Chapter 28: Adrenal Cortex Flashcards Preview

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Flashcards in Chapter 28: Adrenal Cortex Deck (25)
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1

What glucocorticoid receptor agonists are available in an inhaled form? What are these used to treat?

FB FB T (fluticasone, beclomethsone, flunisolide, triamclinolone, budeosonide)

Chronic asthma

2

What glucocorticoid receptor agonists are used cutaneously for things like psoriasis and dermatitis?

Methylprednisolone
Dexamethasone
Hydrocortisone

3

Which glucocorticoid receptor agonist has a long duration of action?

Dexamethasone

D is for Duration

4

What is the relationship between glucocorticoid anti inflammatory potency and duration of action?

The greater the anti-inflammatory potency the longer the duration of action

5

What do you need to keep in mind when switching a patient from oral glucocorticoids to inhaled?

Do not switch abruptly - wean off, especially if oral is high dose.

6

Administering glucocorticoids can lead to what major adverse effects?

Osteoporosis (because of decreased osteoblast activity)

Hypercortisolism w/ Cushing-like symptoms

Growth retardation

Diabetes mellitus

7

What is a negative effect of inhaled glucocorticoids? How can you advise a patient to avoid this?

Oropharyngeal candidiasis

Rinse mouth with water thoroughly after each use

Think of your symbicort

8

Which glucocorticoid can be administered to a pregnant woman without affecting the baby?

Prenisone

P is for Pregnant

9

Which glucocorticoid would you prescribe to promote fetal lung development? (i.e. which will cross placental barrier..?)

Dexamethasone

10

Intra-articular glucocorticoid depots are used to treat what types of conditions?

Gout, arthritis

11

Mifepristone is used for what?

Abortion through day 49 of pregnancy

12

How does the MOA of mifepristone differ at low versus high doses?

Progesterone receptor antagonist

Higher concentrations: blocks glucocorticoid receptor (could then be used for ridiculously high ACTH levels...)

13

Mitotane MOA

Structural DDT analogue

Toxic to adrenocortical mitochondria!!! AHHHH kills that mito MITO-tane

14

What is mitotane used for?

Medical adrenalectomy in severe Cushing's or adenocortical carcinoma...

Because it is toxic to the adrenocortical mitochondria, mitotane will destroy that shit ...
so too much cortisol or ACTH? BAM.

15

Why can mitotane cause hypercholesterolemia?

Because mitotane may also inhibit cholesterol oxidase = buildup of cholesterol

16

What drug would you use to treat Cushing's syndrome in DOGS only?

Trilostane (inhibits 3B hydroxysteroid dehydrogenase)

17

What drug inhibits side-chain cleavage enzyme as well as aromatase - and is used to treat Cushing's syndrome?

Aminoglutethimide

18

Which drug is used for diagnostic evaluation of the hypothalamic-pituitary-adrenal axis? What is the MOA?

Metyrapone

Inhibits 11B hydroxylation --> impaired cortisol and aldosterone synthesis

19

Ketoconazole

Antifungal agent that generally inhibits the wide range of adrenocortical hormones

20

What is Fludrocortisone?

Mineralcorticoid receptor agonist - like aldosterone

But we use this instead of aldosterone because fludrocortisone has a minimal first pass metabolism

Flud-->Fluid-->aldosterone

21

What do we use fludrocortisone for?

hypoaldosteronism - not enough aldosterone? give this crap!

22

When would we want to use mineralcorticoid receptor ANTAGONISTS?

antagonists would inhibit aldosterone action so that we didn't retain so much Na and Water....so this would DECREASE BP

Would use in heart failure patients as antihypertensive agents!

23

Spironolactone MOA

mineralcorticoid receptor antagonist

24

Eplerenone MOA

mineralcorticoid receptor antagonist

25

Advair is _____ and Symbicort is ______

Fluticasone
Budesonide