Adrenal Drugs

Question 1

“Sassy-Passy”—Pasireotide is an agonist at _____ receptors, used to inhibit ACTH release

Answer 1

Pasireotide

Question 2

What is the longest acting synthetic glucocorticoid with no mineralocorticoid potency?

Answer 2

Dexamethasone

Question 3

The main competitive glucocorticoid receptor antagonist is ____

Answer 3

Mifepristone

Question 4

Why is there hyerpigmentation in Addison’s Disease?

Answer 4

Excess ACTH is linked to alpha melanocyte factor

Question 5

prednisone, prednisolone, and dexamethasone are all ______

Answer 5

Glucocorticoids

Question 6

Why do glucocorticoid drugs need to be tapered gradually?

Answer 6

May take months for body to recover own function

Question 7

What is the main mineralocorticoid drug?

Answer 7

Fludrocortisone

Question 8

Mifepristone competitively inhibits the _____ Receptors

Answer 8

GC

Question 9

Name the 5 Glucocorticoid drugs

Answer 9

1. HydroCort
2. Cortisone
3. Prednisone
4. Prednisolone
5. Dexamethasone

Question 10

Phenoxybenzamine is an irreversible ______

Answer 10

Alpha-1 Antagonist

Question 11

2 Intermediate duration Glucocorticoid Drugs?

Answer 11

1. Prednisone
2. Prednisolone
   “Predators are intermediates”

Question 12

Mifepristone inhibits which receptor?

Answer 12

Glucocorticoid

Question 13

Before surgically removing a pheochromocytoma, you need to give ____ before surgery and then consider ____ after surgery

Answer 13

• Alpha Blockers

- Beta Blockers

Question 14

DA and SST both _____ ACTH release

Answer 14

Inhibit

Question 15

Excess glucocorticoids have toxicities on glucose, fat, and protein usually after how long?

Answer 15

Greater than 2 Weeks

Question 16

To treat Cushing’s, ______ boosts D2 receptors and ____ boosts SST receptors ultimately to inhibit ACTH release.

Answer 16

• Cabergoline

- Pasireotide

Question 17

Cabergoline and Pasireotide are both _____ antagonists, but with different receptors targeting

Answer 17

ACTH

Question 18

Prazosin, Terazosin, and Doxazosin are all reversible, competetitive ______

Answer 18

Alpha-1 Antagonists

Question 19

2 MC receptor Antagonists

Answer 19

1. Spironolactone

2. Eplerenone

Question 20

Main inhibitor of catecholamine biosynthesis via Trysoine Hydroxylase inhibition?

Answer 20

Metyrosine

Question 21

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)

Answer 21

21-Beta-Hydroxylase

Question 22

3 Primary toxicities of Glucocorticoid drugs

Answer 22

1. Osteoporosis
2. Muscle Wasting
3. Hyperglycemia

Question 23

First line treatment for Cushing’s Disease is ______

Answer 23

Surgery of tumor

Question 24

Of the Glucocorticoid drugs, which 2 are the shortest acting?

Answer 24

1. Hydrocortisone

2 Cortisone

Question 25

Why does CAH need fludrocortisone?

Answer 25

Because CAH loses mineralocorticoid function in addition to glucocortocoid fxn.

Question 26

The 3 adrenal steroid biosynth inhibitors that "keep me mighty"?

Answer 26

1. Ketoconazole 2. Metyrapone 3. Mitotane

Question 27

Metyrosine competitively inhibits _______ ____ to prevent _____ biosynthesis

Answer 27

- Tyrosine Hydroxylase | - Catecholamine

Question 28

Out of the 3 Adrenal Steroid pathways, from a 21-Beta-Hydroxylase problem, which 2 get lost in CAH?

Answer 28

1. Mineralocorticoid | 2. Glucocorticoid

Question 29

Ketoconazole, Metyrapone, and mitotane inhibit the production of _____ and _____

Answer 29

- Cortisol | - ALD

Question 30

Conn's Syndrome

Answer 30

Excessive ALD by adrenal adenoma

Question 31

Ketoconazole, Metyrapone, and MItotane are all what class of drugs?

Answer 31

Adrenal Biosynth inhibitors

Question 32

Aside from Hyperkalemia, 3 side effects of Spironolactone

Answer 32

1. Cardiac Arrhyth 2. Menstrual Probs 3. Gynecomastia

Question 33

Of the adrenal biosynth inhibitors, which has the most side effects including adnrogenic effects?

Answer 33

Metyrapone

Question 34

Of the adrenal biosynth inhibitors, which is the most non-selective?

Answer 34

Ketoconazole | blocks C17, 17,20 Lyase, 3B, C11

Question 35

3 Cabergoline DA side effects

Answer 35

1. Cardiac Valvulopathy 2. Dizziness 3. Psych problems

Question 36

Spironolactone and eplerenone are both _____

Answer 36

Mineralocorticoid antagonists

Question 37

3 Pasireotide SST side effects

Answer 37

1. GI probs 2. Hyperglycemia 3. Bradycardia

Question 38

"Kraber"---Cabergoline is an agonist at ____ receptors, used to inhibit ACTH release

Answer 38

Dopamine2

Question 39

2 Differences of Dexamethasone vs Cortisone, in respect to Dexa

Answer 39

1. Dexa has no Mineralocorticoid potency | 2. Dexa is longest acting (36-72hrs)

Question 40

Fludrocortisone is a _______ drug

Answer 40

Mineralocorticoid