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Pharmacology 2 > Drugs Acting on the Adrenal Cortex > Flashcards

Drugs Acting on the Adrenal Cortex Flashcards

1
Q

What section of the adrenal glad produces Mineralocorticoids?

A

Zona glomerulosa in the cortex

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2
Q

What second of the adrenal gland produces Glucocorticoids?

A

Zona fasciculata in the cortex

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3
Q

What effect do glucocorticoids have on energy metabolism?

A

Catabolic, antagonistic to insulin

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4
Q

How do glucocorticoids alter calcium metabolism?

A

Decrease GI absorption and increase urinary excretion

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5
Q

What 3 things do glucocorticoids cause with regards to water?

A

PU
PD
Increased GFR

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6
Q

What effect can glucocorticoids have on the heart? (2 things)

A

Chronotropic

Inotropic

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7
Q

What type of leukogram do you see with glucocorticoid use?

A

Stress

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8
Q

What 3 hematology values increase with glucocorticoid use?

A

PCV
Platelets
Clotting/platelet function

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9
Q

What blood chem value will usually increase with glucocorticoid use?

A

ALP

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10
Q

What blood chem values (4) may increase with glucocorticoid use?

A

ALT
GGT
Cholesterol/TGs
Glc (+/-)

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11
Q

What blood chem values (2) may decrease with glucocorticoid use?

A

BUN

T3/T4

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12
Q

What 3 things might you see in the nervous system with glucocorticoid use in animals?

A

Polyphagia
Peripheral neuropathies
Euphoria/depression

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13
Q

What can glucocorticoid use mask?

A

A febrile response

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14
Q

What 3 things can you see in the skin with chronic excess of glucocorticoids?

A

Mineralization (Calcinosis cutis)
Thinning and weakening of skin
Alterations in hair turnover

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15
Q

What can you see in the bones of animals being treated with glucocorticoids?

A

Osteoporosis (increased osteoclasts, decreased osteoblasts)

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16
Q

T/F: Glucocorticoids inhibit fibroblasts.

A

True

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17
Q

What two reproductive processes are inhibited by glucocorticoid use?

A

Spermatogenesis

Ovulation

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18
Q

What detrimental effects can glucocorticoids have on fetal development>

A

Teratogenic

Induce abortion/parturition

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19
Q

What effect does glucocorticoid use have on the stomach?

A

GI ulceration

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20
Q

How do glucocorticoids cause GI ulceration? (2 things)

A

Increased acid secretion

Decreased mucus secretion

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21
Q

What causes significant risk of GI ulcerations if used with glucocorticoids?

A

NSAIDs

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22
Q

What can you see in the liver from glucocorticoid use?

A

Fatty liver

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23
Q

Can glucocorticoid use directly cause pancreatitis?

A

No

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24
Q

What sort of immunologic effect does glucocorticoid use have? (2 things)

A

Anti-inflammatory

Immune suppression

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25
Q

What type of cellular effects does glucocorticoid use have on the leukocytes? (5 things)

A 
Inhibits leukocyte recruitment
Decrease phagocytosis
Reduce bactericidal activity
Inhibit inflammatory mediators
Suppresses fibroplasia/granulation tissue
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26
Q

What “dose-related effect” do glucocorticoids have on the immune system?

A

Lower dose = anti-inflammatory

Higher dose = immunosuppressive

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27
Q

Where are glucocorticoids readily absorbed from?

A

GIT
Skin
MM

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28
Q

What sort of protein binding do glucocorticoids have?

A

High affinity for transcortin

Low affinity for albumin

29
Q

What 3 glucocorticoids need hepatic metabolism to be activated?

A

Methylprednisone
Prednisone
Cortisone

30
Q

What kind of distribution do glucocorticoids have in the body?

A

Wide, including CNS

31
Q

Where are glucocorticoid metabolites excreted?

A

In the urine

32
Q

What are some major contraindications for glucocorticoid use? (name 3… list of 7)

A 
Diabetes mellitus
Infection
Corenal ulceration
Young animals
Pregnant animals
Surgical patients
Preexisting catabolic disease
33
Q

Are glucocorticoids an enzyme inducer or inhibitor?

A

Inducer

34
Q

What do you NEVER use with glucocorticoids?

A

NSAIDs

35
Q

What general side effects can you see with short-term (3-5 days) glucocorticoid use? (3 things)

A

Labwork changes
PU/PD/Polyphagic
Fetal abnormalities.abortion

36
Q

What side effects can you see with long-term (>1 week) glucocorticoid use? (6 things)

A 
Increased susceptibility to infectino
Poor healing
Skin changes
Hypertension
Panting
Addisonian signs (withdrawal)
37
Q

What must be considered with glucocorticoid therapy if discontinuing?

A

Taper dose

38
Q

What are 3 things to consider with glucocorticoid use?

A

Potency
Duration of Action
Require activation?

39
Q

How are steroids divided for duration?

A

Short
Intermediate
Long

40
Q

What do salt esters (Sodium Phosphate and Sodium succinate) do to glucocorticoids? (2 things)

A

IV injection

Larger volumes

41
Q

Do salt esters effect the duration of glucocorticoids?

A

No

42
Q

What do insoluble esters (acetate, acetonide) do to glucocorticoids? (2 things)

A

Longer absorption

Delay onset

43
Q

Do insoluble esters effect the duration of glucocorticoids?

A

Yes, prolonged

44
Q

What are insoluble esters also considered?

A

Depot injection

45
Q

What are long-acting glucocorticoids?

A

Betamethasone

Dexamethasone

46
Q

What are intermediate glucocorticoids?

A

Triamcinolone

47
Q

What are short-acting glucocorticoids?

A

Hydrocortisone
Prednisolone
Prednisone
Methylprednisone

48
Q

What suspensions mean topical use for glucocorticoids?

A

Fluorination or esterification with fatty acids or cyclic acetonides (acetate or acetonamide)

49
Q

What is an excipient?

A

Anything that alters the kinetics of the drug (eg. different propellant to get better lung dispersion)

50
Q

What glucocorticoid is an inhalant?

A

Fluticasone diproprionate

51
Q

What steroid is ~15x more potent that prednisolone?

A

Budesonide

52
Q

Where do mineralocorticoids have their effect?

A

Na+ retention in the kidney and K+ excretion

53
Q

What is the endogenous mineralocorticoid?

A

Aldosterone

54
Q

What are mineralocorticoids used to treat?

A

Addison’s

55
Q

What 2 drugs are used to treat Addisons?

A

DOCP

Fludrocortisone (Florinef)

56
Q

What is hypoadrenocorticism?

A

Addison’s

57
Q

What is iatrogenic hypoadrenocorticism?

A

Suppressed adrenals with exogenous steroids.

58
Q

How do you treat iatrogenic hypoadrenocorticisim?

A

Wean off steroid

59
Q

What is “typical” Addison’s?

A

Deficient in both mineralocortiocid and glucocorticoid

60
Q

How do you treat typical Addison’s?

A

Florinef or DOCP and Prednison

61
Q

What is “atypical” Addison’s?

A

Deficient in glucocorticoid ONLY

62
Q

How do you treat atypical Addison’s?

A

Prednisone only

63
Q

What is the common name for hyperadrenocorticism?

A

Cushing’s

64
Q

What 2 things are commonly used to treat hyperadrenocorticism?

A

Mitotane

Trilostane

65
Q

What do you need to be careful with when using Mitotane?

A

Cytotoxic

66
Q

What can greatly increase absorption of Mitotane?

A

Oil (caution owners in case they supplement oils)

67
Q

How does Trilostane work?

A

Competitive inhibitor of steroid synthesis

68
Q

What 2 drugs are uncommonly used to treat hyperadrenocorticism?

A

Ketoconazole

Selegiline (L-Deprenyl) (Anipryl)

69
Q

What is use to treat hyperadrenocorticism in horse?

A

Pergolide

Pharmacology 2 (9 decks)

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