Adrenal Steroids Flashcards by Ari Strick

Endogenous GC

Cortisol

How well did you know this?

Not at all

Perfectly

Endogenous MC

Aldosterone

How well did you know this?

Not at all

Perfectly

Glucocorticoids control…

Metabolism, especially glucose

How well did you know this?

Not at all

Perfectly

Mineralocorticoids control…

Body fluid

Electrolyte levels

How well did you know this?

Not at all

Perfectly

GC analog purpose

Anti-inflammatory effects, but also cause MC side effects

How well did you know this?

Not at all

Perfectly

Excretion of adrenal steroids

Kidneys

How well did you know this?

Not at all

Perfectly

GC metabolic effects

Increase glucose
Increase protein breakdown
Mobilization of fat from periphery to trunk
Worsen osteoporosis
Worsen peptic ulcers
Inhibit growth in children

How well did you know this?

Not at all

Perfectly

Cortisol secretion

Response to stress

How well did you know this?

Not at all

Perfectly

Synthesis/secretion of cortisol stimulated by…

ACTH from ant. pit., which is stimulated by CRF from hypothalamus (HPA axis)

How well did you know this?

Not at all

Perfectly

Hypercortisolism disease

Cushing’s Disease

How well did you know this?

Not at all

Perfectly

Adrenal steroid deficiency disease

Addison’s Disease

How well did you know this?

Not at all

Perfectly

Cushing’s symptoms

Moon face
Buffalo hump
Muscle wasting
Trunk obesity
HTN
DM
AMS

How well did you know this?

Not at all

Perfectly

Addison’s symptoms

Addisonian crisis with abrupt d/c of GCs

How well did you know this?

Not at all

Perfectly

MC effects

Water retention
Increase BP
Increase H and K excretion

How well did you know this?

Not at all

Perfectly

MC levels regulated by…

Renin-angiotensin system (not HPA axis)

How well did you know this?

Not at all

Perfectly

GC and MC PK

Slow onset, long lasting

How well did you know this?

Not at all

Perfectly

Cortisol binds to what receptors?

GC & MC

How well did you know this?

Not at all

Perfectly

Aldosterone binds to what receptors?

MC only

Prototype short DOA steroid

Hydrocortisone

Hydrocortisone acts on what receptors

GC & MC effects

Hydrocortisone use

MILD inflammation

Hydrocortisone half-life

8-12 hours

Prototype intermediate steroid

Prednisone

Prednisone PK

High potency (5x more than hydrocortisone)
Few MC effects (5x more selective for GC)

Prednisone use

Stronger anti-inflammation w/o severe MC effects

Prototype long DOA steroid

Dexamethasone

Dexamethasone PK

``` High potency (20-30X more potent than hydrocortisone) Almost NO MC effects (even @ high doses) Effective at low doses ```

Prednisone half-life

18-36 hours

Dexamethasone half-life

36-54 hours

Synthetic MC drug

Fludrocortisone

Fludrocortisone PK

Oral Long DOA Potent MC

Fludrocortisone use

Adrenal failure | 21 hydroxylase deficiency

MC receptor antagonist

Spironlactone

Spironlactone use

K+ sparing diuretic b/c blocks aldosterone action | Decreased MC effect from endocrine disorders and aldosterone secreting tumors

Steroid drug preps/formulation

Parenteral —> water soluble (emergent use) | Suspension —> insoluble (sustained effect)

Steroid side effects on MC receptors

Water retention, HTN, edema Hypernatremia Hypokalemia Alkalosis

Steroid side effects on GC receptors

``` Muscle weakness Thin skin/bruising Trunk obesity/weight gain Osteoporosis Ulcers DM/insulin resistance Growth inhibition Cataracts/glaucoma Decrease fibrin ```

Contraindications are relative b/c…

Consequences of inflammation may be worse than underlying disease

Replacement therapy in adrenal insufficiency

Physiologic dose Therapy w/ hydrocortisone for GC/MC effects, supplement w/ Fludrocortisone if more MC needed Therapy w/ prednisone due to longer half-life and b/c many pts don’t need MC effects

What steroid stimulates surfactant?

Betamethasone

What from can be used w/ some cancer regimens?

Prednisone

What steroid is used s/p brain surgery?

Dexamethasone

GCs treatment

Myasthenia gravis MS Spinal cord injury Hypercalcemia