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Pharmacology > Adrenal Drugs > Flashcards

Adrenal Drugs Flashcards

1
Q

What is another name for ACTH?

A

Corticotropin

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2
Q

What are the different zone in the adrenal cortex? What do these zones make?

A

Zona Glomerulosa- mineralcorticoids

Zona fasciculata- glucocorticoids

Zona reticularis- sex hormones/androgens

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3
Q

What zone of the adrenal cortex does ACTH work on? What does it cause

A

Zona fasciculata

Increase release of Cortisol
Increase hypertrophy of adrenal cortex

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4
Q

What is the process of increasing cortisol?

A

Hypo releases CRH which goes to anterior pituitary gland….which releases ACTH which goes to zona fasciculata…which releases cortisol

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5
Q

What factors increase CRH?

A

Low BG
Sleep wake cycle
Stress

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6
Q

What time of day is ACTH highest?

A

Morning

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7
Q

What is betamethasone?

A

Glucocorticoid

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8
Q

What is cortisone?

A

Glucocorticoid

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9
Q

What is dexamethasone?

A

Glucocorticoid

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10
Q

What is hydrocortisone?

A

Glucocorticoid

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11
Q

What is methylprednisolone? Route? What formulation is it available in?

A

Glucocorticoid

SC
IV
Intra-articular/sonovial

Available in long-acting (depot)

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12
Q

What is prednisone? Route commonly given at what time? Indication?

A

Glucocorticoid

PO

Morning to prevent insomnia

Respiratory illness

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13
Q

What is prednisolone?

A

Glucocorticoid

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14
Q

What is triamcinolone?

A

Glucocorticoid

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15
Q

What is aldosterone?

A

Mineralocorticoid

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16
Q

What is fludrocortisone? What activity does this type of corticosteroid have?

A

Mineralocorticoids

Aldosterone
Fludrocortisone

17
Q

What do corticosteroid drugs end in?

A

-one and -ide

18
Q

What routes do glucocorticoids come in?

A

Topical
PO
Inhaled
Nasal

19
Q

What is glucocorticoid 4 MOA?

A

Gluconeogenesis
Protein wasting
Retain Na and H2O
Inhibits PLA2

20
Q

What are indications for glucocorticoids(7)?

A 
Inflammatory conditions
Autoimmune disorders
Allergic conditions
Surfactant production
Organ rejection
Rashes
Addison’s disease
21
Q

What are inflammatory conditions that Tx glucocorticoid?

A

UC
Shock
Head trauma

22
Q

Why are glucocorticoids used to Tx shock and head trauma?

A

Keeps blood in blood vessels by decreasing histamine release

23
Q

What are the autoimmune disorders that are Tx w/ glucocorticoids?

A

RA
MS
MG

24
Q

What is Tx Addison’s disease?

A

Fludrocortisone

Hydrocortisone

25
Q

What is Addison’s disease? Cause? Sx? Tx drugs?

A

Decreased mineralcorticoids and glucocorticoids

Autoimmunity

Dehydration
HoTN
Hyperpigmentation

Fludrocortisone
Hydrocortisone

26
Q

What are the two drug categories of glucocorticoids?

A

Natural steroids

Synthetic steroids

27
Q

What are the 3 differences of synthetic corticosteroids from natural corticosteroids?

A

More potent
Less Na+ retention
Longer acting

28
Q

What is important to know about fludrocortisone (Florinef) and hydrocortisone?

A

Fludrocortisone: mineralcorticoid and a little glucocorticoid activity

Hydrocortisone: glucocorticoid with a little mineralcorticoid activity

29
Q

What is the MOA of Glucocorticoids?

A

Decrease WBC activity
Decrease secretion of proinflammatory and vasoactive cytokines
Inhibits PLA2

30
Q

What is the difference between Cushing’s syndrome and Cushings disease? ACTH levels? Cortisol levels?

A

Cushing disease: only caused by a pituitary adenoma
Increased ACTH
Increased Cortisol

Cushing syndrome: caused by anything that increases the release of cortisol and androgens
Decreased ACTH
Increased Cortisol

31
Q

What are the Sx of a pt w/ Cushing syndrome? What are the Sx d/t?

A

Cortisol release

  • DM
  • moon face
  • Buffalo hump

Androgen release
-Hirsutism

32
Q

What is aminoglutethimide(Cytadren) indicated for? MOA? ADR?

A

Cushing’s syndrome Tx

Inhibits glucocorticoid synthesis in the zona fasciculata

Increases ALT and AST

33
Q

Why do you not want to discontinue glucocorticoids abruptly? ADR?

A

Because the drug cortisol has been sending a negative feedback to ACTH, ACTH is very low and needs to be brought back up

Severe mental depression
Adrenal atrophy

34
Q

Why is it important to taper off glucocorticoid when DC the drug?

A

Allows ACTH levels to taper back up to higher levels

35
Q

How do mineralcorticoids effect Na/K channels?

A

Retain Na+ and waste K+ in the DCT

36
Q

What type of pts do you want to be cautious giving a corticosteroid?

A 
Ulcers
CHF
active infection
DM
Heart issues
Child growth
37
Q

What is the contraindication for corticosteroids? What can it cause? What risk category is it?

A

Pregnancy

Cleft palate

Category C drug

38
Q

Why is giving a corticosteroid to a child who is growing a risk?

A

Because corticosteroids decrease the release of GH

Pharmacology (27 decks)

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