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Flashcards in Adrenal Drugs Deck (18)
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1

Glucocorticoids (drugs 5, mechanism+effects, uses, side effects)

Drugs: hydrocortisone, cortisone, prednisone, prednisolone, dexamethasone

Mechanism: bind glucocorticoid receptor
Uses:
Side effects: Cushingoid effects- hyperglycemia/diabetes, fat redistribution to central obesity, catabolism (muscle wasting, osteoporosis, purple striation & bruising, poor wound healing, reduced growth). Also hirsutism, sweating, acne, depression/anxiety/hypomania, intraocular pressure/glaucoma/cataracts, peptic ulcers, infection, insomnia, HTN (if mineralocorticoid too like cortisol/cortisone)

2

Mineralocorticoids

Fludricortisone

3

Addison's Disease treatment

-glucocorticoids + mineralocorticoids

4

Congenital Adrenal Hyperplasia treatment

Prevents cortisol production, causing increased ACTH. Usually 21ß-hydroxylase issue so decreased gluco and mineralocorticoids, hyperandrogens
Treatment: glucocorticoids/mineralocorticoids

5

Endogenous Cushing's Syndrome treatment

-Ketoconazole/metyrapone (CYP inhibitor)
-mifepristone (GC receptor antagonist)
-Dopamine agonist (cabergoline)
-somatostatin receptor agonist (pasireotide) - latter 2 block ACTH release

6

Conn syndrome treatment

-primary hyperaldosteronism caused by adrenal adenoma
Treatment: spironolactone + eplerenone

7

Pheochromocytoma treatment

Treatment:
-å-agonist (phenoxybenzamine, prazosin/terazosin/doxazosin) preop
-ß-blockers (atenolol/metoprolol/propranolol)
-metyrosine (catecholamine biosynthesis inhibitor)

8

Ketoconazole

Mechanism: CYP inhibitor preventing cortisol/aldosterone production
Use: Cushing's syndrome/disease treatment
Side effects: GI, Hepatotoxicity

9

Metyrapone

Mechanism: CYP inhibitor preventing cortisol/aldosterone production
Use: Cushing's syndrome/disease treatment
Side effects: GI, bp/electrolytes, androgenic effects

10

Mifepristone

Mechanism: GC receptor antagonist
Use: treat cushings
SE: menstrual abnormalities, nausea, fatigue, hypokalemia

11

Cabergoline

Mechanism: Dopamine agonist, Suppresses pituitary ACTH
Use: Cushings
Side effects: cardiac valvulopathy, headaches, lightheadedness + orthostatic hypotension, fatigue, psych stuff

12

Pasireotide

Mechanism: somatostatin receptor agonist
Use: cushings- suppresses ACTH release
SE: GI, hyperglycemia, bradycardia, conduction issues

13

Spironolactone

Mechanism: MC receptor competitive inhibitor
Use: treats hyperaldosteronism
SE: hyperkalemia, cardiac arrhythmia, menstrual issues, gynecomastia

14

Eplerenone

Mechanism: competitive inhibitor of MC receptors
Use: hyperaldosteronism
SE: hyperakalemia

15

Phenoxybenzamine

Mechanism: selective å1 antagonist (irreversible)
Use: Pheochromocytoma HTN treatment preop
SE: orthostatic Hypotension, tachycardia

16

Prazosin, Terazosin, Doxazosin

Mechanism: competitive å1-antagonist
Use: Pheochromocytoma HTN
SE: orthostatic hypotension

17

Atenolol, metoprolol, propranolol

ß-blockers
Use: lower HR, bp, treat pheo with å-antagonists
SE: bradycardia, fatigue, cold hands

18

Metyrosine

Mechanism: tyrosine hydroxylase competitive inhibitor (prevents catecholamine synthesis)
Use: treats pheo HTN
SE: orthostatic hypotension, crystalluria