Plasma steroid levels

Monteiro, P.R.R., Reis-Henriques, M.A., and Coimbra, J. (2000a). Plasma steroid levels in female flounder (Platichthys flesus) after chronic dietary exposure to single polycyclic aromatic hydrocarbons. Marine Environmental Research 49, 453 67. 

Glucocorticoids are available in a wide range of preparations, so that they can be administered parenterally, orally, topically, or by inhalation. Obviously the oral route is preferred for prolonged therapy. However, parenteral administration is required in certain circumstances. Intramuscular injection of a water-soluble ester (phosphate or succinate) formed by esterification of the C21 steroid alcohol produces peak plasma steroid levels within 1 hour. Such preparations are useful in emergencies. By contrast, acetate and tertiary butylacetate esters must be injected locally as suspensions and are slowly absorbed from the injection site, which prolongs their effectiveness to approximately 8 hours. 

HRT (hormone replacement therapy) administration of estrogens to women or androgens to men who, due to menopause or age, have decreased levels of these plasma steroids. 

Endocrine effects Statins interfere with cholesterol synthesis and lower circulating cholesterol levels and, as such, might theoretically blunt adrenal or gonadal steroid hormone production. Small declines in total testosterone with no commensurate elevation in LH have been noted with the use of fluvastatin. Pravastatin showed inconsistent results with regard to possible effects on basal steroid hormone levels atorvastatin, lovastatin, rosuvastatin, and simvastatin did not reduce basal plasma cortisol concentration or basal plasma testosterone concentration or impair adrenal reserve. Appropriately evaluate patients who display clinical evidence of endocrine dysfunction. Exercise caution when administering HMG-CoA reductase inhibitors with drugs that affect steroid levels or activity, such as ketoconazole, spironolactone, and cimetidine. 

Drug/Lab test interactions Plasma corticosteroid levels may be increased. Urinary steroid determinations may be altered by amphetamines. 

Metyrapone is a competitive inhibitor of 11 beta hydroxylation in the adrenal cortex, and effectively inhibits cortisol production. It is used in low doses, titrated to achieve plasma cortisol levels as close as possible to normal day-time values. Occasionally it is used in higher doses combined with replacement corticosteroid treatment. Its main side effects relate to overdosage and resulting hypoadrenalism, but it can also cause hirsutism and hypertension, due to accumulation of precursor steroids. Ketoconazole is also sometimes used to suppress adrenal steroid production, but its potential for hepatotoxicity limits its... 

Munkittrick KR, Van der Kraak GJ, McMaster ME, Portt CB, van den Heuvel MR, Servos MR. 1994. Survey of receiving water environmental impacts associated with discharges from pulp mills. II gonad size, liver size, hepatic EROD activity and plasma sex steroid levels in white sucker. Environ Toxicol Chem 13 1089-1102. 

The usefulness of plasma cortisol measurements and urinary steroid levels is restricted because of the rapid fluctuations in hormone levels in blood and the possible important variations within different groups of urinary steroids which cannot be detected when only total excretion is measured. 

Adrenal failure has been reported more than one year after withdrawal of steroid treatment. A preoperative test to detect patients who will fail to respond to surgery is important. The adrenal may be stimulated by injections of ACTH or synthetic analogs with measurement of changes in plasma cortisol levels (M4). This test, however, only gives information about the adrenal capacity to secrete and tells nothing of the ability of the pituitary adrenal axis to respond to stress. 

Allergic reactions should be treated appropriately with supportive care, maintenance of airway, breathing, and circulation, and antihistamines plus steroids as needed. Discontinue potassium iodide administration and provide symptomatic and supportive care. The extent of iodide adsorption to activated charcoal has not been determined. Plasma iodide levels do not guide therapy the potassium level should be checked. 

Rates of hepatic synthesis of many plasma proteins are affected by a patient s endocrine status. The effects of some steroid hormones on individual plasma protein levels are given in Table 20-5. The plasma protein levels characteristic of a specific disease may therefore be complicated by the steroid status of a patient and by an inflammatory acute phase reaction. The abnormal steroid status may be the result of an intrinsic hormonal disorder or of treatment with steroid hormones, as in inflammation. 

Munkittrick, D.R., M.E. McMaster, C.B. Portt, G.J. Van Der Kraak, I.R. Smith and D.G. Dixon. Changes in maturity, plasma sex steroid levels, hepatic mixed function oxygenase activity, and the presence of external lesions in lake whitefish (Coregonus clupeaformis) exposed to bleached Kraft mill effluent. Can. J. Fish Aquat. Sci. 49 1560-1569, 1992. 

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