Corticosteroid antagonists

Question 1

Corticosteroid antagonists (2 groups)

Answer 1

Corticosteroid receptor antagonists

Corticosteroid synthesis inhibitors

Question 2

Corticosteroid receptor antagonists (3 drugs)

Answer 2

Spironolactone
Eplerenone
Mifepristone

Question 3

Spironolactone - indications

Answer 3

DOC: Primary hyperaldosteronism
Hirsutism
Secondary hyperaldosteronism (pt with heart failure and Bartter syndrome)
Diuresis (potassium sparing)

Question 4

Spironolactone - Adverse effects

Answer 4

Hyperkalemia
Cardiac arrhythmias
Gynecomastia
Menstrual abnormalities
Sedation

Question 5

Corticosteroid receptor antagonist used for hypertension

Answer 5

Eplerenone

Question 6

Cushing caused by inoperable adrenal carcinoma or ectopic ACTH secretion can be treated with

Answer 6

Mifepristone

Question 7

Corticosteroid synthesis inhibitors (4 drugs)

Answer 7

Ketoconazole
Fluconazole
Aminoglutethimide
Metyrapone

Question 8

Antifungal drugs - MOA as corticosteroid antagonists

Answer 8

Ketoconazole and fluconazole inhibits steroid production by inhibiting cytochrome P450 enzymes (β-hydroxylase inhibition)

Question 9

Ketoconazole and fluconazole - indications as corticosteroid antagonists

Answer 9

Adrenal carcinoma, hirsutism, breast and prostate cancer.

Question 10

Aminoglutethimide - MOA

Answer 10

Inhibits synthesis of all hormonally active steroids

Question 11

Corticosteroid synthesis inhibitor used for malignant steroid-producing adrenocortical cancer

Answer 11

Aminoglutethimide

Question 12

Aminoglutethimide - interactions

Answer 12

Increases metabolism of dexamethasone

Question 13

Metyrapone - MOA

Answer 13

Inhibits cortisol synthesis by selectively inh steroid 11β-hydroxylation, shifts production to adrenal androgens

Question 14

Only drug that can be used in pregnant women with Cushing syndrome

Answer 14

Metyrapone

Question 15

Metyrapone - adverse effects

Answer 15

Salt and water retention

Hirsutism