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Pharma > PHARMA adrenocorticoids And Antagonists > Flashcards

PHARMA adrenocorticoids And Antagonists Flashcards

0
Q

Normal amt cortisol secreted daily

A

10-20 mg following pulses of acth

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1
Q

What is compound f

A

Cortisol

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2
Q

Binds about 90% of circulating cortisol

A

Cortisol binding globulin

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3
Q

Metabolite of cortisol measured in urine

A

Dihydroxy ketone

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4
Q

Catabolic effect of cortisol on bone

A

Osteoporosis - major limitation in tx use of glucocorticoid

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5
Q

Characterized by hypotension, hyperpigmentation and fasting hypoglycemia

A

Chronic adrenocortical insufficiency (addisons disease)

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6
Q

Tx for addisons disease

A

Hydrocortisone

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7
Q

How to protect fetus from congenital adrenal hyperplasia

A

DEXAMETHASONE to mother

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8
Q

11 hydroxylation defect in CAH causes what?

A

Large amt of deoxycorticosterone

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9
Q

If 17 hydroxylation is the defect in CAH

A

Hypogonadism!!

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10
Q

Tx for congenital adrenal hyperplasia

A

ORAL hydrocortisone

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11
Q

Bilateral adrenal hyperplasia is

A

Cushings syndrome

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12
Q

Tx of cushings syndrome

A

IV soluble hydrocortisone (300 mg) on the day of SURGERY

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13
Q

Primary aldosteronism

A

Conn’s syndrome / adrenal adenoma

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14
Q

Cause of secondary aldosteronism

A

Lots of reenin and angiotensin ii

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15
Q

Tx for secondary aldosteronism

A

FLUDROCORTISONE

DEOXYCORTICOSTERONE ACETATE

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16
Q

Purpose of DEXAMETHASONE suppression test

A

To diagnose cushings syndrome and diff dx of depressive psychiatric states

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17
Q

How to distinguish between hypercortisolisn due to anxiety and alcoholism (pseudocushings syndrome)

A

Combined test of DEXAMETHASONE and standard CRH test

18
Q

Corticosteroid with increased transfer across placenta

A

Betamethasone

19
Q

Betamethasone clinical use

A

Stimulate lung maturation in premature fetus

20
Q

Daily dose of 100 mg hydrocortisone for MORE THAN 2 WEEKS

A

Iatrogenic cushing syndrome

21
Q

3 mineralocorticoids

A

Aldosterone
Deoxycorticosterone
Fludrocortisone

22
Q

Precursor of aldosterone

A

Deoxycorticosterone

23
Q

Synthetic corticosteorid with both gluco and mineralocorticoid activity

A

Fludrocortisone

24
Q

Oral dose of fludrocortisone

A

0.1 mg 2-7x per week

25
Q

Blocks conversion of cholesterol to pregnenolone

A

Aminoglutethimide

26
Q

Potent non selective inhibitor of adrenal and gonadal steroid synthesis

A

Ketoconazole

27
Q

Ketoconazole adverse effect

A

Hepatotoxic

28
Q

Selective inhibitor of steroid 11-hydroxylation

A

Metyrapone

29
Q

Tx for pregnant women with cushings syndrome

A

Metyrapone

30
Q

Test for ADRENAL function using metyrapone

A

Blood levels of 11-deoxycortisol

Urine excretion if 17-hydroxycorticoids

31
Q

Metyrapone test for PITUITARY function

A

Blood levels of ACTH and 11-deoxycorticosteroid

Or Urine excretion if 17-hydroxycorticosteroids

32
Q

3b-17 hydroxysteroid dehydrogenas inhibitor

A

Trilostane

33
Q

Blocks 17a hydroxylas and 17,20 lyase

A

Arbiraterone

34
Q

Antagonist of steroid receptor, causing generalized glucocorticoid resistance

A

Mifepristone

35
Q

Non selective cytotoxic action on adrenal cortex in dogs

A

Mitotane (my tota/puppy)

36
Q

Slow onset tx for primary aldosteronism

A

Spironolactone

37
Q

Diagnostic use of spironolactone

A

Aldosteronism in hypokalemic patients with hpn

38
Q

Spironolactone use in surgery

A

Reduce incidence of cardiac arrhythmia

39
Q

Tx for women with hirsutism

A

Spironolactone

40
Q

Aldosterone antagonist approved tx for HPN

A

Epleronone

41
Q

Epleronone adverse effect

A

Mild hyperkalemia

42
Q

Progestin in oral contraceptives

A

Drospirenone

Pharma (20 decks)

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