PHARMA adrenocorticoids And Antagonists Flashcards Preview

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Flashcards in PHARMA adrenocorticoids And Antagonists Deck (43):
0

What is compound f

Cortisol

1

Normal amt cortisol secreted daily

10-20 mg following pulses of acth

2

Binds about 90% of circulating cortisol

Cortisol binding globulin

3

Metabolite of cortisol measured in urine

Dihydroxy ketone

4

Catabolic effect of cortisol on bone

Osteoporosis - major limitation in tx use of glucocorticoid

5

Characterized by hypotension, hyperpigmentation and fasting hypoglycemia

Chronic adrenocortical insufficiency (addisons disease)

6

Tx for addisons disease

Hydrocortisone

7

How to protect fetus from congenital adrenal hyperplasia

DEXAMETHASONE to mother

8

11 hydroxylation defect in CAH causes what?

Large amt of deoxycorticosterone

9

If 17 hydroxylation is the defect in CAH

Hypogonadism!!

10

Tx for congenital adrenal hyperplasia

ORAL hydrocortisone

11

Bilateral adrenal hyperplasia is

Cushings syndrome

12

Tx of cushings syndrome

IV soluble hydrocortisone (300 mg) on the day of SURGERY

13

Primary aldosteronism

Conn's syndrome / adrenal adenoma

14

Cause of secondary aldosteronism

Lots of reenin and angiotensin ii

15

Tx for secondary aldosteronism

FLUDROCORTISONE
DEOXYCORTICOSTERONE ACETATE

16

Purpose of DEXAMETHASONE suppression test

To diagnose cushings syndrome and diff dx of depressive psychiatric states

17

How to distinguish between hypercortisolisn due to anxiety and alcoholism (pseudocushings syndrome)

Combined test of DEXAMETHASONE and standard CRH test

18

Corticosteroid with increased transfer across placenta

Betamethasone

19

Betamethasone clinical use

Stimulate lung maturation in premature fetus

20

Daily dose of 100 mg hydrocortisone for MORE THAN 2 WEEKS

Iatrogenic cushing syndrome

21

3 mineralocorticoids

Aldosterone
Deoxycorticosterone
Fludrocortisone

22

Precursor of aldosterone

Deoxycorticosterone

23

Synthetic corticosteorid with both gluco and mineralocorticoid activity

Fludrocortisone

24

Oral dose of fludrocortisone

0.1 mg 2-7x per week

25

Blocks conversion of cholesterol to pregnenolone

Aminoglutethimide

26

Potent non selective inhibitor of adrenal and gonadal steroid synthesis

Ketoconazole

27

Ketoconazole adverse effect

Hepatotoxic

28

Selective inhibitor of steroid 11-hydroxylation

Metyrapone

29

Tx for pregnant women with cushings syndrome

Metyrapone

30

Test for ADRENAL function using metyrapone

Blood levels of 11-deoxycortisol
Urine excretion if 17-hydroxycorticoids

31

Metyrapone test for PITUITARY function

Blood levels of ACTH and 11-deoxycorticosteroid
Or Urine excretion if 17-hydroxycorticosteroids

32

3b-17 hydroxysteroid dehydrogenas inhibitor

Trilostane

33

Blocks 17a hydroxylas and 17,20 lyase

Arbiraterone

34

Antagonist of steroid receptor, causing generalized glucocorticoid resistance

Mifepristone

35

Non selective cytotoxic action on adrenal cortex in dogs

Mitotane (my tota/puppy)

36

Slow onset tx for primary aldosteronism

Spironolactone

37

Diagnostic use of spironolactone

Aldosteronism in hypokalemic patients with hpn

38

Spironolactone use in surgery

Reduce incidence of cardiac arrhythmia

39

Tx for women with hirsutism

Spironolactone

40

Aldosterone antagonist approved tx for HPN

Epleronone

41

Epleronone adverse effect

Mild hyperkalemia

42

Progestin in oral contraceptives

Drospirenone