Corticosteroids and Antagonists

Question 1

Short to Medium Acting Glucocorticoids

Activates glucocorticoid receptors – altered gene transcription

Suppresses inflammation

Replaces cortisol when deficient

Answer 1

Hydrocortisone (Cortisol)
Cortisone
Prednisone
Prednisolone
Methylprednisolone
Meprednisolone

Question 2

Intermediate Acting Glucocorticoids

Answer 2

Triamcinolone
Paramethasone
Fluprednisolone

Question 3

Long Acting Glucocorticoids

Answer 3

Betamethasone

Dexamethasone

Question 4

The glucocorticoid with the HIGHEST ANTI-INFLAMMATORY POTENCY

Answer 4

Betamethasone

Question 5

The mineralocorticoid with the HIGHEST SALT RETAINING POTENCY

Answer 5

Fludrocortisone

Question 6

Mineralocorticoids

Answer 6

Fludrocortisone

Deoxycorticosterone

Question 7

Hastens fetal lung maturation

Answer 7

Betamethasone

Dexamethasone

Question 8

Glucocorticoid Synthesis Inhibitor

Answer 8

Amino-glutethimide
Ketoconazole
Metyrapone
Mifepristone

Question 9

Inhibits desmolase blocks conversion of cholesterol to pregnenolone

Reduces synthesis of all hormonally active steroids

USES:
breast cancer
Cushing syndrome

Answer 9

DESMOLASE INHIBITOR

Amino-glutethimide

Question 10

Inhibits cholesterol side chain cleavage, CYP450, and other enzymes necessary for synthesis of all steroids

Answer 10

CYP450 INHIBITOR

Ketoconazole

Question 11

Selective inhibitor of steroid 11-hydroxylation interfering with cortisol and corticosterone synthesis

Diagnostic testing for adrenal function
Cushing syndrome

DOC - pregnant patients with Cushing syndrome

Answer 11

11-B HYDROXYLASE INHIBITOR

Metyrapone

Question 12

Competitive inhibitor at the GC receptor and progesterone receptor

USES:
Cushing syndrome
abortifacient for medical abortion

Answer 12

Mifepristone (RU486)

Question 13

Mineralocorticoid Agonist

Strong agonist of mineralocorticoid receptors and moderate activation of glucocorticoid receptors

Increases Na reabsorption, K and H excretion

USES:
Addison’s disease (Chronic Adrenal Insufficiency)
CAH
Adrenal Replacement Therapy Post Adrenalectomy

Answer 13

MINERALOCORTICOID AGONIST

Fludrocortisone
Deoxycorticosterone

SE:
salt and fluid retention
hypokalemia
CHF
muscle wasting
osteoporosis
glucose intolerance
behavioral changes

Question 14

Mineralocorticoid Antagonist

Blocks aldosterone receptors

USES:
HF
hypokalemia d.t. other diuretics
for post MI
hyperaldosteronism

Answer 14

Spironolactone

SE:
hyperkalemia
anti-androgenic effect (i.e. gynecomastia)