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Pharm Exam 4 > Adrenal Steroids > Flashcards

Adrenal Steroids Flashcards

1
Q

Endogenous GC

A

Cortisol

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2
Q

Endogenous MC

A

Aldosterone

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3
Q

Glucocorticoids control…

A

Metabolism, especially glucose

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4
Q

Mineralocorticoids control…

A

Body fluid

Electrolyte levels

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5
Q

GC analog purpose

A

Anti-inflammatory effects, but also cause MC side effects

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6
Q

Excretion of adrenal steroids

A

Kidneys

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7
Q

GC metabolic effects

A 
Increase glucose
Increase protein breakdown
Mobilization of fat from periphery to trunk
Worsen osteoporosis
Worsen peptic ulcers
Inhibit growth in children
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8
Q

Cortisol secretion

A

Response to stress

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9
Q

Synthesis/secretion of cortisol stimulated by…

A

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

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10
Q

Hypercortisolism disease

A

Cushing’s Disease

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11
Q

Adrenal steroid deficiency disease

A

Addison’s Disease

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12
Q

Cushing’s symptoms

A 
Moon face
Buffalo hump
Muscle wasting
Trunk obesity
HTN
DM
AMS
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13
Q

Addison’s symptoms

A

Addisonian crisis with abrupt d/c of GCs

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14
Q

MC effects

A

Water retention
Increase BP
Increase H and K excretion

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15
Q

MC levels regulated by…

A

Renin-angiotensin system (not HPA axis)

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16
Q

GC and MC PK

A

Slow onset, long lasting

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17
Q

Cortisol binds to what receptors?

A

GC & MC

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18
Q

Aldosterone binds to what receptors?

A

MC only

19
Q

Prototype short DOA steroid

A

Hydrocortisone

20
Q

Hydrocortisone acts on what receptors

A

GC & MC effects

21
Q

Hydrocortisone use

A

MILD inflammation

22
Q

Hydrocortisone half-life

A

8-12 hours

23
Q

Prototype intermediate steroid

A

Prednisone

24
Q

Prednisone PK

A 
High potency (5x more than hydrocortisone)
Few MC effects (5x more selective for GC)
25
Q

Prednisone use

A

Stronger anti-inflammation w/o severe MC effects

26
Q

Prototype long DOA steroid

A

Dexamethasone

27
Q

Dexamethasone PK

A 
High potency (20-30X more potent than hydrocortisone) 
Almost NO MC effects (even @ high doses)
Effective at low doses
28
Q

Prednisone half-life

A

18-36 hours

29
Q

Dexamethasone half-life

A

36-54 hours

30
Q

Synthetic MC drug

A

Fludrocortisone

31
Q

Fludrocortisone PK

A

Oral
Long DOA
Potent MC

32
Q

Fludrocortisone use

A

Adrenal failure

21 hydroxylase deficiency

33
Q

MC receptor antagonist

A

Spironlactone

34
Q

Spironlactone use

A

K+ sparing diuretic b/c blocks aldosterone action

Decreased MC effect from endocrine disorders and aldosterone secreting tumors

35
Q

Steroid drug preps/formulation

A

Parenteral —> water soluble (emergent use)

Suspension —> insoluble (sustained effect)

36
Q

Steroid side effects on MC receptors

A

Water retention, HTN, edema
Hypernatremia
Hypokalemia
Alkalosis

37
Q

Steroid side effects on GC receptors

A 
Muscle weakness
Thin skin/bruising
Trunk obesity/weight gain
Osteoporosis 
Ulcers
DM/insulin resistance
Growth inhibition 
Cataracts/glaucoma
Decrease fibrin
38
Q

Contraindications are relative b/c…

A

Consequences of inflammation may be worse than underlying disease

39
Q

Replacement therapy in adrenal insufficiency

A

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

40
Q

What steroid stimulates surfactant?

A

Betamethasone

41
Q

What from can be used w/ some cancer regimens?

A

Prednisone

42
Q

What steroid is used s/p brain surgery?

A

Dexamethasone

43
Q

GCs treatment

A

Myasthenia gravis
MS
Spinal cord injury
Hypercalcemia

Pharm Exam 4 (8 decks)

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