Adrenal diseases and paget's bone disease pharmacology Flashcards
What is Cortisol synthesized from?
-Cholesterol
What are mineralcorticoids used for?
-Aldosterone for salt retention
What can androgens be converted to?
-Estrogens
What is the primary use for glucocorticoids?
-Rapid and dramatic anti-inflammatory effects
What do topical glucocorticoids inhibit?
-Histamine release and skin thinning
What do glucocorticoids suppress?
-Leukocytes and inflammatory cytokines/chemokines
What are the side effects of glucocorticoids?
- Loss of muscle mass
- Muscle weakness
- Thinning of skin
- Impaired wound healing
- Osteoporosis
- Diabetogenesis
- GI peptic ulcer
- Catabolic and anti-anabolic effects
What does Diabetogenesis mean?
- Increased glucose levels
- Increase insulin release and lipogenesis
What are short to medium acting glucocorticoids?
- Hydrocortisone
- Cortisone
- Prednisone
What are long acting glucocorticoids?
-Dexamethasone
What are the uses for glucocorticoids?
- Allergic reactions
- Inflammatory bowel disease
- Acute respiratory distress syndrome
- Dermatitis
What occurs in Addison’s disease?
-The adrenal glands produce too little cortisol and aldosterone
How do you treat Addison’s disease?
-Hydrocortisone daily (Increase doses during stress)
-
When treating Addison’s disease what do you combine with hydrocortisone?
-Salt-retaining hormone
What is Cushing’s disease?
-Chronic high levels of cortisol usually due to ACTH secreting tumor
What are the symptoms of Cushing’s disease?
- Fatty hump (Buffalo hump)
- Moon face
- Strech marks on skin
- Osteoporosis
- Hypertension
What drugs are used for treatment in Cushing’s disease?
- Ketoconazole
- Metryapone
What does Ketoconazole do?
-Inhibit adrenal steroid synthesis
What does Metyrapone do?
-Selective inhibitor of cortisol/corticosterone synthesis
What is osteoporosis?
-Abnormal loss of bone leading to fractures
What are the three principal hormonal regulators of Ca2+ homeostasis?
- PTH
- Vitamin D
What are bisphosphonates used to treat osteoporosis?
- Ibandronate (Boniva)
- Alendronate sodium (Fosamax)
- Zoledronic acid (Reclast, Aclasta)
