L35- Steroid Pharmacology (corticosteroid antagonists)

Question 1

list the corticosteroid antagonists

Answer 1

Gluco: Mifepristone

Mineralo: Spironolactone

Question 2

Spironolactone MOA

Answer 2

competes with aldosterone for renal receptors

Question 3

Spironolactone uses

Answer 3

• aldosteronism (Dx, Tx)
• diuretic
• hirsutism in women –> androgen antagonist

Question 4

Spironolactone AEs

Answer 4

• hyperkalemia
• cardiac arrhythmia
• menstrual abnormalities
• gynecomastia
• sedation
• HAs
• GI issues
• skin rashes

Question 5

Mifepristone MOA

Answer 5

antagonist at glucocorticoid receptors and progesterone receptors

Question 6

Mifepristone uses

Answer 6

inoperable ectopic ACTH syndrome or adrenal carcinoma

Question 7

list the steroid synthesis inhibitors

Answer 7

• ketoconazole
• aminoglutethimide
• metyrapone

Question 8

Aminoglutethimide:

• (1) MOA
• (2) uses

Answer 8

1- blocks cholesterol to pregnenolone –> reduces synthesis of all steroid hormones

2- adrenal cancer adjunct with hydrocortisone / dexamethasone

Question 9

Ketoconazole:

• (1) MOA
• (2) uses

Answer 9

1- potent non-selective inhibitor of adrenal and gonadal steroid synthesis

2- Cushing’s syndrome, Prostate cancer

Question 10

Metyrapone MOA

Answer 10

selective inhibitor of steroid 11 hydroylation –> interferes with cortisol and corticosterone (–> aldosterone) synthesis

Question 11

Metyrapone uses

Answer 11

tests adrenal function

Cushing’s syndrome in pregnancy

Question 12

Metyrapone AEs

Answer 12

• salt / water wasting
• hirsutism
• transient disease
• GI disturbances