Adrenal Cortex Disease Flashcards Preview

Pharmacology II > Adrenal Cortex Disease > Flashcards

Flashcards in Adrenal Cortex Disease Deck (24):
1

How much cortisol (hydrocortisone) is secreted each day?

10-20mg

2

When does ACTH peak

1. Early morning
2. After meals (esp. lunch)

3

What is the difference in regards to protein binding between cortisol and synthetic corticosteroids

cortisol is 90% bound to coticosteroid-binding globulin

synthetic corticosteroids (ex. dexamethasone) are bound to albumin

4

Effects of cortisol

-facilitate responsiveness to catecholamines in the vasculature and bronchial smooth muscle

-Help maintain adequate glucose supply to the brain (gluconeogenesis)

5

In what disease state are you most likely to see acute adrenocortical insufficiency (Adrenal Crisis)?

Addison's Disease

6

Adrenal crisis: Signs and symptoms

-Low blood pressure*
-Skin pigmentation increased*
-weakness

7

What test is utilized for Adrenal Crisis?

Cosyntropin (synthetic ACTH) unable to stimulate cortisol to increase to above 20mcg/mL

8

Adrenal Crisis: tx

1. Hydrocortisone IV
2. Fludrocortisone acetate (oral) [mineralcorticoid]

9

Which steroid formulation is injectable?

Methylprednisolone

10

How much more potent is Prednisone than Hydrocortisone for inflammation?

4x more potent

11

How much more potent of an antiinflammatory is Triamcinolone than Hydrocortisone?

5x

12

How much more potent is Betamethasone compared to Hydrocortisone?

25-40

13

How much more potent is the anti-inflammatory affect of Dexamethasone compared to hydrocortisone?

30x more

-equivalent dose is 0.75mg

14

How much more potent is Fludrocortisone than Hydrocortisone in salt-retaining ability

250x

(also, 10x more anti-inflammatory action)

15

Addison's Disease: clinical presentation

-Skin pigmentation
-Hypotension
-Hyponatremia
-Hyperkalemia, Hypercalcemia
-Elevated BUN

ACTH is elevated in the blood

16

What 2 drugs are used to treat Addison's Disease?

1. Hydrocortisone
-take 2/3 dose in the morning and 1/3 in late afternoon

2. Fludrocortisone acteate

17

Addison Crisis: treatment

1. IV saline!!!
2. Glucose
3. Glucocorticoids

18

Cushing's Syndrome: key points

-exogenous drug is MC reason**
-ACTH hypersecretion
-Women (more common)

19

Which drug for treating Cushing Syndrome is an abortifacient--so rule out pregnancy

Mifepristone

20

Hyperaldosteronism is caused by ______or ______

excess aldosterone secretion

or

Low levels of angiotensin II

21

Primary Hyperaldosteronism

AKA Conn's Syndrome

-adrenals are making too much aldosterone

22

Secondary Hyperaldosteronism

Low plasma renin activity

and

Angiotensin II

23

What are the 3 main symptoms of Hyperaldosteronism?

1. HTN w/ hypokalemia

2. Tetany/paralysis

3. Polydipsia/nocturnal polyuria

24

What is the common ADE lab value to monitor in Hyperaldosteronism?

hypokalemia

(Amiloride, Eplerenone, Spironolactone)