency, rectal bleeding, mucosal appearance and physician's rating of disease activity (score of 0 to 3 for each of the components).

It is important for the nurse to be aware of the physiological dynamics of surgical diuresis. After a major surgical procedure that produces high physiologic and psychological stress, increased secretion of antidiuretic hormone causes fluid retention within the vascular space. As stress after surgery decreases, ADH and other hormones, such as glucocorticosteroids, begin to drop to normal values, and the fluid that was held in reserve is excreted. This increase in urine volume a few days after surgery is sometimes referred to as a surgical diuresis. It is important for nurses to consider this type of fluid retention and related increase in urine specific gravity in the immediate post-operative patient to avoid excessive fluid replacement.

Glucocorticosteroids in sport

glucocorticosteroids in sport

It is important for the nurse to be aware of the physiological dynamics of surgical diuresis. After a major surgical procedure that produces high physiologic and psychological stress, increased secretion of antidiuretic hormone causes fluid retention within the vascular space. As stress after surgery decreases, ADH and other hormones, such as glucocorticosteroids, begin to drop to normal values, and the fluid that was held in reserve is excreted. This increase in urine volume a few days after surgery is sometimes referred to as a surgical diuresis. It is important for nurses to consider this type of fluid retention and related increase in urine specific gravity in the immediate post-operative patient to avoid excessive fluid replacement.

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