Adrenal Pharmacology

Question 1

The most common cause of secondary adrenal insufficiency is _____________.

Answer 1

pharmacologic doses of glucocorticoids

Question 2

Among steroids, the ___________ effects can be separated from ___________ effects.

Answer 2

anti-inflammatory; mineralocorticoids

Question 3

Which two steroids (of the ones listed in Dr. French’s chart) have no salt-retaining effects?

Answer 3

Triamcinolone and dexamethasone

Question 4

Where is the cellular receptor for glucocorticoids?

Answer 4

In the cytosol, but it moves into the nucleus upon binding

Question 5

Cortisol stimulates contrary processes in the liver. Explain.

Answer 5

It stimulates gluconeogenesis and glycogen synthesis.

Question 6

The kidney has the enzyme _____________ to allow it not be affected by the mineralocorticoid function of cortisol.

Answer 6

11-beta hydroxysteroid dehydrogenase

Question 7

Which adrenal hormones will be absent in 21-hydroxylase deficiency?

Answer 7

Aldosterone and cortisol

Question 8

Without 17-alpha hydroxylase you don’t get _____________.

Answer 8

cortisol or androgens

Question 9

Describe the three pharmacologic things you can do for those with pheochromocytoma.

Answer 9

Alpha-blockade
Beta-blockade (once alpha blockade is sufficient)
Calcium channel blockers (for inadequate BP control)

Question 10

There are two kinds of 11-beta hydroxysteroid dehydrogenase. Which is deactivating?

Answer 10

11-B HSD2

Question 11

Lack of 17-alpha dehydrogenase results in what clinical picture?

Answer 11

Non-virilizing hypertension

Question 12

Lack of 21 hydroxylase results in what clinical picture?

Answer 12

Virilizing hypotension

Question 13

Lack of 11-beta hydroxylase results in what clinical picture?

Answer 13

Virilizing hypertension