Adrenal drugs/corticosteroids

Question 1

Adrenal glands

Answer 1

Medulla: catecholamines (epi, NE)
Cortex: corticosteriods (cortisol, aldosterone, sex hormones)

Question 2

Corticosteriods

Answer 2

Complex group of drugs that alter gene expression
Low doses –> metabolic effects (feed brain)
High doses –> anti-inflammatory effects (a SAID vs. a NSAID)
Incl 2 groups: Glucocorticoids, Mineralocorticoids

Question 3

Glucocorticoids

Answer 3

Group of corticosteroids
Mimic cortisol
Low doses physiologically tx adrenal insufficiency
High doses pharmacologically tx inflammation/inflam d/os
Incl (from least to most anti-inflam activity): Hydrocortisone, Prednisone, Methylprednisolone, Dexamethasone
Lots of AEs: “CUSHINGOID”

Question 4

“CUSINGOID”

Answer 4

Lots of AEs for glucocorticoids: 
C: cataracts
U: ulcers
S: skin thinning, striae
H: HTN, hirsutism
I: immunosuppression, infection 
N: necrosis of femoral heads
G: glucose increase 
O: osteoporosis, obesity
I: impaired wound healing 
D: depression

Question 5

S/s of Cushing Syndrome

Answer 5

Moon face, buffalo hump

Possible AE/effect of glucocorticoids on endocrine system

Question 6

Mineralocorticoids

Answer 6

Group of corticosteroids
Mimic aldosterone (retain H2O and Na, eliminate K and H)
Incl Fludrocortisone
Lots of AEs (same as glucocorticoids): “CUSHINGOID”