Anabolic steroid - PowerPoint PPT Presentation

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Title:

Anabolic steroid

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Glucocorticoids. Pathology. Pharmacology . . . Addison disease. Cushing Syndrome – PowerPoint PPT presentation

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Title: Anabolic steroid


1
(No Transcript)
2
Anabolic steroid
  • ????? ?? ????? ??????????? ???????? ?????????
    ?????? ?? ????
  • ?? ???? ????? ????? ????? ?????? ???? ?????? ???
    ?? ????
  • ???? ?????? LDL ? ???? HDL ?? ????
  • ????? ?????? ??????? ?? ????? ???? ???
  • ????? ????? (hypomania , aggressiveness)

3
????? ?????? ?? ?? ?????? ??
????? ??? ?? ???? ??? ??? ???
???? ????????? ???? ?????
???? ??? ????? ??? ???
???? ?????
4
????? ????? ?? ??????
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????
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???? ??? ????? ???? ? ???
????? ??? ??? - ???? ??????
??????? ???
5
??????? ???? ?????????
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?? ?????????? ???????????
???????? ??? ????????? ??????????? ?????????
6
????? ????? ?? ??????
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???? ???????????
???? ????????????
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??? ?? ????
??????????
7
???????? ?? ???? ?????????? ?? ????
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8
????? ????? ???
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?????? 17- ???? ??????
??? ?? ??? ?? ????? ??? ?? ?? ???
???? ???? ?? ???? ? ?????
??????
?????? LDL ???? HDL
9
(No Transcript)
10
???? ???? ?????? ?????????
?? ???? ?????? ?????? ?????? ??? ???? ?????
????? ????? ?? ??? ?????? ? ??? ?? ???? ?? ?????
?????? ?? ????? ????? ????? ?? ???.
11
(No Transcript)
12
????? ????
??? ????? ??? ?????
?????
  • ?????? ?????? ?? ???????
  • ???? HDL ? ?????? LDL
  • ????? ?? ?????????

?????????
13
Contraceptives Oral - parenteral - implanted
14
???? ?????
  • ????? ????? ??? ????? ??? ????? ? ??? ??????
    ????? ??????? ????????? ?? ??? ???? ?? ?????
    ??????? ?? ?????? ??? ???? ?? HRT ????? ???.

15
????? ????????????? ??????
16
(No Transcript)
17
????? ???????? ? ????? ???? ?? ??
18
????? ???????? ? ????? ???? ?? ??
19
????? ????? ??????? ??????
?????
progestin
20
????? ????? ?????????
?????? ???
????? ?????????
???? ? ?????????
????? ?????? ?? ???????
21
????? ????? ?????????
???? - ???? ???????
???? ??? ?????? ? ????
????
?????
22
????? ????? ????
??? ????
?????? ?????? ????? ??? ????????? ????
???????
23
????? ?????? (???? ??? ??????????)
  • ???? ????????
  • (???? ?????-??? ????? - ??????????)
  • ??????? ????? ????? ???????? ????
  • (??????????? - ??? ?????)

24
????? ?????? (???? ??? ??????)
  • ??????? ?? ??????? ??????
  • ??????? ?? ???????
  • ???????
  • ???????????

25
????? ?????? (?????? ???? ??????)
  • ???????????
  • ?????????????????
  • ??????? ?? ??????? ?? ???? ??

26
(No Transcript)
27
??????????
  • ??????? ????? ??????? ???
  • ????? ??????? ??? ?? ??
  • ??? ?????? ???? ??? ??????? ? ???? ???
  • ?????? ??? ????? ??? ?????? ?? ???????(????)
  • ?????? ?????? ?? ???????

28
??????????
1) ???? ???? ??????? (????? 70mg/dl) 2) ????
????????? ????? ????? ???????? ????????
?????????? ???????? 3) ???? ??? ????? ??????
????? ????? ?????? ???? ??? ??? ????
?????? 4) ?? ?????????? ???? ?? ?? ????? ???
??? ?????- ?????? ??? ??? ???? ?????? ????
??? ??? ???????
29
??? ??????????
????? ????? ????? ????? ?????????
25 ?? 50 ???? ???? ????? 50
?? ????? ????? ?????? ?????
30
???????? ???? ?? ??????????
  • ?? ???? ????? ????????? ?????????? ?????? ?????.
  • ????? ?????????? ?? ??? ??
  • (??? ???? ????? - ????? ??????? - ????? ????????)

31
?????????? ???????
  • ?? ???? ??? ???????? ??????? ?????? ???
  • Post-hypoglycaemic hyperglycaemia
  • ?????? ???? ????????? ?????? ?????
  • Somogyi phenomenon
  • ????? ??????? ?? dawn phenomenon

32
Refractory obesity insulin resistance
metformin
0.5 - 2.5 g /d
?? ?????? ?? ????? ?? ???????? ???? ??? ????? ??
??? ???????? ?????? ????? ?????? ?? ???
??? ???? ?? ??????? ???? ? ????
33
?????? ??? ?? ????? ???????? ???? ??
  1. ?????????? ??????? ????? ???????? ???? ??
  2. ?????? ?? ??????? ???? ? ???
  3. ???? ????? ?????? ???????? ???????? ???? ?? ?
    ???????????? ? ????????
  4. ????? ??????? ?? ????? ????? ? ???? ?????
  5. ????? ?????? ?? ??????? ????? ????? ?? ???????
    ???? ? ??????? ???? ?? ??????

34
Pioglitazone
???? ?????? ?? ??????? ?? ?????
???? ???? ??? ? ?????? ???? ??? ????
??? ???? ??? ??? ??? ?? ?????
?????? ??? ???? - ?????
35
Acarbose
???? ??? ????? ?????? ??? ?? ??? ?? ????? ??? 1 ?
????? ??? 2
????? ?????? ?? ???
?????? ???? ???? ?????
?? ?????????? ???? ?? ??????? ???? ????? ?????
???
36
(No Transcript)
37
Glucocorticoids
  • Physiology

????? ????? ??????? ???? ????? ????? ???? ????
?????? ?????? ???? ???
38
HPA axis
???????????
CRH
????? ???????????????
???????
???????????????
ACTH
??????
39
1) ????? ?? ??? ??? ??? ????? ???? ????? ?? ???.
2) ?? ????? ??? ?? 2 ?? 3 ???? ????? ???? ?????
????? ???? ????.
3) ??? ??????? ??? ?? ???? ?????? ???? ???? ?????
??????? ?????? ??????.
4) ??? ?????? ?? ??? ??????? ?? ??? ?? ???????
?????? ?????? ??? ??????.
40
Glucocorticoids
  • Pathology

Cushing Syndrome
Addison disease
41
????? ? ?????
?? ??????
?? ??????
?????????????
????? ?? ?????????????????
????? ?????
??? ? ????
???
????
???????
?????
?????????
CNS HPA axis
42
????? ? ?????
?? ??????
?? ??????
?????????????
????? ?? ?????????????????
????? ?? ?? ?? ????
?????????
CNS HPA axis
43
????? ????? ?? ?? ??? ????
  • ????? ???????
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  • ???? ?????
  • ????????? ???
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  • ????? ?? ?????
  • ??? ???? ?? ?????
  • ???? ????? ??????

44
????? ????? ??? ??? ?? ??? ???
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  • ?????????
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  • ????????
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  • ???????? ???? ???

45
????? ????? ?????????????????
  • ???? ????? ??? ???????

???? ?????? ????
????? ?? ????? ???
46
????? ????? ?????????????????
  • ????? ?? ???? ????????? ?????? ?? ???? ???????
    ???? ???? 15 ???? ?? ????? ???? ?? ???.
  • ???
  • ?????? ??? ??? ??????? ??????? ???? ?????
  • ???? ???? ????? ??? ?? ?? ??? ????? ?? ??? ? ??
    ?? ???? ??? ?? ??? ???? ????? ????
  • ???? ?????? ?????? ??? ???? ??????? ??????
  • ???? ?????? ??? ??????? ??? ????? ??????? ?????

47
?????? ? ??? ???? ?? ?? ????? ??????????????????
????? ????? ??? ???
48
?????? ? ?????? ?? ?? ????? ??????????????????
????? ????? ??? ???
49
Steroid rosacea.
50
??????? ?????? ??? ????? ???? ???? ?? ???? ??
??????????????? ???
51
???????? ?? ????? ?????? ? ?? ??? ??????? ?? ???
????? ???? ?? ????
  • Agents Affecting Calcification and Bone Turnover

52
???????? ?????
2 ?? 2/1 ???? ??
???? ???
?????????? ???????? ??????? ????????????? ???????
????? ??????
53
????? ???? ?????????
1) ??? ??????? ? ????? ? ?? ?????? 2) ????
?????????????? 3) ??????? ??????? ???? 4)
??????? ??????? 5) ?????? ??? ??????? ??? ????
54
?????
55
??????????
1) ?????????????????? 2( ???????? 3)
????????????? D 4) ?????
-Sarcoidosis -Thyrotocxicosis -Milk alkali
syndrome -Adrenal insufficiency -Immobilization
56
????? ??????????
?? ??? ??????? ?????????? Serum normal saline
6-8L/d frusmide
??????? ???? ?? ????? ????????? ?????????????????
?? ??????? ?? ???? ????? - ????? - ???????????
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