Adrenal hormones

Question 1

glucocorticoids

Answer 1

• stimulate gluconeogenesis and glycogen syntehsis in a fasting state
• increase serum glucose by inhibiting uptake of glucose into muscle
• Stimulate hormone sensitive lipase and thus lipolysis (this is a minor effect)

Question 2

hydrocortisone

Answer 2

short acting steroid

can be used to mimic diurnal rhythem

Question 3

prednisone

Answer 3

better for non complient patients

Question 4

methylprednisolone

Answer 4

corticosteroid

Question 5

fludrocortisone

Answer 5

mainly a mineralocorticoid

cuases Na retention in the kidney (mimic aldosterone)

Question 6

mitotane

Answer 6

• Use this for patients with adrenal cancer
• Non selective cytotoxic agent of adrenal cortex - basically ablates the adrenal
• Many patients have a severe tox - needs a dose reduction
  
  • This includes diarrhea, nausea, vomiting and depression

Question 7

mifepristone

Answer 7

• Glucocorticoid receptor antagonists
• Can be rapidly effective for diabetes related to cushings disease
  
  • Decreases A1C from 7.4 - 6.3
  • When patienst get diabetes from their cushings - give them this drugs
• SE
  
  • Profound hypokalemia and QT prolongation

Question 8

dexamethasone

Answer 8

long acting steroid

better for non complenet patienst

Question 9

ketoconazole

Answer 9

• Nonselective inhibitor of the adrenal and gonadal steroids
• Blocks multiple enzymes in the cortisol pathway - CYP 17-20 and 3B hydroxysteroid
• SE - can cause headaches, sedation, nausea
  
  • Potential for hepatotoxic with high doses or patients with preexisting hepatic disease

Question 10

spironolactone

Question 11

eplerenone

Question 12

cortisol

Answer 12

affects vascular and bronchial SM - enchances effects of catecholamines