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Flashcards in Adrenal/Bone Pharm Deck (27)
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1
Q

What are the 3 adrenocorticosteroids?

A

1-Glucocorticoids (regulation of intermediary metabolism/immunity)
2-Mineralcorticoids (aldosterone-salt retention)
3-Androgens (dehydroepiandrosterone-can be converted to estrogens)

2
Q

What drugs are used for their rapid and dramatic effect on inflammation and slows bone erosion and rheumatoid arthritis?

A

Glucocorticoids

*may cause loss of muscle mass and diabetogenesis

3
Q

What is the half-life of cortisol (hydrocortisone)?

A

60-90 minutes

*synthesized from cholesterol

4
Q

When plasma cortisol levels exceed ______ mug/dL CBG is saturated and the concentration of free cortisol rises rapidly

A

20-30

5
Q

Steroids interact with _______ to regulate and transcribe target genes

A

promoters

6
Q

What do glucocorticoids stimulate in the fasting state?

A

Gluconeogenesis and glycogen synthesis

7
Q

How do glucocorticoids affect fat deposits?

A

Has a net increase in fat deposition

8
Q

How do glucocorticoids affect bone?

A

They have catabolic and anti-anabolic effects on bone causing osteoporosis

*major limitation of long term steroid use

9
Q

How is inflammation reduces by glucocorticoids?

A

They affect leukocytes and suppress inflammatory cytokines/chemokines

10
Q

What are 3 short-medium acting glucocorticoids?

A

1-Hydrocortisone
2-Cortisone
3-Prednisone

11
Q

Which glucocorticoid is long-acting?

A

dexamethasone

12
Q

What are 7 conditions steroids can be used for?

A
1-Allergic rxns
2-GI disease
3-Systemic inflammation
4-Infection
5-Inflammatory conditions of bones/joints
6-Pulmonary disease
7-Skin disease
13
Q

Which disease is a result of adrenal glands producing too little cortisol, often has insufficient levels of aldosterone and may have weakness and weight loss?

A

Addison’s disease

14
Q

What is the typical treatment for Addison’s disease?

A

20-30 mg of hydrocortisone daily

*fludrocortisone may be added for salt-retention

15
Q

Which disease has chronic high levels of cortisol usually due to a ACTH secreting tumor?

A

Cushing syndrome

*fatty hump between shoulders, round face, stretch marks, osteoporosis and hypertension

16
Q

What are 3 cushings medications?

A

1-Ketoconazole (nizoral)
2-Metyrapone (Metopirone)
3-Mifepristone (korlym)

17
Q

Which drug is an inhibitor of adrenal and gonadal steroid synthesis by inhibiting side chain cleavage required for steroid hormone synthesis?

A

Ketoconazole (Nizoral)

18
Q

Which drug has a relatively selective inhibitor of steroid 11-hydroxylaiton and interferes with cortisol and corticosterone synthesis?

A

Metyrapone (Metopirone)

19
Q

Which drug is an antagonist to steroid receptors?

A

Mifepristone (Korlym)

20
Q

_______ Is abnormal loss of bone whereas ______ is uncontrolled osteoclastic bone resorption and poor bone formation

A

Osteoporosis

Paget’s disease

21
Q

What drug is secreted by thyroid, is 32 AA peptide, administered by injection or spray and inhibits osteoclastic bone resorption?

A

Calcitonin

22
Q

What are the three main regulators of Ca homeostasis?

A

1-Parathyroid Hormone (PTH)
2-Fibroblast growth factor 23 (FGF23)
3-Vit D

*Calcitonin is less critical

23
Q

Which group of drugs suppress activity of osteoclasts in part through the inhibition os farnesyl pyrophosphate synthesis?

A

Bisphophonates

*inhibit bone resorption. used to prevent osteoporosis and pagets disease

24
Q

What are the two main bisphosphonate drugs?

A

1-Ibandronate (Boniva)-monthly

2-Alendronate sodium (Fosamax)-daily/weekly

25
Q

What are 4 drugs that secondarily regulate bone mineral homeostasis?

A

1-Calcitonin
2-Glucocorticoids (reverse hypercalcemia)
3-Estrogens (prevent bone loss)
4-Selective estrogen Receptor Modulators

26
Q

Which drug is an antibody to the osteoclast stimulating RANK?

A

Denosumab (XGEVA)

*Blocks osteoclast number and activity

27
Q

Which drug is a recombinant form of parathormone segment and activates osteoblasts to stimulate new bone formation?

A

Terparatide (Forteo)