Adrenal Disease Flashcards
What is CBG?
Binds about 90% of the circulating cortisol under normal circumstances
Decreased CBG
hypothyrodism
Increased CBG
hyperthyroidsm
T/F Steroids inhance effect of bronchodilators
true
PK of cortisol
metabolized in liver
released in urine
Chronic Adrenocortical Insufficiency
Addison’s
dysfunction or absence of the adrenal cortices
Acute Adrenalcorticol insufficiency
Adrenal crisis
-Emergency state due to insufficient cortisol
Sx: Low blood pressure, dehydration, skin pigmentation may be increased
Hypercortisolism
Cushing “Syndrome” (drugs)
Cushing “Disease”* (tumor)
Tx for adrenal crisis
- Hydrocortisone 100-300mg IV; 50-100mg every 6-8 h and adjust to response
- Fludrocortisone acetate orally added as IV hydrocortisone dose is decreased
Fluticortisone MOA?
strong receptor of mineralcorticoid receptor
aka mineralcorticoid agonsit
CLinical use of fluticortisone
adrenal insufficiency, Addison’s disease
Tx for Addison’s disease
Combination of corticosteroids (alone if mild) and mineralocorticoids
Hydrocortisone 15–30 mg orally daily is drug of choice with 2/3 of dose given in the am and 1/3 given in the late afternoon