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Pharmacology > Adrenal Steroids 2 > Flashcards

Adrenal Steroids 2 Flashcards

1
Q

Betamethasone - MoA

A

Promotes fetal lung maturation

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2
Q

Betamethasone - Clinical use

A

Prevent RDS in premature infants by leading to lung maturation, psoriasis, seborrheic/atopic dermatitis, neurodermatitis

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3
Q

Betamethasone - Special considerations

A

Can enter placenta, used systemically and topically

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4
Q

Budesonide - Clinical use

A

Ulcerative colitis

Asthma

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5
Q

Ciclesonide - Clinical use

A

Hay fever/ allergic rhinitis

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6
Q

Beclomethasone, Flunisolide and Mometasone furoate - Clinical use

A

Extremely good for asthma, allergic rhinitis

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7
Q

Topical steroids

A 
Loteprednol
Difluprednate
Desonide 
Hydrocortisone
Dexamethasone
Fluticasone
Triamcinolone
Desoximethasone
Fluocinonide 
Clobetasol
Betamethasone
Dipropionate
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8
Q

Low-potensy topical steroids

A

Desonide
Hydrocortisone
Dexamethasone

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9
Q

Medium-potensy topical steroids

A

Fluticasone

Triamcinolone

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10
Q

High-potency topical steroids

A

Desoximethasone

Fluocinonide

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11
Q

Very-high-potency topical steroids

A

Clobetasol
Betamethasone
Dipropionate

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12
Q

Topical corticosteroids - Special consideration

A

Ointment: dry, cracked, scaly or hardened skin.

Lotions and gels: hairy areas

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13
Q

Ophthalmis cortisol preparations

A

Loteprednol

Difluprednate

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14
Q

Loteprednol - Clinical use

A

With tobramycin for corneal inflammation and keratitis

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15
Q

Difluprednate - Clinical use

A

Pain and inflammation associated with ocular surgery

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16
Q

Desonide,
Hydrocortisone,
Dexamethasone - Clinical use

Fluticasone - Clinical use

A

Redness, swelling, itching in various skin conditions (Atopic dermatitis, seborrheic dermatitis, contact dermatitis, and psoriasis)

Asthma

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17
Q

Low potency steroids used in what kind of areas?

A

Areas with thinner skin and intertriginous areas where skin is folded or overlapped.

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18
Q

Low to medium potency used in what kind of areas?

A

ears, trunk, arms, legs and scalp.

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19
Q

Medium to very high potency are used in what kind of areas?

A

thicker skin.

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20
Q

Mineralocorticoids - MoA

A

Na+ reabsorption coupled (loosely) with K+ & H+ excretion. Binds to mineralocorticoid receptors in cytoplasm causing increased expression of Na/K-ATPase & epithelial sodium channels. (Receptors have same affinity for cortisol, but in kidney cortisol is converted to cortisone with lower affinity)

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21
Q

Mineralocorticoids - Adverse Effects

A

Hypokalemia, metabolic alkalosis, Increased plasma volume, hypertension

22
Q

Fludrocortisone - MoA

A

Both glucocorticoid and mineralocorticoid actions

Potent salt retaining activity

23
Q

Fludrocortisone - Clinical use

A

Primary adrenal insufficiency (Addison`s disease)
Preferred in replacement therapy in adenectomy
CAH in combo with hydrocortisone.

24
Q

Fludrocortisone - Special considerations

A

Also glucocorticoid activity, but 20 times more potent salt-retaining activity

Only oral adm

25
Q

Adrenal androgens

A

DHEA (Dehydroepiandrosterone)

26
Q

DHEA - Clinical use

A

USED IN ALTERNATIVE MEDICINE

Studies indicate: protective for DM, immune disorders, cancer, weight gain, increased muscle mass and sexual function, and prolong life.

27
Q

DHEA - Contraindication and Special consideration

A

Prostate cancer (because it is a weak androgen)

Extremely weak androgen, partly converted to testosterone.

28
Q

DHEA - Adverse effects

A

Mild acne, seborrhea, and facial hair growth

29
Q

Corticosteroid receptor antagonists

A

Spironolactone
Eplerenone
Mifepristone

30
Q

Spironolactone - MoA

A

Competitive inhibition of mineralocorticoids receptors in the kidney

31
Q

Spironolactone - Clinical use

A

Used as potassium-sparing diuretic,
Primary hyperaldosteronism (DOC)– diagnostic & therapeutic,
Secondary hyperaldosteronism (with heart failure, Bartter syndrome)
Hirsutism in women

32
Q

Spironolactone - Special consideration

A

Reduce mortality in heart failure

Potassium-sparing diuretic.

33
Q

Spironolactone - Adverse Effect

A

Hyperkalemia, cardiac arrhythmias, menstrual abnormalities, gynecomastia, sedation, headache, GI disturbances, skin rashes

34
Q

Eplerenone - Clinical use

A

Hypertension

35
Q

Eplerenone - Special consideration

A

Reduce mortality in heart failure

No effect on androgen receptors

36
Q

Eplerenone - Adverse effects

A

Hyperkalemia (usually mild)

37
Q

Mifepristone - MoA

A

It antagonizes both progesterone and glucocorticoid receptors

38
Q

Mifepristone - Clinical use

A

Cushing’s syndrome (esp. hyperglycemia in patients with cushing syndrome)

39
Q

Mifepristone - Special consideration

A

Strong antiprogestin activity (first intended to be contraceptive)

40
Q

Corticosteroid synthesis inhibitors

A

Ketoconazole
Fluconazole
Aminoglutethimide
Metyrapone

41
Q

Ketoconazole and Fluconazole - MoA

A

Inhibits steroid production by inhibiting 11β-hydroxylase (fungal cytochrome P450 enzyme)

42
Q

Ketoconazole and Fluconazole - Clinical use

A

Cushing syndrome

Adrenal carcinoma, hirsutism, breast & prostate cancer.

43
Q

Ketoconazole and Fluconazole - Adverse effects

A

Hepatotoxicity

Gynecomastia

44
Q

Aminoglutethimide - MoA

A

Blocks conversion of cholesterol to pregnenolone & inhibits synthesis of all hormonally active steroids

45
Q

Aminoglutethimide - Clinical use

A
  • Reduce estrogen production in pt with breast cancer (in combo with dexamethasone and hydrocortisone)
  • Reduce steroid secretion in pt with Cushing`s syndrome due to adrenocortical cancer who do not respond to mitotane (in combo with metyrapone or ketoconazole)
46
Q

Aminoglutethimide - Adverse effects and interactions

A

High doses: Lethargy and skin rash

Interactions: increased Metabolism of dexamethasone

47
Q

Metyrapone - MoA

A

Inhibits glucocorticoid synthesis by selectively inhibiting 11β-hydroxylation, shifts production to adrenal androgens

48
Q

Metyrapone - Clinical use

A

Diagnostic test of adrenal function
Pregnant women with Cushing syndrome (ONLY drug for this).
Cushing syndrome in pt whose condition is refractory to other treatments and who are not candidates for surgery
Preparation for surgery

49
Q

Metyrapone - Special consideration

A

Not normally used for Cushing syndrome (only choice for pregnancy. Also if other drugs failed and not candidate for surgery)

50
Q

Metyrapone - Adverse effects

A

Transient dizziness and GI disturbances
Salt and water retention
Hirsutism

Pharmacology (55 decks)

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