Adrenal Steroids

Question 0

Topical corticosteroids

Answer 0

Cortisol, methylprednisolone, dexamethasone

Question 1

Inhaled corticosteroids

Answer 1

Fluticasone, beclomethasone, flunisolide, triamcinolone

Question 2

Depot corticosteroids

Answer 2

Methylprednisolone suspended in polyethylene glycol

Question 3

Mifepristone

Answer 3

Glucocorticoid antagonist - progesterone receptor antagonist

Used in induce abortion in early pregnancy.
At high levels blocks glucocorticoid receptors- Tx of life threatening elevated glucocorticoids in ectopic ACTH syndrome

Question 4

Mitotane

Answer 4

Synthesis inhibitors - mitochondria - all pathways

Question 5

Aminoglutethimide.

Answer 5

Synthesis inhibitors - inhibits side chain cleavage enzyme cyp11a1

All pathways

Question 6

Ketoconazale

Answer 6

Synthesis inhibitors - inhibits 17,20 lyase

Low levels decreases androgen synthase
Highly levels decreases all adrenal and gonadal steroid synthesis

Question 7

Metyrapone

Answer 7

Synthesis inhibitors

11- B- hydroxylase
Decreases cortisol and aldosterone

Question 8

Trilostane

Answer 8

Synthesis inhibitor - 3 B hydroxysteroid dehydrogenase

All but primarily cortisol and aldosterone

Question 9

Fludrocortisone

Answer 9

Mineralocorticoid agonist

High mineral corticoid/ glucocorticoid activity ratio
Side effects same as having excessive aldosterone production ( extra cellular volume expansion, hypokalemia, HTN, k wasting, - renin release)

Question 10

Spironolactone

Answer 10

Mineralcorticoid antagonist

K sparing diuretic
- androgen and progesterone receptor antagonist
Causes gynecomastia in males

Question 11

Eplerenone

Answer 11

Mineral. Antagonist

K sparing diuretics
Pure Mineralcorticoid receptor antagonist