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Endocrine > adrenocorticosteroids > Flashcards

adrenocorticosteroids Flashcards

1. Identify the symptoms of both over- and under-production of adrenocorticoides and be able to describe the regulatory mechanisms of adrenocorticoid production. 2. List the prototype short- to medium-acting glucocorticoids, describe their clinical use, and list their major adverse effects. 3. List the prototype intermediate-acting glucocorticoids, describe their clinical use, and list their major adverse effects. 4. List the prototype long-acting glucocorticoids, describe their clinical use,

1
Q

moon face, truncal obesity, striae, hypertension, osteoporosis, diabetes

A

cushings

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2
Q

cushing cause

A

ACTH overproduction

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3
Q

masculinization/feminization is overproduction of

A

androgens

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4
Q

low K, high Na without edema, weakness, tetany, polyuria, and hypokalemic alkalosis

A

Conn’s

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5
Q

cause of Conn’s

A

excess mineralcorticoids

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6
Q

pigmentation, decreased cardiac size, hypotension,

A

addison’s

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7
Q

cause of addisons

A

incomplete adrenal desctruction

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8
Q

what happens when your adrenals are removed and you stop taking your meds

A

high K, low Na, decreased plasma volume, hypoglycemia, high ACTH

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9
Q

main glucocorticoid

A

cortisol

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10
Q

main mineralcorticoids

A

aldosterone

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11
Q

role of glucocorticoids

A

glucose, amino acid and lipid metabolism

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12
Q

medical use of glucocorticoids

A

anti-inflammatory and immunosupressiion

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13
Q

role of mineralcorticoids

A

salt and water balance

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14
Q

rate limiting step in adrenal hormone prodction

A

cholesterol to pregenolone

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15
Q

resivoir of corticosteroids

A

blood

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16
Q

converts cholesterol to pregneolone

A

ACTH and NADPH

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17
Q

t 1/2 of cortisol

A

60-90 minutes

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18
Q

metabolizes cortisol

A

liver

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19
Q

MOA of cortisol

A

binds to intracellular receptor to increase transcription of DNA/translation of RNA

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20
Q

best dosing practice for hormone replacment therapy with glucosteroids

A

give highest dose in the AM when andogenous production is highest, then smaller dose mid-day if needed

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21
Q

overuse of glucosteroids can result in

A

suppression of ACTH release, leading to adrenal suppression, leading to atrophy of adrenal cortex

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22
Q

dx drug for adrenal insufficiency

A

cosyntropin

23
Q

ACTH binds to

A

membrane G protien receptor

24
Q

effect of ACTH on cortisol

A

increases transport of cholsteral, increases conversion of cholesterol to pregnalone

25
Q

primary regulator of cortisol

A

ACTH

26
Q

inactive pro-drug converted to prednisolone

A

prednisone

27
Q

short to medium acting corticosteroids

A

anything with cortisone or predinsone/prednisolone (NOT fluprednisone)

28
Q

intermediate acting corticosteroids

A

triamcinlone
paramethasone
fluprednisone

29
Q

long active corticosteroids

A

beta/dexamethasone

30
Q

mineralocorticoid f=drugs

A

fludrocortisone/desoxycorticosterone

31
Q

disease that Glucocortoids can mimic/exacerbate

A

diabetes

32
Q

effect of cortisol on protein

A

stimulates breakdown and amino acid conversion to glucose

33
Q

effect of cortisol on lipid

A

increases catabolsim

34
Q

effect of lipid catabolism on body

A

increase in free fatty acids, ketosis and fat redistribution (cushings)

35
Q

test for cushing

A

failure of dex to supress ACTH/cortisol levels

36
Q

general principles og corticosteroid use

A

attenpt to treat target tissue rather than systemic
try to give least amount for shortest time
single large dose is better than long term use

37
Q

very short half life corticosteroid

A

cortisol

38
Q

very long t1/2 corticosteroid

A

dex

39
Q

use of dex

A

inhibitor of ACTH

40
Q

use of beclomethasone

A

topical anti-inflammatory, seasonal allergies via nasal/inhaler

41
Q

tox of cortisol

A 
fluid/electrolyte disturbances
hyperglycimia and muscle wasting
infections
osteoporisis
insomniea, "ten feet high and bullet-proof"
adrenal insuffiency
42
Q

treatment for addisons

A

oral hydrocortisone and possibly fludrocortisone

43
Q

blocks synthesys of cortisol

A

metyrapone

44
Q

antifungal agent

A

ketoconazole

45
Q

used for adrenal carcinoma

A

mitotane

46
Q

blocks production of all adrenal steroids

A

aminoglutethimide

47
Q

MOA of aminoglutethimide

A

blocks coversion of cholesterol to preg

48
Q

use of mifepristone

A

terminate pregnancy and glucocorticoid receptor antagonist

49
Q

primary endogenous MC

A

aldosterone

50
Q

potent replacement MC

A

fludrocortisone

51
Q

toxic effects of MC treatment

A

edema, hypertension, CHF, hypokalemia, alkalosis

52
Q

MOA of aldosterone

A

increases NA channels in DCT
NA reabsorbed
which absorbs H20 and HCO3

53
Q

MC agonists (2)

A

spirolactone

elperone

54
Q

MOA of spirolactone

A

competes with aldosterone for receptors, K sparing diuretic

Endocrine (13 decks)

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