Endocrine II Flashcards
a glucocorticoid receptor antagonist that has anti-progestin activity as an oral contraceptive
mifepristone
how do glucocorticoids decrease inflammation/stop the production of prostaglandins?
to allow lipocortin to stop the conversion of phospholipase A2 to phospholipids, no longer creating PGs
which 2 corticosteroids are good for children and why?
fluticasone
budesonide
have a high first-pass effect
what are the ADR of corticosteroids?
Cushing’s syndrome
Osteoporosis
Retarded growth
Thin skin - bruising
Immunosuppression
Cataracts + glaucoma
Oedema
Suppression of HPA axis
Teratogenic
Emotional disturbance
Rise in BP
Obesity
Increased hair growth
Diabetes mellitus
Striae
what are the ADR of long term use of inhaled corticosteroids? (3)
candidiasis
dry mouth
dysphonia
why is there an increase risk of infection/immunosuppression in a patient who is taking a corticosteroid?
prevents accumulation of neutrophils and monocytes at sites of inflammation
why is osteoporosis possible in a patient taking a corticosteroid?
corticosteroids suppress calcium absorption
why would taking a corticosteroid decrease normal adrenal release of cortisol in stressful situations like major surgery, acute infection, or trauma?
because the body will think we have enough cortisol to handle the stress
what should we do for a patient that is taking a corticosteroid, who is experiencing or about to experience a stressor?
increase dose 2-3x the usual maintenance dose
what should we do to the increased corticosteroid dose once the stressor is over?
decrease dose over several days to previous maintenance level
why should we avoid cold turkey in corticosteroids?
cold turkey can lead to adrenal crisis
what is a short acting corticosteroid, it’s dosing, administration route, and its duration of action?
hydrocortisone
20mg
IV/IM
8-12 hrs
what are the 4 medium acting corticosteroids?
prednisone
prednisolone
methylprednisolone
triamcinolone
what is the prednisone dosing, administration route, and its duration of action?
5mg
PO
18-36 hrs
what is the prednisolone dosing, administration route, and its duration of action?
5mg
IV
18-36 hrs
what is the methylprednisolone dosing, administration route, and its duration of action?
4mg
IV/IM
18-36 hrs
what is the triamcinolone dosing, administration route, and its duration of action?
4mg
topical
18-36 hrs
what are the 2 long acting corticosteroids?
dexamethasone
betamethasone
what is the dexamethasone dosing, administration route, and its duration of action?
0.75mg
PO
36-54 hrs
what is the betamethasone dosing, administration route, and its duration of action?
0.6-0.75 mg
PO
36-54 hrs
which corticosteroid has the best sodium-retaining potency?
hydrocortisone
which corticosteroids have the best anti-inflammatory potency? (2)
dexamethasone
betamethasone
what are 4 androgens that are used to replace or augment endogenous androgen in hypogonadal men?
testosterone
methyltestosterone
fluoxymesterone
danazol
what is an antiandrogen that is known as a synthesis inhibitor?
cyproterone
what is cyproterone used for? (2)
hirsutism in women
male to female gender transition
what are androgen receptor antagonists used for?
treat prostate cancer
what are 5alpha-reductase inhibitors used for?
“5 alpha reductace inhibitors like to reduce the prostate”
prostate enlargement
what hormone is responsible for the enlargement of the prostate?
DHT
what drug class will we use to prevent the conversion of testosterone to DHT, to treat benign prostate hypertrophy?
5alpha-reductace inhibitor
-steride
5alpha-reductase inhibitors
which type of 5alpha-reductase inhibitor drug works everywhere/is non-selective?
what’s the name of the drug?
type 1 - dutasteride
which type of 5alpha-reductase inhibitor drug works in the prostate/is selective? what’s the name of the drug?
type 2 - finasteride
-sin
alpha 1 receptor antagonists
which drug class prevents the narrowing of the lumen of the urethra / relaxes the smooth muscle of prostatic urethra to treat BPH?
alpha 1 receptor antagonists
which of the drug classes used to treat BPH has a slower onset? what is it?
5alpha-reductase inhibitors
6 months
-fil
PDE5 inhibitors
how do PDE5 inhibitors help with erectile dysfunction?
inhibits PDE5 from turning cGMP into GMP
encourages more cGMP (vasodilation) for longer lasting erections
what are 4 ADR of PDE5 inhibitors?
since PDE5 inhibitors dilate vessels, they cause:
headache
flushing
dizziness
rhinitis
what 2 drugs are CI in patients using a PDE5 inhibitor, due to drug-drug interactions?
nitrates
antihypertensives
why do PDE5 inhibitors have a lot of drug interactions?
they are CYP3A4 substrates (metabolized by liver)
