Adrenal Pharm Flashcards
What are Metabolic affect of glucocortiiosteroids?
Glucocorticsteroids
SE Increase serum glucose Increase lipolysis Net increase in fat deposits Slow wound healing -purple straie Decreased muscle mass, thinning of skin, osteoporosis INFX GI ulcers MDD Bipolo hypomania Hypernatremia
Anti-inlammatory Immunosuppressive- diminish vaccine response) Mood control psych exacerbations Adrenal suppression Fetal lung development
WHO ARE THE Mineralocorticoids?
Fludrocortisone
Desoxycorticosterone
What tumor secretes ACTH and cause what?
PITUITARY TUMOR
Cushing DZ
INC ACTH
TX-adrenalectomy
High dose hydrocortisone for surgery
Gradual reduction to prevent withdrawal -Fever, joint pain
Supplement- mineralocorticoid LTC
How do you treat adrenocortical insufficiency?
Addison’s
Hydrocortisone (20-30 mg/day) plus Fludrocortisone
Acute- IV hydrocortisone at high dose/ 8 hours, reduce gradually
Who are Bet DEXter want blow up is Laboratory
Long-acting
Betamethasone
Dexamethasone
What is also androgen antagonsit along with minercorticoid?
Spriolactone
MOA: Combines w/ DHT for androgen receptors in target tissues; reduces plasma testosterone and androstenedione
Use: hirsutism in women!
MONITOR K+ levels
What are the other mineralcorticoid antagonists? What did SED say to the adrenal?
Drospierone-progesion
Epelerone
STOP!
What do you treat newborn and mom with for congential hyperlasia?
Decreased cortisol synthesis in the mother produces compensatory increase in ACTH- hyperplasia
TX- Dexamethasone -causes increase in 17-hydroxyprogesterone L/T virilization of the fetus
INFANT- TX W/ hydrocortisone
Pt has HTN, weakness, tetany, hypokalemia, alkalosis, hypernatremia? TX
PRIMARY HYPERALDOSTERONE
-inc minercorsteroids
TX- spironolactone
Combines w/ DHT for androgen receptors in target tissues, aldosterone receptor blocking agent
potassium sparing
Why is dexamethosone important for long acting?
Dexamethasone suppression test
Suppression indicates ACTH origin
Cushing dz- means pitutary tumor secreting ACTH
Exogenous cortisol= ACTH should stop
Lack of suppression -tumor in adrenal gland gone nutty
Psych disorders
What is given to develop lungs of fetus?
Betamethasone
anticipation of preterm delivery under 34 weeks
Male high risk of Respiratory distress
What are medium actioN cortiocsteriods? PrePMT
Prednisone,
Prednisolone,
methylprednisolone
Triamcinolone
Asthma
DO NOT STOP ABRUTLY
TAPER- if RX longer than 3-4dys
What blocks conversion of cholesterol to pregnenolone?
Aminoglutethimide
What is potent and non-selective inhibitor of adrenal and gonadal steroid synthesis?
Ketoconazole
WHat is a selective inhibitor of steroid 11-hydroxylation
Metyrapone
used in diagnosis and treatment
