Steroid Drugs

Question 1

Spironolactone (spare-no-aldosterone)

Answer 1

1. mineralcorticoid(Aldosterone) antagonist
2. Block aldosterones receptor, inhibiting transcription of protein to stimaulate ENaC (Block ENaC, inhibting Na/K pump)

Uses: Primary hyperaldosteronism & diuretic (K sparing diuretic

Adverse effects: Gynecomastia (anti-androgen effect blocking its channel)

Question 2

Fludrocortisone (Fluke-cortisone)

Answer 2

Mineralcorticoid Analog
- more selective than hydrocortisone with its effects ( & less dose)

Uses: Addison’s disease

Question 3

Ketaconazole

Answer 3

1. inhibits Cp450- inhibtion of steroid synthesis (thus decreasing production of cortisol & androgens)
2. also used as anti-fungal

Uses: Cushings Syndrome

Adverse Effects: Gynecomastia
CANNOT be stopped abruptly .. otherwise could cause Addisonian crisis (get rid of tumor first THEN hormone)

Question 4

Mifepristone (RU486)

Answer 4

Progestrone receptor antagonist (mainly on glucocorticoid)

Target: peripheral tissue
Uses: Cushings Syndrome (control the hyperglycemia)
** With Misoprostol: prego termination**

Adverse Effects: Immune depression & Anti-Inflammatory effect

Question 5

Hydrocortisone (Cortisone)
Dexamethasone
Prednisone
* bottom two more selective*

Answer 5

Act as a Glucocorticoid

Uses: Addison’s disease & Acute Adrenal Insufficiency (Addisonian Crisis: Medical Emerg)

Maintenance requires: Hydrocortisone & Fludrocortisone (DONT confuse with Fluticosone: a glucocorticoid used as an anti-inflammatory via B2 agonist)