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14 Cards in this Set
- Front
- Back
Adrenal Medulla
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Epinephrine
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Epinephrine
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Tx for anaphylactic shock
- beta 1 receptors - increased heart rate and force of contraction, increase BP - beta 2 receptors - bronchial dilation, opens the airways for maximal respiration |
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Glucocorticoids
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SE: Looks like Cushing's Syndrome: osteoporosis, cataracts, immune suppression, fat redistribution, diabetes
Chronic therapy cannot be stopped abruptly; could end up with Addisionian crisis |
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Glucocorticoid drugs
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Short:
hydrocortisone - IV for Addisonian crisis cortisone fludrocortisone - high salt retention Intermediate: prednisone - inactive prednisolone methylprednisolone triamcinolone Long: (highest anti-inflam) dexamethasone betamethasone - delay labor and prevent RDS |
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Mineralocorticoid drugs
(controls H2O and electrolytes) |
Aldosterone - reabsorb Na+/H2O -> dec K+/H+
Deoxycorticosterone (DOC) Fludrocortisone Uses: acute adrenal insufficiency, chronic adrenal insufficiency, Addison's disease MOA: regulation of gene expression |
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Replacement therapy for Addison's Disease
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Glucocorticoid:
Hydrocortisone 20 – 30 mg / day orally; with meals 2/3 in the morning and 1/3 in the evening Increase dose during stress - infections, surgery. Mineralocorticoid: Fludrocortisone 0.05 – 0.2 mg / day Increase dose during exercise, sweating, diarrhea. Acute adrenal insufficiency (Addisonian crisis) A medical emergency!! Tx with IV hydrocortisone until stabilized, followed by oral therapy |
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Ketoconazole
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Tx for Cushing's Disease
MOA: Anti-fungal agent that inhibits several P450 enzymes involved in steroid biosynthesis. SE: inhibits androgen synthesis; can cause gynecomastia |
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Mifepristone
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Uses - maybe Cushing's Syndrome; inoperable pts with ectopic ACTH secretion of adrenal carcinoma
Progesterone antagonist, also. |
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Spironolactone
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MOA: Inhibits Aldosterone, "potassium sparing" diuretic
SLOW ACTING!! Other MOA: binds to the androgen receptor, competing with dihydrotestosterone, and is also used as an antiandrogen. Uses - hyperaldosteronism, Hirsutism, DOC for primary hyperaldosteronism AE - gynecomastia |
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Aminoglutethimide
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MOA: reversible blockade of conversion of cholesterol to pregnenolone (all adrenal steroids inhibited)
Use: Cushing's syndrome |
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Metyrapone
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MOA: --| GC syn by --| 11B-hydroxylase (androgen syn)
Uses: Cushing's syndrome AE: hirsutism |
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Mitotane
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Adrenolytic drug
Used in pts with adrenal carcinoma |
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Eplerenone
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MOA - more selective aldosterone antagonist
Uses - Tx of HTN and CHF |
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Medial Adrenalectomy
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Ketaconazole
Metyrapone Aminoglutethimide Mitotane |