Adrenal Hormones Flashcards
Adrenal suppression manifests after how long of corticosteroid therapy
> 2 weeks
Progestin in oral contraceptive; aldosterone antagonist
Drospirenone
Diagnostic test for Cushing’s syndrome
Dexamethasone Suppression Test
1/3 of cortisol produced daily is excreted in the urine as
dihydroxyketone metabolites
enzyme that converts cortisol to cortisone
11-hydroxysteroid dehydrogenase
Potent steroid with both glucocorticoid and mineralocorticoid activity
Fludrocortisone
used diagnostically for detection of aldosteronism in hypokalemic patients with hypertension dosage of 400-500 mg/d for 4-8 days
Spironolactone
Approved for treatment of hypertension; spironolactone antagonist
Epleronone
Treatment for Aldosteronism
Fludrocortisone Deoxycorticosterone acetate
major limitation in the treatment use of glucocorticoids
Osteoporosis
Causes generalized glucocorticoid resistance
MIfepristone
What is present if 17-hydroxylation in the adrenals is defective?
Hypogonadism
Precursor of aldosterone, half life
Deoxycorticosterone, 70 mins
Half life of Cortisol
60-90 minutes
Excessive production of aldosterone by adrenal adenoma
Primary Aldosteronism
Treatment for Congenital Adrenal Hyperplasia
Oral Hydrocortisone
Glucocorticoid antagonists
MAKAMTM Metyrapone Aminogluthetimide Ketoconazole Abiraterone Mifepristone Trilostane Mitotane
a 3β-17 hydroxysteroid dehydrogenase inhibitor
Trilostane
Drug of choice for stimulation of lung maturation in fetus
IM Bethamethasone (mother)
Ketoconazole ADR
Hepatotoxic
Relative selective inhibitor of 11 hydroxylation, interfering with cortisol and corticosterone synthesis
Metyrapone
Reduces synthesis of corticosteroids in the gonads
Abiraterone
excreted cortisol in the urine is measured by
17-hydroxysteroids
Treatment of Hirsutism in women
Spironolactone (50-200mg/d)
Treatment for Addison’s Disease
Large amount of parenteral hydrocortisone + correction of fluid and electrolyte abnormalities
Low suppressed levels of plasma renin activity & angiotensin II
Secondary Aldosteronism
what is the daily hydrocorticosteroid levels in Addison’s Disease?
20-30 mg
Blocks 17ά-hydroxylase and 17,20-lyase
Abiraterone
Most commonly prescribed salt retaining hormone
Fludrocortisone
Used in conjunction with dexamethasone or hydrocortisone (eliminate estrogen production in breast CA)
Aminogluthetimide
Normal individual morning cortisol
< 3 mcg/dl
An orally active prodrug and has been studied in the treatment of refractory prostate cancer.
Abiraterone
Related to the DDT class of insecticides
Mitotane
Used in treatment of Primary Aldosteronism with dosage of 50-100mg/d
Spironolactone
large amounts of deoxycorticosterone is produced when this adrenocortical enzyme is deficient
11-hydroxylase
Treatment for Cushing’s Syndrome
surgical removal of the tumor resection of the adrenals given with 300mg soluble hydrocortisone as continuous IV on the day of surgery
Block conversion of cholesterol to pregnenolone
Aminogluthetimide
half life of aldosterone
15 -20 minutes
Daily dose of 100 mg hydrocortisone or more , for > 2 weeks produces?
Iatrogenic Cushing’s Syndrome
Potent and rather nonselective inhibitor of adrenal and gonadal steroid synthesis
Ketoconazole
what is the source of synthetic corticosteroids?
Cholic acid
Result of bilateral adrenal hyperplasia secondary to an ACTH –secreting pituitary adenoma
Cushing’s syndrome
How to differentiate between Hypercortisolism due to anxiety and alcoholism
Dexamethasone for 2 days and then followedby CRH test
rare but serious acute adverse effects of high dose glucocorticoids
Acute pancreatitis
Mineralocorticoid antagonist
SPIRONOLACTONE
