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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, (54 cards)

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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

23
Q

ACTH binds to

Study These Flashcards
A

membrane G protien receptor

24
Q

effect of ACTH on cortisol

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A

increases transport of cholsteral, increases conversion of cholesterol to pregnalone

25
primary regulator of cortisol
ACTH
26
inactive pro-drug converted to prednisolone
prednisone
27
short to medium acting corticosteroids
anything with cortisone or predinsone/prednisolone (NOT fluprednisone)
28
intermediate acting corticosteroids
triamcinlone paramethasone fluprednisone
29
long active corticosteroids
beta/dexamethasone
30
mineralocorticoid f=drugs
fludrocortisone/desoxycorticosterone
31
disease that Glucocortoids can mimic/exacerbate
diabetes
32
effect of cortisol on protein
stimulates breakdown and amino acid conversion to glucose
33
effect of cortisol on lipid
increases catabolsim
34
effect of lipid catabolism on body
increase in free fatty acids, ketosis and fat redistribution (cushings)
35
test for cushing
failure of dex to supress ACTH/cortisol levels
36
general principles og corticosteroid use
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
very short half life corticosteroid
cortisol
38
very long t1/2 corticosteroid
dex
39
use of dex
inhibitor of ACTH
40
use of beclomethasone
topical anti-inflammatory, seasonal allergies via nasal/inhaler
41
tox of cortisol
``` fluid/electrolyte disturbances hyperglycimia and muscle wasting infections osteoporisis insomniea, "ten feet high and bullet-proof" adrenal insuffiency ```
42
treatment for addisons
oral hydrocortisone and possibly fludrocortisone
43
blocks synthesys of cortisol
metyrapone
44
antifungal agent
ketoconazole
45
used for adrenal carcinoma
mitotane
46
blocks production of all adrenal steroids
aminoglutethimide
47
MOA of aminoglutethimide
blocks coversion of cholesterol to preg
48
use of mifepristone
terminate pregnancy and glucocorticoid receptor antagonist
49
primary endogenous MC
aldosterone
50
potent replacement MC
fludrocortisone
51
toxic effects of MC treatment
edema, hypertension, CHF, hypokalemia, alkalosis
52
MOA of aldosterone
increases NA channels in DCT NA reabsorbed which absorbs H20 and HCO3
53
MC agonists (2)
spirolactone | elperone
54
MOA of spirolactone
competes with aldosterone for receptors, K sparing diuretic

Endocrine (13 decks)

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