32: Corticosteroids

Question 1

five receptor in the steroid nuclear receptor family

Answer 1

1. androgen
2. estrogen
3. progesterone
4. glucocorticoids
5. mineralocorticoids

Question 2

six ways to make sure steroids arent being overused in pt**

Answer 2

1. use them no longer than necessary to achieve desired effect
2. if tx objective is not being reached, discontinue use
3. use lowest dose for shortest duration
4. use topical or inhaled forms to reduce systemic concentration
5. give single doses in the AM (this is when cortisol is highest)
6. dose tapering when finishing up

Question 3

Mitotane

Answer 3

used to treat adrenal cortical carcinoma

Question 4

the primary mineralocorticoid is _____, but H’s ____ and ____ also have mineralocorticoid function

Answer 4

1. Aldosterone

2. Progesterone, Deoxycorticosterone

Question 5

Metyrapone

Answer 5

used to Dx adrenal insufficiency, sometimes to tx Cushings

Question 6

two compounds that interact with glucocorticoids and what enzyme they inhibit

Answer 6

glycyrrhizin (licorice), carbenoxolone -> inhibit 11B-HSD2

Question 7

adrenal condition treated by spironolactone and eplereonone

Answer 7

1. spironolactone: hyperaldosteronism, hypokalemia

2. eplerenone: HTN

Question 8

how to tx Addison’s and CAH

Answer 8

hydrocortisone + fludrocortisone