252 Pharmacology - Adrenal Drugs

Question 1

Addison’s disease

Answer 1

A potentially life-threatening condition caused by partial or complete failure of adrenocortical function, with resulting decrease in glucocorticoid, mineralocorticoid, and androgenic hormones; a chronic disease of hyposecretion of steroids.

Question 2

Adrenal cortex

Answer 2

The outer portion of the adrenal gland.

Question 3

Adrenal crisis

Answer 3

An acute, life-threatening state of profound adrenocortical insufficiency requiring immediate medical management; characterized by glucocorticoid deficiency, a drop in extracellular fluid volume, hyponatremia, and hyperkalemia.

Question 4

Adrenal medulla

Answer 4

The inner portion of the adrenal gland.

Question 5

Aldosterone

Answer 5

A mineralocorticoid steroid hormone produced by the adrenal cortex that regulates sodium and potassium balance.

Question 6

corticosteroids

Answer 6

Any of the natural or synthetic adrenocortical hormones, including those produced by the cortex of the adrenal gland (adrenocorticosteroids).

Question 7

Cushing’s syndrome

Answer 7

A metabolic disorder characterized by abnormally increased secretion of the adrenocorticosteroids.

Question 8

Epinephrine

Answer 8

An endogenous hormone secreted into the bloodstream by the adrenal medulla; also a synthetic drug that is an adrenergic vasoconstrictor and also increases cardiac output.

Question 9

Glucocorticoids

Answer 9

A major group of corticosteroid hormones that regulate carbohydrate, protein, and lipid metabolism and inhibit the release of adrenocorticotropic hormone (corticotropin).

Question 10

Hypothalamic-pituitary-adrenal (HPA) axis

Answer 10

A negative feedback system involved in regulating the release of corticotropin-releasing hormone by the hypothalamus, adrenocorticotropic hormone (corticotropin) by the pituitary gland, and corticosteroids by the adrenal glands. Suppression of the HPA may lead to Addison’s disease and possible adrenal crisis or addisonian crisis; this suppression results from chronic disease or exogenous sources, such as long-term glucocorticoid therapy.

Question 11

Mineralocorticoids

Answer 11

A major group of corticosteroid hormones that regulate electrolyte and water balance; in humans, the primary mineralocorticoid is aldosterone.

Question 12

Norepinephrine

Answer 12

An adrenergic hormone, also secreted by the adrenal medulla, that increases blood pressure by causing vasoconstriction but does not appreciably affect cardiac output; the immediate metabolic precursor to epinephrine.

Question 13

What does the adrenal medulla secrete?

Answer 13

Catecholamines

• Epinephrine
• Norepinephrine

Question 14

What does the adrenal cortex secrete?

Answer 14

Corticosteroids

• Glucocorticoids
• Mineralocorticoids (primarily aldosterone)

Question 15

What does over secretion of adrenocortical hormones lead to?

Answer 15

Cushing’s syndrome

Question 16

What does under secretion of adrenocortical hormones lead to?

Answer 16

Addison’s Disease

Question 17

What are the adverse effects of of glucocorticoids on the CVS?

Answer 17

• Cardiovascular system: heart failure, cardiac edema, hypertension—all caused by electrolyte imbalances (hypokalemia, hypernatremia), impaired glucose tolerance, dysrhythmias, bradycardia, pulmonary edema, syncope, vasculitis

Question 18

What are the adverse effects of of glucocorticoids on the CNS?

Answer 18

• convulsions, headache, vertigo, mood swings, nervousness, aggressive behaviours, psychotic symptoms, neuritis, peripheral neuropathy, paresthesia, arachnoiditis, meningitis, insomnia

Question 19

What are the adverse effects of of glucocorticoids on the endocrine system?

Answer 19

• growth suppression, Cushing’s syndrome, menstrual irregularities, carbohydrate intolerance, hyperglycemia, hypothalamic–pituitary–adrenal axis suppression, hirsutism, hypertrichosis, glycosuria

Question 20

What are the adverse effects of of glucocorticoids on the GI system?

Answer 20

peptic ulcers, pancreatitis, ulcerative esophagitis, abdominal distension

Question 21

What are the adverse effects of of glucocorticoids on the integumentary system?

Answer 21

• fragile skin, petechiae, ecchymosis, facial erythema, poor wound healing, urticarial, hypersensitivity reactions, acne, dry skin, skin hyperpigmentation, skin striae

Question 22

What are the adverse effects of of glucocorticoids on the MSK system?

Answer 22

• myopathy, muscle weakness, loss of muscle mass, osteoporosis, osteonecrosis of femoral and humeral heads, pathological fracture, malaise

Question 23

What are the adverse effects of of glucocorticoids on the ocular system?

Answer 23

increased intraocular pressure, glaucoma, cataracts

Question 24

What are other non-system specific effects of glucocorticoids?

Answer 24

• weight gain, leukocytosis, opportunistic infections, hypokalemia alkalosis, impaired healing

Question 25

In which systemic infection might corticosteroids still be used?

Answer 25

Tuberculous meningitis