Adrenal Drugs Flashcards
“Sassy-Passy”—Pasireotide is an agonist at _____ receptors, used to inhibit ACTH release
Pasireotide
What is the longest acting synthetic glucocorticoid with no mineralocorticoid potency?
Dexamethasone
The main competitive glucocorticoid receptor antagonist is ____
Mifepristone
Why is there hyerpigmentation in Addison’s Disease?
Excess ACTH is linked to alpha melanocyte factor
prednisone, prednisolone, and dexamethasone are all ______
Glucocorticoids
Why do glucocorticoid drugs need to be tapered gradually?
May take months for body to recover own function
What is the main mineralocorticoid drug?
Fludrocortisone
Mifepristone competitively inhibits the _____ Receptors
GC
Name the 5 Glucocorticoid drugs
- HydroCort
- Cortisone
- Prednisone
- Prednisolone
- Dexamethasone
Phenoxybenzamine is an irreversible ______
Alpha-1 Antagonist
2 Intermediate duration Glucocorticoid Drugs?
- Prednisone
- Prednisolone
“Predators are intermediates”
Mifepristone inhibits which receptor?
Glucocorticoid
Before surgically removing a pheochromocytoma, you need to give ____ before surgery and then consider ____ after surgery
- Alpha Blockers
- Beta Blockers
DA and SST both _____ ACTH release
Inhibit
Excess glucocorticoids have toxicities on glucose, fat, and protein usually after how long?
Greater than 2 Weeks
To treat Cushing’s, ______ boosts D2 receptors and ____ boosts SST receptors ultimately to inhibit ACTH release.
- Cabergoline
- Pasireotide
Cabergoline and Pasireotide are both _____ antagonists, but with different receptors targeting
ACTH
Prazosin, Terazosin, and Doxazosin are all reversible, competetitive ______
Alpha-1 Antagonists
2 MC receptor Antagonists
- Spironolactone
2. Eplerenone
Main inhibitor of catecholamine biosynthesis via Trysoine Hydroxylase inhibition?
Metyrosine
In 90% of patients, CAH results from mutations in _______, resulting in a buildup of pregnenolone that gets shunted into a Dehydroepi-androsterone pathway to make androgens. (look for ambiguous genitalia in newborns)
21-Beta-Hydroxylase
3 Primary toxicities of Glucocorticoid drugs
- Osteoporosis
- Muscle Wasting
- Hyperglycemia
First line treatment for Cushing’s Disease is ______
Surgery of tumor
Of the Glucocorticoid drugs, which 2 are the shortest acting?
- Hydrocortisone
2 Cortisone
Why does CAH need fludrocortisone?
Because CAH loses mineralocorticoid function in addition to glucocortocoid fxn.
The 3 adrenal steroid biosynth inhibitors that “keep me mighty”?
- Ketoconazole
- Metyrapone
- Mitotane
Metyrosine competitively inhibits _______ ____ to prevent _____ biosynthesis
- Tyrosine Hydroxylase
- Catecholamine
Out of the 3 Adrenal Steroid pathways, from a 21-Beta-Hydroxylase problem, which 2 get lost in CAH?
- Mineralocorticoid
2. Glucocorticoid
Ketoconazole, Metyrapone, and mitotane inhibit the production of _____ and _____
- Cortisol
- ALD
Conn’s Syndrome
Excessive ALD by adrenal adenoma
Ketoconazole, Metyrapone, and MItotane are all what class of drugs?
Adrenal Biosynth inhibitors
Aside from Hyperkalemia, 3 side effects of Spironolactone
- Cardiac Arrhyth
- Menstrual Probs
- Gynecomastia
Of the adrenal biosynth inhibitors, which has the most side effects including adnrogenic effects?
Metyrapone
Of the adrenal biosynth inhibitors, which is the most non-selective?
Ketoconazole
blocks C17, 17,20 Lyase, 3B, C11
3 Cabergoline DA side effects
- Cardiac Valvulopathy
- Dizziness
- Psych problems
Spironolactone and eplerenone are both _____
Mineralocorticoid antagonists
3 Pasireotide SST side effects
- GI probs
- Hyperglycemia
- Bradycardia
“Kraber”—Cabergoline is an agonist at ____ receptors, used to inhibit ACTH release
Dopamine2
2 Differences of Dexamethasone vs Cortisone, in respect to Dexa
- Dexa has no Mineralocorticoid potency
2. Dexa is longest acting (36-72hrs)
Fludrocortisone is a _______ drug
Mineralocorticoid
