Corticosteroids And Antagonists

Front 1

3 zones of the adrenal cortex and their products

Back 1

1) Glomerulosa-mineralocorticoids
2) Fasciculata-glucocorticoid
3) Reticularis- Adrenal androgens

Front 2

Used for Addison's disease, CAH, inflammation, allergies, and asthma (as a local inhalation)

Back 2

Glucocorticoids

Front 3

Short-acting GCs

Back 3

Cortisone and hydrocortisone(AKA cortisol)

Front 4

Intermediate acting GCs

Back 4

Prednisone, methylprednisolone, prednisolone and triamcinolone

Front 5

Long acting GCs

Back 5

Bethamethasone, dexomethasone, and paramethasone

Front 6

Synthetic mineralocorticoids

Back 6

Fludrocortisone, deoxycorticosterone

Front 7

SE of corticosteroids

Back 7

Osteopenia, impaired wound healing, inc risk of infection, inc appetite, HTN, edema, PUD, euphoria, psychosis, stria and thinning of skin

Front 8

Period of time of therapy after which GC therapy will need to be tapered

Back 8

5-7 days

Front 9

Used for Cushing's syndrome and sometimes adrenal function tests

Back 9

Metyrapone

Front 10

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

Back 10

Aminoglutethimide

Front 11

Antifungal agent used for inhibition of all gonadal and adrenal steroids

Back 11

Ketoconazole

Front 12

Antiprogestin used as potent antagonist of GC receptor

Back 12

Mifepristone

Front 13

Diuretic used to antagonize aldosterone receptors

Back 13

spironolactone

Front 14

Common SE of spironolactone

Back 14

Gynecomastia and hyperkalemia

Front 15

GC metabolic effects

Back 15

Stimulate gluconeogenesis w/ resultant increase in blood glucose, muscle protein catabolism and insulin secretion; lipolysis and lipogenesis are stimulated w/ moon face and buffalo hump

Front 16

Catabolic effects of GC

Back 16

Muscle protein catabolism; lymphoid and CT, fat, and skin undergo wasting under the influence of high conc GCs

Front 17

GC immunosuppressive effects

Back 17

inhibit cell mediated immunologic functions; actively lyphotoxic and, as such, are important in tx of hematologic cancers; delay rejection rxns

Front 18

Anti-inflammatory effects of GC

Back 18

Induce synthesis of an inhibitor of phospholipase A2, dec mRNA for COX-2, decreases in IL-2 and IL-3, and decreases in PAF, an inflammatory cytokine

Front 19

Partial or complete loss of adrenocortical function, including loss of GC and mineralocorticoid function

Back 19

Addison's disease

Front 20

A suppression of the ability of the adrenal cortex to produce corticosteroids. Most commonly is an iatrogenic effect of prolonged exogenous GC tx that results from inhibition by the GC of the secretion of ACTH by the pituitary

Back 20

Adrenal Suppression

Front 21

Major natural GC

Back 21

Cortisol (hydrocortisone)

Front 22

Regulates the physiologic secretion of cortisol

Back 22

ACTH and the circadian rhythm

Front 23

Major plasma form of cortisol

Back 23

bound to CBG (95%)

Front 24

GC w/ a small but very significant mineralocorticoid effect

Back 24

cortisol

Front 25

Synthetic GCs that readily penetrate the airway mucosa but have very short half-lives after they enter the blood so systemic effects and toxicity are greatly reduced; used for asthma

Back 25

Beclomethasone, Budesonide

Front 26

A GC w/ a low degree of protein binding, given to pregnant women in premature labor to hasten maturation of the fetal lungs

Back 26

Betamethasone

Front 27

Major natural mineralocorticoid in humans

Back 27

Aldosterone

Front 28

Secretion of this steroid is regulated by ACTH and by the renin-angiotensin system and is very important in the regulation of blood volume and BP

Back 28

Aldosterone

Front 29

Mineralocorticoid favored for replacement therapy after adrenalectomy due to its long DOA

Back 29

Fludrocortisone

Front 30

Antagonists of aldosterone at its receptor

Back 30

Spironolactone and eplerenone

Front 31

Competitive inhibitor of GC receptors as wells as progesterone receptors and has been used in the tx of Cushin's

Back 31

Mifepristone (RU-486)

Front 32

Inhibits the normal synthesis of cortisol but not that of cortisol precursors; can be used in diagnostic tests of adrenal function

Back 32

metyrapone

Front 33

MOA of Ketoconazole

Back 33

Inhibits the cytochrome p450 enzymes necessary for the synthesis of all steroids