Adrenal

Question 1

Dexamethasone

Answer 1

• used for Dexamethasone suppression test

- potent inhibitor of ACTH

Question 2

Glucocorticoids

*Cortisol (hydrocortisone), *Fludrocortisone, *Prednisone, Methylprednisolone

Answer 2

Adrenal
-“-sone, -olone, -olide, -onide, -asol”
-used for Addison’s disease (adrenalcortical insufficiency)
-glucocorticoid replacement=hydrocortisone
-mineralocorticoid replacement=fludrocortisone
MOA
-anti-inflammatory
-blocks extravasation
-inhibit cytokine signaling and TCR signaling
-inhibits lipocortin
ADE
-eye: impaired corneal growth, glaucoma, cataracts
-psych: appetite, euphoria, depression, HA, seizures
-immuno: hyperglobulinemia, INC leuks, DEC lymphocytes, DEC eosinophils
-GI: ulcers, preforation, pancreatitis, DM
-CV: HTN, edema, tachycardia
-Liver: hyperlipidemia, fat redistribution
-skin: striae, impaired wound healing, pigment alterations
-bone: osteoposrosis, bone necrosis
-muscle: atrophy, asthenia, myopathy, tendon necrosis/rupture
Contraindication
-*Acquired 2’ adrenal insufficiency (most common clinical problem caused by sudden cessation of exogenous glucocorticoid therapy)
-recovery takes 6-9 months
-respiratory distress syndrome (fetal cortisol=fetal lung maturation)