Adrenal Steroids

Question 1

Aldosterone is a gluco or mineralcorticoid?

Answer 1

Minimal glucocorticoid effect

Question 2

How do we decrease the mineralcorticoid effect of Cortisol?

Answer 2

Mineralocorticoid effect is depleted by 11B-hydroxysteroid dehydrogenase converting cortisol to cortisone

Question 3

What does 11B-hyroxysteroid DH do?

Answer 3

Converts Cortisol to cortisone which decreases it’s mineralcorticoid effect

Question 4

What is the glucocorticoid: mineralcorticoid activity of Cortisol?

Answer 4

1:1 glucocorticoid to mineralocorticoid effects (in theory) —> keep in mind it converts to cortisone

Question 5

Both aldosterone and cortisol act on this receptor

Answer 5

mineralcorticoid receptor

Question 6

Where is Aldosterone synthesized?

Answer 6

Zona glomerulosa - cholesterol → pregnenolone → desoxycorticosterone → aldosterone

Question 7

Where is Cortisol synthesized?

Answer 7

Zona fasciculata and reticularis – cholesterol → pregnenolone → desoxycortisol → cortisol

Question 8

This Steroid has zero mineralcorticoid effect?

Answer 8

Dexamethasone

Question 9

Does Dexamethasone have glucocorticoid or mineralcorticoid effcts?

Answer 9

Glucocorticoid effects

Question 10

Prednisolone has how much gluococorticoid:mineralcoid activity?

Answer 10

3:1

Question 11

Fludrocortisone has how much mineralcorticoid:glucocorticoid activity?

Answer 11

10:1 mineralocorticoid to glucocorticoid

Question 12

Prevent production of cortisol from deoxycortisol -> no neg. feedback on pituitary -> excess ACTH

Answer 12

Metyrapone

Question 13

Drug used for Diagnostic test: If given and no large increase in ACTH is noted, the lesion is in the pituitary

Answer 13

Metyrapone

Question 14

Metyrapone blocks:

Answer 14

11B hyrdoxylase

Question 15

Metyrapone prevents production of

Answer 15

cortisol from deoxycortisol

Question 16

What is the result of Metyrapone’s inhibition of 11 B hydroxylase

Answer 16

blocks deoxycortisol—> cortisol thus no negative feedback on pituitary. We expect in health individual to see increase in ACTH

Question 17

Progesterone and glucocorticoid receptor antagonist

Answer 17

Mifepristone

Question 18

What do we see in urine as result of Metyrapone?

Answer 18

ACTH stimulates synthesis and excretion of 17-hydroxycorticoids as 11-desoxycortisol

Question 19

Drug used to terminate pregnancy and tx Cushings disease

Answer 19

Mifeprisone

Question 20

Spironolactone and Epleronone act on which receptor?

Answer 20

Mineralcorticoid receptor antagonist (aldosterone antagonist)

Question 21

Steroid drug used to treat HTN (diuretic), heart failure, cardiac hypertroph

Answer 21

Spironolactone and Epleronone

Question 22

What is special about Spironolactone and Epleronone as far as their diuretic activity?

Answer 22

K Sparing

Question 23

Progesterone AGONIST. Mineralocorticoid, and androgen receptor antagonist

Answer 23

Drospirenone

Question 24

Drospirenone is a _______ agonist and _______ and ______antagonist

Answer 24

progesterone Agonist

Mineralcorticoid and androgen antagonist

Question 25

Suppress ovulation (w/ estrogen), post-menopausal hormone therapy (w/ estrogen). As a diuretic (antagonizes the salt retaining effects of estrogen)

Answer 25

Drospirenone

Question 26

Drospirenone's mineralcorticoid effects

Answer 26

Mineralocorticoid receptor antagonist Diuretic Antagonizes the salt retaining effects of estrogen

Question 27

Drospirenone's Progesterone affects

Answer 27

Progesterone receptor agonist 1. Used with estrogen to suppress ovulation 2. Used with estrogen as hormone replacement therapy in post-menopausal women