Endocrine Drugs - Corticosteroids And Antagonists Flashcards Preview

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Flashcards in Endocrine Drugs - Corticosteroids And Antagonists Deck (22):
0

What are the clinical applications of prednisone?

1. Many inflammatory conditions
2. Organ transplantation
3. Hematologic cancers

1

What are the pharmacokinetics of prednisone?

Duration of activity is longer than pharmacokinetic half-life of drug owing to gene transcription.

2

What is the toxicity of prednisone?

1. Adrenal suppression
2. Growth inhibition
3. Muscle wasting
4. Osteoporosis
5. Salt retention
6. Glucose intolerance
7. Behavioral changes

3

Besides prednisone mention some other primarily glucocorticoids.

1. Triamcinolone
2. Dexamethasone

4

What is the mechanism of action of fludrocortisone?

Strong agonist of mineralocorticoid receptors and moderate activation of glucocorticoid receptors.

5

What is the clinical application of fludrocortisone?

Addison's disease.

6

What are the pharmacokinetics of fludrocortisone?

Long duration of action.

7

What are the toxicities of fludrocortisone?

1. Salt and fluid retention
2. Congestive heart failure
3. Signs and symptoms of glucocorticoid excess

8

What is the mechanism of mifepristone?

Pharmacologic antagonist of glucocorticoid and progesterone receptors.

9

What are the clinical applications of mifepristone?

1. Medical abortion
2. Very rarely Cushing's syndrome

10

How is mifepristone administered?

Oral administration.

11

What is the toxicity of mifepristone?

1. Vaginal bleeding in females
2. Abdominal pain
3. GI upset
4. Diarrhea
5. Headache

12

What is the mechanism of action of spironolactone?

1. Pharmacologic antagonist of mineralocorticoid receptor.
2. Weak antagonism of androgen receptors.

13

What are the clinical applications of spironolactone?

1. Aldosterone am from any cause.
2. Hypokalemia due to other diuretics.
3. Post-MI

14

What are the pharmacokinetics of spironolactone?

Slow onset and offset of effect.
24-48h duration.

15

What are the toxicities of spironolactone?

1. Hyperkalemia
2. Gynecomastia (not eplerenone)
3. Additive interaction with other K-retaining drugs

16

What is the mechanism of action of ketoconazole?

Blocks fungal and mammalian CYP450 enzymes.

17

What is the clinical application of ketoconazole?

Inhibits mammalian steroid hormone synthesis and fungal ergosterol synthesis.

18

How is ketoconazole administered?

Oral or topical administration.

19

What is the toxicity of ketoconazole?

Hepatic dysfunction - many drug-drug CYP450 interactions.

20

What are the advantages of the synthetic glucocorticoids compared to cortisol?

1. Longer half-life
2. Longer duration of action
3. Reduced salt retaining effect
4. Better penetration of lipid barriers for topical activity

21

Besides ketoconazole, mention two other steroid synthesis inhibitors.

1. Aminoglutethimide
2. Metyrapone

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