B / 13 : Mineralocorticoids. Topically applied glucocorticoids. Adrenocortical antagonists, inhibitors of corticosteroid synthesis

Question 1

Mineralocorticoids
- Effects
- Clinical use
- Side-effects

Answer 1

• Increased Na reabsorption / K and H excretion
• Replacement therapy in adrenal hypofunction
• Edema, increased BP, hypokalemia, pro-inflammatory effect

Question 2

Example of a mineralocorticoid

Answer 2

fludrocortisone

Question 3

Fludrocortisone
- MOA
- Effect
- Indication
- SE
- ROA

Answer 3

• Synthetic mineralocorticoid
• Na and water reabsorption, K and H excretion by increased Na/k-ATPase and ENaC
• Replacement therapy in adrenal hypofunction or adrenalectomy
• Edema, hypertension, hypokalemia, metabolic acidosis, pro-inflammatory effect
• Oral

Question 4

What are the topically applied glucocorticoids? (4)

Answer 4

• Mometasone
• Budesonide
• Fluticasone
• Fluocinolone

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Question 5

Fluocinolone, mometasone, budesonide, fluticasone
- MOA
- Effect
- Indication
- SE
- ROA

Answer 5

• Synthetic corticosteroids (glucocorticoids)
• Anti-inflammatory
• For asthma, allergic rhinitis + conjunctivitis
• Oropharyngeal candidiasis
• Topical

Question 6

What is a corticosteroid antagonist?

Answer 6

Metyrapone

Question 7

Metyrapone
- MOA
- Effect
- Indication
- ROA

Answer 7

• Synthesis inhibitor : 11B-hydroxylase inhibitor
• Prevents synthesis of cortisol : less negative feedback on ACTH production
• For ACTH producing tumors and tumors of adrenal gland + diagnostic tests
• Oral