Wk1 Adrenal Pharm

Question 1

General effect of glucocorticoid meds:

Answer 1

suppress immune system

Question 2

Why are WBC’s elevated in glucocorticoid use?

Answer 2

neut’s get stuck in vessels – no chemotaxis

Question 3

Anti-allergic effect of GC’s:

Answer 3

inhibit histamine synthesis by mast cells

**no effect on receptors so still some effect from existing histamine

Question 4

Drug that has more mineralcorticoid effect

used to replace aldosterone

Answer 4

Fludrocortisone

**all others have greater glucocorticoid effect

Question 5

Potential risk in GC use in diabetics:

Answer 5

hyperglycemia

Question 6

Read slide…

Answer 6

28 – Dex test for cushing syndrome

Question 7

Glucocorticoid effect on cardiovascular system:

Answer 7

ionotropic

Na/H2O retention –> increased BP

Question 8

Tx for Cushing disease

inhibits cholesterol side chain cleavage

inhibits glucocorticoid and androgen synthesis

Answer 8

Ketoconazole

Question 9

Tx for Cushing disease

inhibits 11 beta hydroxylase in adrenal cortex

Answer 9

Metyrapone

Question 10

Dopamine effect on ACTH:

Answer 10

suppression via D2 receptors

Cabergoline (dopamine agonist) used to treat pituitary adenomas that secrete ACTH

Question 11

Last line for refractory ACTH secreting tumors

glucocorticoid receptor antagonist

Answer 11

Mifepristone