Steroids

Question 1

Synthetic steroids

Answer 1

Prednisone, Prednisolone, Dexamethasone
- replacement therapy in Addison’s (low daily dose)
- suppression therapy in CAH (low dose 2x daily)
- induction therapy in nephrotic syndrome (high dose daily)
- anti-inflammatory in arthritis, rheumatic carditis
- cancer chemo
- allergy, asthma, fetal lung syndrome, immunosuppression
Adverse Effects: pituitary-adrenal suppression, hypokalemic alkalosis, edema, hyperglycemia in diabetics, susceptibility to infections, behavioral disturbances

Question 2

Fluticasone, Mometasone

Answer 2

• modified steroid, undergoes extensive first-pass hepatic metabolism

Question 3

Beclomethasone

Answer 3

• Moidifed steroid, metabolized more rapidly in the lung for asthma

Question 4

Mifepristone

Answer 4

• Glucocorticoid antagonist, for hyperglycemia in Cushing’s patients with diabetes who aren’t surgically operable.

Question 5

Spironolactone

Answer 5

• Mineralocorticoid competitive inhibitor, for hypertension, and CHF after acute MI
  Side effects: hyperkalemia, gynecomastia

Question 6

Eplerenone

Answer 6

• selective mineralocorticoid receptor antagonist, for hypertension and heart failure

Question 7

Metyrapone

Answer 7

• inhibits 11beta-hydroxylase, which inhibits steroid biosynthesis

Question 8

Aminoglutethimide

Answer 8

• inhibits desmolase and aromatase, which inhibits steroid biosynthesis