Pharmacology of Glucocorticoids & Mineralocorticoids Flashcards
Excessive glucocorticoid use leads to adrenal cortex atrophy. Why is this?
ACTH, released by the anterior pituitary, stimulates growth of the adrenal cortex. When glucocorticoid levels are high, ACTH is decreased due to negative feedback. Over time this can lead to adrenal cortex atrophy
What major ADR is associated with the drug used to inhibit cortisol synthesis?
Levoketoconazole - hepatotoxicity
What is a possible effect of spironolactone and eplerenone on acid/base balance?
Metabolic acidosis
What are the only drugs administered to premature newborns to stimulate maturation of lung tissue?
Dexamethasone & betamethasone - mineralocorticoids are not used
This disease is characterized by decreased synthesis of cortisol and aldosterone by the adrenal cortex. It is treated with mineralocorticoids.
Addison’s Disease
This drug inhibits the 11B hydroxylase, thus preventing cortisol synthesis.
Levoketoconazole
What is the synthetic mineralocorticoid to treat Addison’s disease?
Fludrocortisone
What are the metabolic effects of glucocorticoids?
Gluconeogenesis and glycogenolysis, and protein catabolism
This aldosterone antagonist is known to cause gynecomastia in men.
Spironolactone
What is the effect of aldosterone on electrolyte balance?
Na+ reabsorption, excretion of K+ and H+ - the result is increased blood pressure
This drug acts as a glucocorticoid receptor blocker to reverse Cushing’s syndrome.
Mifepristone
From where are glucocorticoids and mineralocorticoids released?
Adrenal cortex
What is the primary endogenous glucocorticoid?
Hydrocortisone/Cortisol
What drug directly suppresses the adrenal cortex and is used to treat inoperable adrenal cortical carcinoma?
Mitotane
What is the effect of cortisol on electrolyte balance?
Na+ retention and K+ loss leading to hypokalemic alkalosis
What is the primary mineralocorticoid synthesized by the adrenal cortex?
Aldosterone
What are the hematopoietic effects of glucocorticoids?
Increased Hb, RBCs, and platelets. Decreased monocytes, basophils, eosinophils, and lymphocytes
A patient has been using glucocorticoids longterm. They now present with a moon face appearance, buffalo hump, and thin extremities. What is the diagnosis?
Cushing’s Syndrome
Cortisol is responsible for various MSK ADRs. What MSK ADR is most associated with cortisol?
Tendon rupture
True/False. Glucocorticoids impair bone development.
True - they decrease osteoblast activity and Ca2+ absorption in the GI tract
