adrenal agents

Question 1

is cortisol or cortisone active?

Answer 1

cortisol

Question 2

does cortisol or cortisone bind to NEITHER MR or GR?

Answer 2

cortisone

Question 3

how are corticosteroids typically dosed?

Answer 3

2/3 dose in AM, 1/3 in PM to mimic circadian rhythm

Question 4

↓ CRH ↑ACTH, high dose dexamethasone suppression test shows 50% reduction in cortisol - which type of Cushing’s?

Answer 4

pituitary hypersecretion of ACTH

Question 5

high dose dexamethasone suppression test shows NO reduction in cortisol - which type of Cushing’s?

Answer 5

can be adrenal adenoma or ectopic ACTH production

Question 6

how to differentiate between adrenal adenoma or ectopic ACTH production?

Answer 6

adrenal adenoma: decr levels of CRH and ACTH

ectopic ACTH production: decr CRH, elevated ACTH

Question 7

fluticasone should be administered with _________to reduce desensitization of receptors and increase expression of receptors

Answer 7

beta 2 agonists

Question 8

what sort of patients require decr dosages of glucocorticoids?

Answer 8

1. liver disease2. chronic inflammatory disease(both decr serum proteins)

Question 9

what is the potential systemic adverse effects of glucocorticoids associated with children?

Answer 9

impaired growth

Question 10

for how long does HPA axis suppression last after glucocorticoids are stopped?

Answer 10

up to 12 months

Question 11

what is an antifungal that can be used to tx Cushing’s?

Answer 11

ketoconazole

Question 12

↓ CRH ↓ACTH, high dose dexamethasone suppression test =no reduction in cortisol - which type of cushings?

Answer 12

Adrenal adenoma

Question 13

↓ CRH ↑ACTH, high dose dexamethasone suppression test =no reduction in cortisol - which type of cushings

Answer 13

Ectopic ACTH production

Question 14

which drug is a Selective inhib of 11B-hydroxylase used to tx cushings

Answer 14

Metyrapone

Question 15

which drug is an Inhibitor of 17A-hydroxylase, used to tx Cushing’s?

Answer 15

Ketoconazole

Question 16

MOA: GC receptor antagonist; Anti-progestin effects used to terminate pregnancy; tx inoperable pt with ectopic ACTH secretion or adrenal Ca

Answer 16

Mifepristone

Question 17

which GC are prodrugs?

Answer 17

prednisone, cortisone

Question 18

hydrocortisone & cortisone are short, intermediate or long acting?

Answer 18

short acting (8-12 hrs)

Question 19

fludrocortisone is short, intermediate or long acting?

Answer 19

short acting (8-12 hrs)

Question 20

prednisone is short, intermediate or long acting?

Answer 20

intermediate acting (12-36 hrs)

Question 21

dexamethasone is short, intermediate or long acting?

Answer 21

long acting (24-72 hrs)

Question 22

which GC has the greatest salt retaining potency

Answer 22

fludrocortisone (200)

Question 23

which GC has the greatest anti-inflamm potency?

Answer 23

dexamethasone (30)

Question 24

which glucocorticoid is ONLY used as a minerlcorticoid?

Answer 24

fludrocortisone

Question 25

which form of 11-beta-HSD converts cortisone to cortisol

Answer 25

11-beta-HSD type 1