Corticoids, Urinary

The answer is e. (Katzung, p 672. Hardman, pp 1477—1978.) Fludrocortisone is a synthetic steroid compound that exhibits profound mineralo-corticoid activity and some glucocorticoid activity Electrolyte and water metabolisms are affected by the administration of this compound. Fludrocortisone promotes the reabsorption of Na and the urinary excretion of K and hydrogen ions in the collecting duct of the nephron. The drug is indicated for mineralocorticoid replacement therapy in primary" adrenal insufficiency... 

After metyrapone administration, a patient with a disease of pituitary origin cannot achieve a compensatory increase in the urinary excretion of 17-hydroxycorti-costeroids or 11-deoxysteroids. Moreover, if pituitary corticotrophin is suppressed by an autonomously secreting adrenal carcinoma, there will be no increase in response to metyrapone. On the other hand, if pituitary corticotrophin secretion is maintained, as occurs in adrenal hyperplasia, the inhibition of corticoid synthesis produced by metyrapone will stimulate corticotrophin secretion and the release of metabohtes of precursor urinary steroids, which can be measured as 17-hydroxycortico-steroids. Metyrapone is now used less frequently in the differential diagnosis of Cushing s syndrome because of the ability to measure plasma corticotrophin directly. 

Urinary corticoid measurements (in 17-24 h, but not short-term samples) can be used to assess adrenocortical function as alternatives to blood sampling techniques (Hilfenhaus 1977). The use of urinary measurements over a timed period may provide a better indication of corticosteroid metabolism in contrast to the fluctuations observed in plasma measurements. Although some reports in the literature use randomly collected urine for veterinary clinical diagnosis, these measurements are not suitable for toxicological studies. Older methods for urinary 17-hydroxycorticoster-oids have been replaced by cortisol or corticosterone measurements. 

Effect on Protein Metabolism, Corticoid hormones affect various steps of protein metabolism amino acid penetration in the cells, intracellular biosynthesis of amino acids from small precursors, protein synthesis, and protein catabolism. In discussing the effect of corticoid hormones on protein synthesis, it is necessary to distinguish between the effects of the glucocorticoid on muscle and liver. The injection of Cl 1-oxygenated corticosteroid increases the excretion of urinary nitrogen, with loss of tissue nitrogen (e.g., in heart and kidney) [51]. 

Thirteen urinary anabolics and corticoids (e.g., cortisone, 11-ketotestosterone, hydroxyprogesterone, epitestosterone, androstenolone) and synthetic anabolics (bolderone, bolasterone) were extracted from urine and analyzed on a C g column X = 200 nm) and 245 nm) using a 60/40 water/acetonitrile mobile phase [1507]. Baseline resolution was not achieved for all compounds and elution was complete in 24 min. Calibration data for each compound were generated from 2 to 10 (ig/mL. Detection limits were reported as 0.05 (ig/mL. It is interesting to note that the authors used an optimization triangle approach to maximize resolution and minimize analysis time. For 10 of the compounds, a <20 min analysis was achieved using a 56.7/20/13.3/10 water/methanol/acetonitrile/THF mobile phase. 

Standardization and Application of Hormone Assays. 8. Gas Chromatographic Assay of Urinary Corticoids Rinsho Byori 19(5) 341-342 (1971) ... 

The following procedures are thought to measure corticoid function in adrenalectomized animals the rat growth assay of Grollman (13), the muscle fatigue test of Everse and de Fremery (10,11), the determination of blood urea (42) and sodium retention in dogs (54,55), the measurement of sodium retention in rats (28), and the determination of the urinary ratio of the radioactive electrolytes Na and in the rat (49). Many other tests have been described for the measurement of similar activities. 

The role that cyclic nucleotides may play in the etiology and/or maintenance of a number of disease states is becoming clearer. In asthma, the ability of patients with this disease to excrete increased amounts of cyclic AMP in urine in response to epinephrine is greatly diminished, possibly due to a disease-related decrease in the sensitivity of adenylyl cyclase (AC) to the catecholamine. This lack of AC sensitivity however could be reversed by corticoid therapy in accord with the long established permissive effects of these hormones on cyclic AMP synthesis. In nephrogenic diabetes insipidus, diminished urinary production of cyclic AMP in response to ADH was also reported. Other conditions that may involve deficient cyclic AMP production include hypertension , psoriasis and stroke . On the other hand, cyclic AMP production appears... 

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