Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4 Pharm Self > Adrenocortical steroids > Flashcards

Adrenocortical steroids Flashcards

1
Q

What does the hypothalamus release to stimulate the adrenal cortex? what does it act on?

A

corticotropin releasing hormone CRH

Pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the pituitary release to stimulate the adrenal cortex?

A

adrenocorticotropin ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the major precursor to the creation of aldosterone, cortisol, and androgens?

A

cholesterol and pregnenolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What zone is aldosterone released from?

A

zona glomerulosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What zone is cortisol and androgens from?

A

zona fasciculata and reticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What also increases activity of zone glomerulosa besides ACTH?

A

K and angiotensin II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does increased ACTH levels result in?

A

adrenal hyperplasia and decreased ACTH levels result in hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 5 main effects of glucocorticoids?

A
  1. increased protein breakdown
  2. increase lipolysis and cause fat redistribution
  3. increase gluconeogenesis and glycogen synthesis
    4 decrease glucose utilization
  4. inhibit immune system and inflammatory response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T-f–do cytokines from the immune system inhibit the hypothalamus and pituitary and their release of CRH and ACTH?

A

False- they increase release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The kidney is the main effector organ of mineral corticoids…what are the 3 main effects?

A

Increase Na reabsorption
Increase K excretion
Increse H excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T-F mineral corticoids are usefule in treating adrenal insuficiency and immune/inflammatory disorders?

A

false- only glucocoticoids do both, mineral corticoids only for adrenal insuficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the glucocorticoid activity, mineral corticoid activity and method of administration for the following steroids-

  1. cortisol
  2. prednisolone
  3. Fludrocortisone
  4. Dexamethasone
A
  1. 1, 1, oral, injection, topical
  2. 5, .3, oral,injection
  3. 10, 250, oral
  4. 30, 0, oral, injectable, topical
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 4 common uses of glucocorticoids for non-adrenal disorders?

A
  1. speed up lung maturation prior to birth
  2. suppressing the immune system prior to organ transplant
  3. treatment of childhood acute lymphoblastic leukemia (w/methotrexate)
  4. suppressing immune system for a variety of inflammatory and immune disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T-F-side effects are few when used systemically for under 2 weeks?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do we see side effects with glucocorticoids?

A

Used at high doses (greater 100mg) for over 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Review the list of side effects of glucocorticoids–

A
  • hyperglycemia and glycosuria
  • increased protein breakdown
  • increased infection risk
  • myopathy
  • osteoporosis
  • behavior change
  • cataracts
  • ulcers
  • sodium and fluid retention, loss of potassium
  • growth retardation in children
  • supression of HPA acis
17
Q

What commonly results from withdrawal of glucocortcoids?

A

flare up of underlying disease and adrenal insufficiency

18
Q

T-f–when administering glucocorticoids we should use the smallest possible dose?

A

True and check periodically

19
Q

Why should we use alternate day administration of glucocorticoids?

A

Alleviates suppression of the HPA axis

20
Q

T-F with glucocorticoids we should administer together with newer immune suppressants?

A

True

21
Q

How should we modify our diet when using glucocorticoids?

A

high protein, high K and low Na

22
Q

What is the most widely used mineral corticoids?

A

fludrocortisone

23
Q

Are both glucocorticoids and mineral corticoids useful in acute adrenal insufficiency and chronic adrenal insufficiency?

A

yes

24
Q

In congenital adrenal hyperplasia 1, what enzyme is taken out?

A

21 beta hydroxylase– see increases in pregnenolone, progesterone, and androgens.

25
Q

In congenital adrenal hyperplasia 2, what enzyme is taken out?

A

11 beta hydroxylase– see increases in 11- deoxycorticosterone and 11 desoxycortisol and pregnenolone, progesterone, and androgens.

26
Q

How to treat CAH 1?

A
  1. Mineralocorticoids + salt as replacement
    therapy
  2. Glucocorticoids
  3. Antiandrogens
27
Q

How to treat CAH 2

A
  1. Mineralocorticoid antagonists and salt
    restriction
  2. Glucocorticoids
  3. Antiandrogens
28
Q

Is eplerenone or spironolactone an androgen antagonist?

A

spironolactone

29
Q

Cushings syndrome that increases cortisol production is caused by what 2 things?

A
  1. primary adrenal defect
  2. increased ACTH (pituitary or other tissue)

[hypertension, hyperglycemia, fat redistribution and muscle wasting]

30
Q

What are the 2 main treatments for cushings?

A

Surgery or irradiation

drugs that block adrenocortical steroid

31
Q

When does dexamethasone suppress cortisol?

A

If cushings is due to increase ACTH secretion by pituitary (cushing’s disease)

32
Q

What does it mean if dexamethasone does not suppress cortisol?

A
  1. primary adrenocortical hyper function

2. ACTH secretion by tumor or other tissues

4 Pharm Self (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions