PHARMA adrenocorticoids And Antagonists

Question 0

Normal amt cortisol secreted daily

Answer 0

10-20 mg following pulses of acth

Question 1

What is compound f

Answer 1

Cortisol

Question 2

Binds about 90% of circulating cortisol

Answer 2

Cortisol binding globulin

Question 3

Metabolite of cortisol measured in urine

Answer 3

Dihydroxy ketone

Question 4

Catabolic effect of cortisol on bone

Answer 4

Osteoporosis - major limitation in tx use of glucocorticoid

Question 5

Characterized by hypotension, hyperpigmentation and fasting hypoglycemia

Answer 5

Chronic adrenocortical insufficiency (addisons disease)

Question 6

Tx for addisons disease

Answer 6

Hydrocortisone

Question 7

How to protect fetus from congenital adrenal hyperplasia

Answer 7

DEXAMETHASONE to mother

Question 8

11 hydroxylation defect in CAH causes what?

Answer 8

Large amt of deoxycorticosterone

Question 9

If 17 hydroxylation is the defect in CAH

Answer 9

Hypogonadism!!

Question 10

Tx for congenital adrenal hyperplasia

Answer 10

ORAL hydrocortisone

Question 11

Bilateral adrenal hyperplasia is

Answer 11

Cushings syndrome

Question 12

Tx of cushings syndrome

Answer 12

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

Question 13

Primary aldosteronism

Answer 13

Conn’s syndrome / adrenal adenoma

Question 14

Cause of secondary aldosteronism

Answer 14

Lots of reenin and angiotensin ii

Question 15

Tx for secondary aldosteronism

Answer 15

FLUDROCORTISONE

DEOXYCORTICOSTERONE ACETATE

Question 16

Purpose of DEXAMETHASONE suppression test

Answer 16

To diagnose cushings syndrome and diff dx of depressive psychiatric states

Question 17

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

Answer 17

Combined test of DEXAMETHASONE and standard CRH test

Question 18

Corticosteroid with increased transfer across placenta

Answer 18

Betamethasone

Question 19

Betamethasone clinical use

Answer 19

Stimulate lung maturation in premature fetus

Question 20

Daily dose of 100 mg hydrocortisone for MORE THAN 2 WEEKS

Answer 20

Iatrogenic cushing syndrome

Question 21

3 mineralocorticoids

Answer 21

Aldosterone
Deoxycorticosterone
Fludrocortisone

Question 22

Precursor of aldosterone

Answer 22

Deoxycorticosterone

Question 23

Synthetic corticosteorid with both gluco and mineralocorticoid activity

Answer 23

Fludrocortisone

Question 24

Oral dose of fludrocortisone

Answer 24

0.1 mg 2-7x per week

Question 25

Blocks conversion of cholesterol to pregnenolone

Answer 25

Aminoglutethimide

Question 26

Potent non selective inhibitor of adrenal and gonadal steroid synthesis

Answer 26

Ketoconazole

Question 27

Ketoconazole adverse effect

Answer 27

Hepatotoxic

Question 28

Selective inhibitor of steroid 11-hydroxylation

Answer 28

Metyrapone

Question 29

Tx for pregnant women with cushings syndrome

Answer 29

Metyrapone

Question 30

Test for ADRENAL function using metyrapone

Answer 30

Blood levels of 11-deoxycortisol

Urine excretion if 17-hydroxycorticoids

Question 31

Metyrapone test for PITUITARY function

Answer 31

Blood levels of ACTH and 11-deoxycorticosteroid

Or Urine excretion if 17-hydroxycorticosteroids

Question 32

3b-17 hydroxysteroid dehydrogenas inhibitor

Answer 32

Trilostane

Question 33

Blocks 17a hydroxylas and 17,20 lyase

Answer 33

Arbiraterone

Question 34

Antagonist of steroid receptor, causing generalized glucocorticoid resistance

Answer 34

Mifepristone

Question 35

Non selective cytotoxic action on adrenal cortex in dogs

Answer 35

Mitotane (my tota/puppy)

Question 36

Slow onset tx for primary aldosteronism

Answer 36

Spironolactone

Question 37

Diagnostic use of spironolactone

Answer 37

Aldosteronism in hypokalemic patients with hpn

Question 38

Spironolactone use in surgery

Answer 38

Reduce incidence of cardiac arrhythmia

Question 39

Tx for women with hirsutism

Answer 39

Spironolactone

Question 40

Aldosterone antagonist approved tx for HPN

Answer 40

Epleronone

Question 41

Epleronone adverse effect

Answer 41

Mild hyperkalemia

Question 42

Progestin in oral contraceptives

Answer 42

Drospirenone