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Block 2 Pharm > Endocrine: Adrenal Drugs > Flashcards

Endocrine: Adrenal Drugs Flashcards

1
Q

Three Types of Corticosteroids

A

Glucocorticoids —- Cortisol
Mineralocorticoids —- Aldosterone
Sex Steroids —- DHEA, Androstenedione, Testosterone

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2
Q

Mineralcorticoid Actions

A
  • INC Na+ reabsorption from the DCT and CD

- INC K+ and H+ Excretion in Urine

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3
Q

Glucocorticoid Actions: Carbohydrates

A
  • Promotes Gluconeogenesis

- Inhibit peripheral utilizations and stimulating glucose release from liver

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4
Q

Glucocorticoid Actions: Proteins

A
  • INC Breakdown of bone, muscle, fat and skin
  • Mobilization of amino acids for glucose production
  • Negative nitrogen balance (more nitrogen excreted than taken in)
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5
Q

Glucocorticoid Action: Fat

A
  • Lipolysis

- Redistribution of fat

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6
Q

Glucocorticoid Action: Lymph Nodes

A
  • INC in destruction of lymphoid cells
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7
Q

Glucocorticoid Action: CVS

A
  • INC Capillary Permeability
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8
Q

Glucocorticoid Action: Inflammation

A
  • DEC Inflammatory cell recruitment
  • DEC inflammatory cytokines
  • Inhibit PLA2 — DEC PGs and LTs
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9
Q

Glucocorticoid Action: Immunity

A
  • Inhibit fxn of macrophages and presenting cells
  • Inhibit IL1 and IL2
  • Suppression of NK Cells
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10
Q

Excess Cortisol Manifestations

A
  • INC Protein Catabolism
  • INC Glucose Production (DM)
  • Truncal Obesity
  • Osteoporosis (bone breakdown)
  • Catechol synth (HTN)
  • Immunosuppression (opportunistic infxns)
  • Inhibition of HPG Axis (Amenorrhea, impotence)
  • Depression and memory difficulties
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11
Q

Cushing’s Syndrome

A
  • Cortisol Excess from any source
  • Most common non-iatrogenic source is a Pituitary Adenoma
    S/Sx: Moon face, mood swings, HTN, Obesity, Purpura, poor wound healing, thin wrinkled skin, buffalo hump
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12
Q

Short to Medium Acting Glucocorticoids

A

“Hi Can the Prime Minister Play?”

  • Hydrocortisone
  • Cortisone
  • Prednisone
  • Prednisolone
  • Methylprednisone
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13
Q

Intermediate Acting Glucocorticoids

A

“Do you have TP?”

  • Triamcinolone
  • Paramethasone
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14
Q

Long Acting Glucocorticoids

A

“Beth and Dex do Meth w/ their Son”

  • Bethamethasone
  • Dexamethasone
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15
Q

Mineralocorticoids

A

“He was DOA w/ the Flu”

  • Fludrocortisone
  • DesOxycorticosterone Aceteate (DOA)
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16
Q

Topical Steroid Preparations

A

“BBF not BFF”

  • Beclomethasone
  • Budesonide
  • Fluticasone
17
Q

Acute Adrenal Insufficiency, S/Sx and Tx

A

S/Sx: Nausea, Vomiting, Abd pain, Hyponatremia, Hyperkalemia, weakness, Hypotension, Dehydration
Tx: IV D5NS, Hydrocortisone Infusion and fix the precipitating cause (Infxn, trauma, hemorrhage)

18
Q

Chronic Adrenal Insufficiency (Addison’s) S/Sx and Tx

A

S/Sx: Weight loss, hypotension, fatigue, weakness

Tx: Daily Corticosteroids and Mineralocorticoid replacement (Fludrocortisone Acetate)

19
Q

Congenital Adrenal Hyperplasia, Cause and Tx

A
  • CYP21 defect

TX: Hydrocortisone and Mineralocorticoid (for salt wasting)

20
Q

Non-Endocrine Uses

A
  • RA
  • Collagen Vascular Disorders
  • Gout
  • Severe Allergic Rxns
  • Fetal Lung Maturation (Betamethasone - Reduces risk of RDS at birth)
21
Q

Bronchial Asthma Tx

A

“Best Friend Turned BoyFriend”

  • Beclomethasone Diproponate
  • Fluticasone
  • Triamicinolone Acetonide
  • Budesonide
  • Flunisolide
22
Q

Corticosteroids SE

A
  • Peptic Ulcers
  • Osteoporosis
  • Precipitation of DM and HTN
  • Edema
  • Glaucoma
  • Cataract
  • Fetal Abnormalities
  • Muscle Wasting
  • Immune Responses
  • Suppression of HPA Axis
23
Q

General Principles in Corticosteroid Therapy

A
  • Use short acting, lowest possible dose for short period
  • Long Term Tx - HP Suppression
  • ABRUPT CESSATION - WITHDRAWAL
  • Gradually Taper Off Dose
  • Infxn, Severe Stress, trauma = INC THE DOSE (acute adrenal insufficiency)
  • Use more locally applicable preparations
24
Q

Glucocorticoid Antagonists

A
  • Metyrapone - Used in Cushing’s; Suppress CYP11B1
    SE: Edema, Hirsutism
  • Aminoglutethimide - CYP11A1 in Cushing’s; Also used in Breast Cancer
  • Trilostane - 3-17 Hydroxysteroid Dehydrogenase Inhibtor
25
Q

Mineralocorticoid Antagonist

A
  • Spironolactone - Used in Hyperaldosteronism tx (SE: Hirsutism)
  • Eplerenone
  • Drospirenone

Block 2 Pharm (8 decks)

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