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14 Cards in this Set

  • Front
  • Back
Adrenal Medulla
Epinephrine
Epinephrine
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
Glucocorticoids
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
Glucocorticoid drugs
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
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
Replacement therapy for Addison's Disease
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
Ketoconazole
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
Mifepristone
Uses - maybe Cushing's Syndrome; inoperable pts with ectopic ACTH secretion of adrenal carcinoma

Progesterone antagonist, also.
Spironolactone
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
Aminoglutethimide
MOA: reversible blockade of conversion of cholesterol to pregnenolone (all adrenal steroids inhibited)
Use: Cushing's syndrome
Metyrapone
MOA: --| GC syn by --| 11B-hydroxylase (androgen syn)
Uses: Cushing's syndrome
AE: hirsutism
Mitotane
Adrenolytic drug
Used in pts with adrenal carcinoma
Eplerenone
MOA - more selective aldosterone antagonist
Uses - Tx of HTN and CHF
Medial Adrenalectomy
Ketaconazole
Metyrapone
Aminoglutethimide
Mitotane