Ch 33 adrenal steroids

Question 1

fludrocortisone

Answer 1

• oral mineralocorticoid
• replacement for primary adrenal insufficiency in Addison’s disease
• has 20X more salt retaining potency than anti-inflammatory potency
• low potency; short acting
• add to chronic adrenal insufficiency morning dose if hyperkalemia with treatment
• salt wasting congenital hyperplasia

Question 2

cortisone

Answer 2

• low potency; short acting
• oral, parental, topical
• rapidly metabolized to hydrocortisone by the liver
• can be used for anti-inflammatory

Question 3

hydrocortisone

Answer 3

• low potency; short acting
• has equal glucocorticoid and mineralocorticoid effect
• may use for anti inflammatory effects
• IV for up to 48 hours in Addison’s crisis
• oral dose for chronic adrenal insufficiency
• suppress corticotropin in congenital adrenal hyperplasia

Question 4

dexamethasone

Answer 4

• low potency topically
• oral, parental, topically
• mitigate lymphotoxin effects of leukemias and lymphomas and control emesis

Question 5

prednisone

Answer 5

• medium potency; intermediate acting
• used for cancer, inflammation, allergy, autoimmune disorders
• oral
• rapidly converted to prednisolone upon administration

Question 6

desoximetasone (topicort)

Answer 6

• high potency topical

- dermatological disorders on thicker skin

Question 7

betamethasone

Answer 7

• very high potency topical
• oral, parental, topical
• treat respiratory distress syndrome in premature infants

Question 8

beclomethasone (beconase, qnasl)

Answer 8

• allergic rhinitis
• asthma
• nasal

Question 9

mometasone (nasonex)

Answer 9

• nasal
• allergic rhinitis
• asthma

Question 10

budesonide (rhinocort)

Answer 10

• nasal

- rhinitis

Question 11

triamcinolone

Answer 11

• medium potency; intermediate acting
• oral, parental, topical
• treat cancer, inflammation, allergy, autoimmune

Question 12

prednisolone

Answer 12

• medium potency; intermediate acting

- used for cancer, inflammation, allergy, autoimmune

Question 13

methylprenisolone

Answer 13

• medium potency; intermediate acting

- used for cancer, inflammation, allergy, autoimmune

Question 14

loteprednol

Answer 14

• ophthalmic
• corneal inflammation
• keratitis
• medium potency; intermediate acting

Question 15

difluprednate

Answer 15

• ophthalmic
• pain and inflammation in ocular surgery
• medium potency; intermediate acting

Question 16

desonide

Answer 16

• topical
• low potency; short acting
• OTC for allergic reaction

Question 17

fluticasone

Answer 17

• nasal
• asthma
• allergic rhinitis
• medium potency topical

Question 18

fluocinonide

Answer 18

• high potency; long acting

- topical

Question 19

ciclesonide

Answer 19

• nasal
• rhinitis
• hay fever

Question 20

clobetasol

Answer 20

• topical

- very high potency

Question 21

dehydroepiandrosterone (DHEA)

Answer 21

• major androgen secreted by adrenal cortex
• should not be used by men with prostate cancer
• OTC dietary supplement
• may increase muscle mass and strength

Question 22

fluconazole

Answer 22

• antifungal
• can help lower cortisol levels in Cushing’s
• also inhibits androgen synthesis and can cause gynecomastia

Question 23

ketoconazole

Answer 23

• antifungal
• can help lower cortisol levels in Cushing’s
• also inhibits androgen synthesis and can cause gynecomastia

Question 24

metyrapone

Answer 24

• inhibits synthesis of glucocorticoids
• occasionally used to treat Cushing’s in patients who are refractory to other treatment and not a candidate for surgery
• also used in tests of adrenal function

Question 25

mifepristone

Answer 25

- antagonist at both progesterone and glucocorticoid receptors - treatment of hyperglycemia in Cushing's

Question 26

spironolactone

Answer 26

- competes with aldosterone for aldosterone receptors on renal tubule - treatment for primary hyperaldosteronism caused by bilateral adrenal hyperplasia - may also improve secondary hyperaldosteronism