Adrenal Steroids

Question 1

Zones of Adrenal Cortex

Answer 1

1) Zona glomerulosa - secretes mineralocorticoids
2) Zona fasciculata - secretes glucocorticoids
3) Zona reticularis - synthesizes androgens

Question 2

Mineralocorticoids

Answer 2

Aldosterone
Fludrocortison
Desoxycorticosterone

Question 3

Major mineralocorticoid in humans

Answer 3

Aldosterone

3000x potent
Salt-retaining

Question 4

Replacement therapy in patients with Primary Adrenal insufficiency (Addison’s Disease)

Answer 4

Fludrocortisone

Question 5

Glucocorticoids

Answer 5

Short-Acting
* Cortisol
* Cortisone

Intermediate-Acting
* Prednisolone
* Prednisone
* Methylprednisolone
* Triamcinolone

Long-Acting
* Betamethasone
* Dexamethasone

Question 6

Major glucocorticoid in human

Answer 6

Cortisol / Hydrocortisone

Question 7

Preferred HRT for adrenal insufficiency

Answer 7

Cortisol/Hydrocortisone

Question 8

Most commonly used in systemic treatment of cancer and inflammation

Answer 8

Intermediate-Acting glucocorticoids

Question 9

Treatment of Respiratory Distressed Syndrome & promotes fetal lung maturity

Answer 9

Betamethasone

No salt retaining property

Question 10

Treatment of emesis in cancer chemotherapy

Answer 10

Dexamethasone

Non-salt retaining

Question 11

Clinical Uses of Glucocorticoids

Answer 11

1. Inflammation, Allergy and Autoimmune Disorders
2. Cancer (lymphoma, emesis)
3. Resp. Distress Syndrome (Betamethasone)
4. DOC for Sarcoidosis
5. Immunosuppressant (Prevent tossue rejection after transplant)
6. Adrenal Insufficiency
7. Congenital Adrenal Hyperplasia (Hydrocortisone)
8. Cushing Syndrome (Hypercortisolism)

Question 12

Adverse Effects of Glucorticoids

Answer 12

Crushing Syndrome
Osteoporosis
Retardartiong of growth
Thin Skin
Immunosuppresion
Cataract/Glaucoma
Oedema
Skin problems
Teratogenic
Emotional disturbances
Rise in BP
Obesity
Increase hair growth
Diabetes
Striae distensae

Question 13

Adrenal Androgens

Answer 13

Dehydroepiandrosterone (DHEA)

Question 14

Major androgen secreted by the adrenal cortex

Answer 14

Dehydroepiandrosterone (DHEA)

Question 15

Dehydroepiandrosterone (DHEA)

Answer 15

• Extremely weak androgen
• Converted to testosterone
• Dietary supplement
• “Fountain of Youth” Antiaging medicine

Question 16

Corticosteroid Synthesis Inhbitors

Answer 16

• Metyrapone
• Ketoconazole
• Fluconazole

Question 17

Metyrapone MOA

Answer 17

Blocks II-B-Hydroxylase enzyme

Question 18

Treatment of Cushing syndrome in patients not candidates for surgery

Answer 18

Metyrapone

Question 19

Antifungal drugs that inhibits cytochrome P450 enzyme

Answer 19

Ketoconazole
Fluconazole

For Cushing Syndrome
S/E: Gynecomastia

Question 20

Corticosteroid Receptor Antagonists

Answer 20

• Spirinolactone
• Mifepristone

Question 21

Spirinolactone MOA

Answer 21

Aldosterone antagonist, competes for mineralocorticoid receptors in renal tubules

Question 22

DOC for Conn’s Disease (Primary Aldosteronism) and Barther Syndrome

Answer 22

Spirinolactone

Question 23

MOA of Mifepristone

Answer 23

Progesterone and glucocorticoid receptor Antagonist

Question 24

Treatment of hyperglycemia in patients with Cushing Syndrome

Answer 24

Mifepristone