Adrenocorticosteroids And Adrenalcortical Antagonists

Question 1

Glucocorticoids

Answer 1

Cortisol, control by HPA
Inc gluconeogenesis, glycogenesis, protein catabolism
Dec insulin sensitivity, Ab production, inflammation, neoplasm in certain cell lines

Question 2

Mineralocorticoids

Answer 2

Aldosterone, control by RAAS
Inc Na and H2O retention
Dec K retention

Question 3

Dehydroepiandosterone

Answer 3

Precursor for sex steroids

Question 4

Cushing syndrome

Answer 4

Effects of long term overuse of exogenous steroids
Moon face, osteoporosis, buffalo hump, cardiac hypertrophy, obesity, amenorrhea, skin ulcers
HYPERGLYCEMIA

Question 5

Spironolactone

Answer 5

Aldosterone receptor antagonist
Competes with aldosterone for receptor sites in DCT
Inc Na and H2O secretion, conserves K
AE: hyperkalemia, gynecomastia

Question 6

Addison’s disease

Answer 6

Hypoadrenalism
May occur iatrogenecially due to abrupt withdrawal of high dose chronic exogenous steroid
Chronic > 7 days
Prevent by tapering
Due to diurnal rythym, dosing in am may help

Question 7

Fludrocortisone

Answer 7

Both mineralocorticoids and glucocorticoids effects

Question 8

SE of exogenous corticosteroids

Answer 8

(sone or olone)

Short term: hyperglycemia, infection, impaired wound healing
Long term: osteoporosis, fat redistribution

Teach pt to report sx of insuffiency: fatigue, at loss, diarrhea, dizziness

Use lowest dose for shortest period of time