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Pharmacology Test 4 Material > Adrenocortical Steroids > Flashcards

Adrenocortical Steroids Flashcards

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1
Q

What are the actions of glucocorticoids?

A
  1. Increase protein breakdown
  2. Increase lipolysis and cause fat redistribution
  3. Increase gluconeogenesis and glycogen synthesis
  4. Decrease glucose utilization by muscle
  5. Decrease calcium absorption
  6. Suppress immune cell functions
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2
Q

___ ACTH level results in adrenal hyperplasia and _____ ACTH level results in adrenal hypoplasia

A

Increased, decreased

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3
Q

What are the actions of mineralocorticoids?

A
  1. Increase Na+ reabsorption
  2. Increase K+ excretion
  3. Increase H+ excretion
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4
Q

Cortisol

  1. Use
  2. Mechanism of action
  3. Length of action
A
  1. Adrenal insufficiency and symptomatic treatment of immune and inflammatory disorders
  2. Glucocorticoid: glucocorticoid and mineralocorticoid agonist
  3. Short acting (6-12 hrs)
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5
Q

Aldosterone

  1. Use
  2. Mechanism of action
  3. Length of action
A
  1. Adrenal insufficiency and symptomatic treatment of immune and inflammatory disorders
  2. Glucocorticoid: glucocorticoid and mineralocorticoid agonist
  3. Very short (1-2 hrs)
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6
Q

Prednisolone

  1. Use
  2. Mechanism of action
  3. Length of action
A
  1. Adrenal insufficiency and symptomatic treatment of immune and inflammatory disorders
  2. Glucocorticoid: glucocorticoid and mineralocorticoid agonist
  3. Intermediate (12-24 hrs)
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7
Q

Fludrocortisone

  1. Use
  2. Mechanism of action
  3. Length of action
A
  1. Adrenal insufficiency
  2. Mineralocorticoid: mineralocorticoid agonist
  3. Intermediate (12-24 hrs)
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8
Q

Dexamethasone

  1. Use
  2. Mechanism of action
  3. Length of action
A
  1. Adrenal insufficiency and symptomatic treatment of immune and inflammatory disorders
  2. Glucocorticoid: glucocorticoid and mineralocorticoid agonist
  3. Long acting (24-48 hrs)
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9
Q

What are some of the many side effects of glucocorticoids?

A

Hyperglycemia, increased protein breakdown, increased risk of infection, sodium and fluid retention, loss of potassium, hypertension, suppression of HPA axis

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10
Q

What are the side effects of mineralocorticoids?

A

Fluid and electrolyte abnormalities and HTN

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11
Q

What is used to treat acute adrenal insufficiency?

A

Glucocorticoids and/or mineralocorticoids

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12
Q

What is used to treat chronic adrenal insufficiency?

A

Glucocorticoids and Mineralocorticoids or GC+Salt

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13
Q

What are the signs and symptoms of Cushing’s syndrome?

A

Hyperglycemia, HTN, fat redistribution, muscle wasting

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14
Q

Dexamethasone WILL suppress cortisol if Cushing’s syndrome is due to:

A

Cushing’s disease: Increased ACTH secretion by the pituitary

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15
Q

Dexamethasone WILL NOT suppress cortisol if Cushing’s syndrome is due to:

A

Primary adrenal tumor or ACTH secretion by tumor in other tissues

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16
Q

Aminoglutethimide

  1. Use
  2. Mechanism of action
A
  1. Cushing’s syndrome

2. Inhibits conversion of cholesterol to pregnenolone (CYP11A1)

17
Q

Ketoconazole

  1. Use
  2. Mechanism of action
A
  1. Cushing’s syndrome

2. Inhibits many steps in steroid synthesis

18
Q

Metyrapone

  1. Use
  2. Mechanism of action
A
  1. Cushing’s syndrome

2. Inhibitor of 11B-hydroxylase (CYP11B1)

19
Q

Etomidate

  1. Use
  2. Mechanism of action
A
  1. Cushing’s syndrome

2. Inhibitor of CYP11B1

20
Q

Spironolactone

  1. Use
  2. Mechanism of action
A
  1. Primary aldosteronism

2. Mineralocorticoid receptor antagonist (also an androgen receptor antagonist)

21
Q

Eplerenone

  1. Use
  2. Mechanism of action
A
  1. Primary aldosteronism

2. Mineralocorticoid antagonist without anti-androgen activity

Pharmacology Test 4 Material (12 decks)

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