adrenal drugs

Question 1

adrenal medulla secretes

Answer 1

catacholamines (epinepherine and norepinephrine)

Question 2

adrenal cortex secretes

Answer 2

corticosteroids (glucocorticoids and mineralocorticoids )

Question 3

oversecretion and undersecretion of adrenocortical hormones

Answer 3

oversecretion: cushing syndrome
undersecretion: addisons syndrome

Question 4

glucocorticoids ex

Answer 4

hydrocortisone, methylprednisolone, prednisolone

Question 5

mineralocorticoid ex

Answer 5

fludrocortisone 21-acetate.
treats addisons disease

Question 6

adrenal steroid inhibitor ex

Answer 6

ketoconazole

Question 7

MOA corticosteroids

Answer 7

• modify enzyme activity

Question 8

MOA glucocorticoids

Answer 8

• differ in potency, duration, extent of salt and fluid retention
• inhibit or control inflammatory and immune response

Question 9

Indications of adrenal drugs (A-C)

Answer 9

• adrenocortical deficiency
• adrenogenital syndrome
• allergic disorders
• autoimmune blistering diseases
• bacterial meningitis
• cancer
  -cerebral edema
• collagen diseases

Question 10

indications of adrenal drugs (D-H)

Answer 10

• dermatological diseases
  -endocrine disorders (thyroiditis)
• GI diseases (UC, regional enteritis)
• exacerbation of chronic resp illnesses ( asthma, COPD)
• hematological disorders

Question 11

indications of adrenal drugs (N-L)

Answer 11

• nonrheumatic inflammation
• nephrotic syndrome
• opthalmic disorders (nonpyogenic inflammations)
• organ transplantation (decrease immune response to prevent organ rejection)
• leukemias and lymphomas

Question 12

indications of adrenal drugs (R-T)

Answer 12

• rheumatic disorders
• spinal cord injury
• thyroiditis

Question 13

administration of glucocorticoids

Answer 13

• inhalation for control of steroid responsive bronchospastic states
• nasally for rhinitis or polyps
• topically for eyes, ears, skin

Question 13

what to do after giving glucocorticoids(inhale)

Answer 13

gargle, rinse, spit

Question 13

when to give glucocorticoids

Answer 13

1st thing in the morning

Question 13

CI of glucocorticoids

Answer 13

• glaucoma, cataracts
  -peptic ulcer disease
• metal health problems
  -diabetes

Question 14

glucocorticoids are avoided with

Answer 14

infections: septicemia, systemic fungal infections, varicella

Question 15

glucocorticoids with TB and meningitis

Answer 15

glucocorticoids can prevent inflammatory CNS damage

Question 16

use with caution in pts with

Answer 16

gastritis, reflux disease, ulcer disease
cardiac, renal, liver dysfunction

Question 17

glucocorticoid adverse effects: cardio

Answer 17

HF, cardiac edema, hypertension (from elec imb), impaired glucose tolerance, dysrhythmias, bradycardia, pulmonary edema, syncope, vasculitis

Question 18

glucocorticoid adverse effects: CNS

Answer 18

convulsion, headache, vertigo, mood swings, nervousness, aggressive, psychotic sympt, neuritis, peripheral neuropathy, paresthesia, arachnoiditis, meningitis, insomnia

Question 19

glucocorticoid adverse effects: endocrine

Answer 19

growth suppression, cushing, menstural irreg, carb intolerance, hyperglycemia, hypothalamic- pituitary- adrenal axis supression, hirsutism, hypertrichosis, glycosuria

Question 20

glucocorticoid adverse effects: GI

Answer 20

peptic ulcer, pancreatitis, ulcerative esophagitis, abd distension

Question 21

glucocorticoid adverse effects: integumentary

Answer 21

fragile skin, petechiae, ecchymosis, facial erythema, poor wound healing, urticarial, hypersensitivity, acne, dry, hyperpigmentation, striae

Question 22

glucocorticoid adverse effects: MSK

Answer 22

myopathy, weakness, loss of muscle mass, osteoporosis, osteonecrosis of femoral and humeral heads, pathological fracture, malaise

Question 23

glucocorticoid adverse effects: occular and other

Answer 23

occular: increased intraocular pressure, glaucoma, cataracts other: weight gain, leukoctosis, opportunistic infection, hypokalemia alkalosis, impaired healing

Question 24

hypokalemia from which drugs

Answer 24

furosemide with prednisone

Question 25

glucocorticoid interactions

Answer 25

- non potassium sparing diuretics can lead to hypocalcemia and hypokalemia - NSAIDS and aspirin can lead to GI effects - anticholinesterase can produce weakness with myasthenia gravis - immunizing biologics - antidiabetic drugs: increased blood glucose

Question 26

prednisone

Answer 26

- most common PO glucocorticoid for ant inflammatory purposes - treats exacerbations of chronic resp illnesses - inadequate for management of adrenocortical insuff (addisons)

Question 27

methylprednisolone

Answer 27

- IV and injectable -for anti-inflammatory or immunosuppressant - not for pregnancy - contains benzyl alc that is CI <28 days old

Question 28

look alike sound alike drugs

Answer 28

slou- cortef and solu-medrol - both IV glucocorticoids - 4 mg medrol= 20 mg cortef - not interchangeable

Question 29

what to assess before giving adrenal drugs

Answer 29

- edema and electrolytes - peptic ulcer disease and other CI - drug interactions

Question 30

adrenal drugs alter

Answer 30

serum glucose and electrolyte levels

Question 31

dont take adrenal drugs with

Answer 31

coffee, alcohol, aspirin, NSAIDs

Question 32

do you taper the dose

Answer 32

yes