Adrenal Drugs Flashcards
What are the 2 parts of the adrenal gland?
Adrenal medulla
Adrenal cortex
What does the adrenal medulla secrete?
Catecholamines: Epinephrine and norepinephrine
What does the adrenal cortex secrete?
Corticosteroids: Glucocorticoids and mineralocorticoids
What is the difference between oversecretion and undersecretion of adrenocortical hormones?
Over: Cushing syndrome
Under: Addison’s disease
Name 3 glucocorticoids
Hydrocortisone
Methylprednisolone
Prednisone
Name a mineralocorticoid
Fludrocortisone 21-acetate
Name an adrenal steroid inhibitor
Ketoconazole
What is the MOA of most corticosteroids?
Modification of enzyme activity
What are the general indications of adrenal drugs?
Any adrenal deficiencies or disorders
Overexaggeration of the immune system
Inflammation diseases (-itis)
Rheumatic disorders
What are the different forms of glucocorticoids used for? 3
Inhalation: Control of steroid-responsive bronchospastic states
Nasal: Rhinitis and prevention of recurring polyps after surgical removal
Topical: Inflammations of the eye, ear, and skin
What are the contraindications of adrenal drugs?
Cataracts, glaucoma, PUD, mental health problems, diabetes, serious infections
In what conditions should you exercise caution when administering adrenal drugs?
Gastritis, reflux disease, ulcer disease, diabetes.
Cardiac, renal or liver dysfunction
What are the cardiovascular adverse effects of adrenal drugs?
HF, Cerebral edema, HTN, impaired glucose tolerance, dysrhythmias, bradycardia, pulmonary edema, syncope, vasculitis
What are the CNS adverse effects of adrenal drugs ?
Convulsions, headache, vertigo, mood swings, nervousness, aggressive behaviours, psychotic symptoms, neuritis, peripheral neuropathy, paresthesia, arachnoiditis, meningitis, insomnia
What are the endocrine adverse effects of adrenal drugs?
Growth suppression, cushing’s syndrome, menstrual irregularities, carbs intolerance, hyperglycemia, suppression of hypothalamic-pituitary-adrenal axis, hirsutism, hypertrichosis, glycosuria
What are the integumentary adverse effects of adrenal drugs?
Fragile skin, petechiase, ecchymosis, facial erythema, poor wound healing, urticarial, hypersensitivity reactions, acne, dry skin, skin hyperpigmentation, skin striae
What are the MSK adverse effects of adrenal drugs?
Myopathy, muscle weakness, loss of muscle mass, osteoporosis, osteonecrosis of femoral and humeral heads, pathological fracture, malaise
What are the GI, ocular and other adverse effects of adrenal drugs?
GI: PUD, pancreatitis, ulcerative esophagitis, abdominal distension
Ocular: Increased intraocular pressure, glaucoma, cataracts
Other: Weight gain, leukocytosis, opportunistic infections, hypokalemia alkalosis, impaired healing
What are possible interactions with adrenal drugs?
Non-K-sparing diuretics can lead to severe hypocalcemia and hypokalemia
Aspirin, NSAIDs and other ulcerogenic meds increase GI effects the chance of gastric ulcer development
Anticholinesterase meds produce weakness in pts with myasthenia gravis
Antidiabetic drugs can reduce hypoglycemic effects and result in elevated CBGs
Immunizing biologics inhibit the immune response to the biological agent
What is the most commonly used oral glucocorticoid for anti-inflammatory or immunosuppressant purposes? and what else is it used for ?
Prednisone
Treatment of exacerbations of chronic respiratory illnesses
What is the most commonly used injectable glucocorticoid? What are its primary uses and contraindications?
Methyprednisolone (Solu-medrol)
ID: Anti-inflammatory or immunosuppressant drugs
CI: Pregnancy, children <28 days of age
What is a consideration for the drugs: Solu-cortef and Solu-Medrol?
They are LASA drugs
Both are IV glucocorticoids but are different.
_______ of Solu-Medrol is equivalent to _______ of Solu-cortef
4 mg; 20 mg
It is important to ___________ before giving a nasal corticosteroid
Clear nasal passages
