Adrenal Pharmacology Flashcards

1
Q

What is used to treat adrenal insufficiency?

A

Glucocorticoids

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2
Q

How do synthetic glucocorticoids compare to natural as far as metabolism? Potency? Protein bound?

A

Metabolism: Slower
Potency: Increased
Protein bound: Less

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3
Q

What is the strength of synthetic glucocorticoids in decreasing potency?

A
Dexamethasone
Betamethasone
Fludrocortisone
Methylprednisone
Prednisolone
Prednisone
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4
Q

Which is the strongest mineralocorticoid? Which has virtually no effect?

A

Strongest: Fludrocortisone

No effect: Dexamethasone

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5
Q

Which is the inactive form of cortisol? Chemically, how does it get to that state?

A

Cortisone, gets reduced

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6
Q

What is the best thing to give for acute adrenal insufficiency?

A

I.V. Cortisol

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7
Q

What is the best thing to give for chronic primary adrenal insufficiency?

A

Cortisol

Fludrocortisone if needed

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8
Q

What is the best thing to give for secondary adrenal insufficiency?

A

Cortisol

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9
Q

What is the best thing to give for partial or complete 21 hydroxylase deficiency?

A

Cortisol

Fludrocortisone

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10
Q

What are major side effects of glucocorticoid treatments?

A
Hyperglycemia
Infection
Ulcer
Myopathy
Osteoporosis
HTN, K loss
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11
Q

What candy can augment cortisol effects?

A

Licorice

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12
Q

What is the method of administration for ACTH?

A

Injection

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13
Q

How is ACTH useful in testing adrenal insufficiency?

A

Distinguishes 1° from 2° adrenal insufficiency

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14
Q

How is ACTH useful in cisplatin treatment?

A

Anticonvulsant for infantile spasms and to prevent neurotoxicity of cisplatin

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15
Q

What is ACTH toxicity like?

A

Increased glucocorticoid effects

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16
Q

What can you do to treat Cushing disease for those who are poor surgical candidates?

A

Radiation

17
Q

What drugs can suppress ACTH secretion?

A

Pasireotide (SST analog)

Cabergoline (D2 analog)

18
Q

How does ketoconazole help cushing disease?

A

Blocks glucocorticoid synthesis by inhibiting side chain cleavage

19
Q

How does aminoglutethimide help cushing disease?

A

Inhibits side chain cleavage enzyme

20
Q

How does Etomidate help cushing disease?

A

Inhibits 11 beta hydroxylase

21
Q

How does Metyrapone treat Cushing disease?

A

inhibits 11 beta hydroxylase in adrenal gland

22
Q

What is mifepristone?

A

Synthetic steroid that acts as an antiprogestin.

High doses: binds strong to glucocorticoid receptors and some androgen receptors

23
Q

What is mitotane?

A

DDT insecticide with adrenal toxicity