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30 Cards in this Set

  • Front
  • Back
what are the metabolic effects of glucocorticoids?
stimulate gluconeogenesis, insulin secretion, lipolysis and lipogenesis;

catabolism of muscle proteins, lymphoid tissue, cartilage, bone, fat and skin
immune effects of glucocorticoids?
decrease lymphocytes, eosinophils, basophils, and monocytes;

increase neutrophils;

inhibit leukocyte migration
other than immune suppression and metabolic effects, what effects do glucocorticoids have on the body?
aid in renal excretion of water

CNS effects in large doses

stimulate gastric acid in large doses
at what time of day does cortisol peak in the system?

when is it at its lowest?
high in AM

lowest around midnight
this glucocorticoid has moderate salt-retaining mineralocorticoid effects
cortisol
glucocorticoid with longest duration?
dexamethasone (24-36 h)
glucocorticoid with most anti-inflammatory effects?
dexamethasone (30x cortisol)
benefits of synthetic glucocorticoids?
less salt-retention, longer half-life, better penetration of lipid barriers for topical activity
why are glucocorticoids administered in some kinds of CAH?
suppress ACTH secretion to reduce synthesis of abnormal steroids
corticosteroid given to pregnant women to help fetal lung maturation?
betamethasone
toxic metabolic effects of glucocorticoids?
growth inhibition, diabetes, muscle wasting, osteoporosis
how should glucocorticoids be administered to avoid pituitary insufficiency?
alternate-day therapy, tapering soon after achieving therapeutic response or when discontinuing
pts on long-term glucocorticoids may need what to avoid adrenal crises?
additional "stress doses" of glucocorticoids during serious illness or before major surgery
what is the naturally occuring precursor of aldosterone?
deoxycorticosterone
mineralocorticoid given after adrenalectomy d/t its long half-life?
fludrocortisone
glucocorticoids aerosolized and used for asthma?

why?
beclomethasone, budesonide

readily penetrate airway mucosa but very short half-lives after entering blood
aldosterone receptor antagonists?
spironolactone, eplerenone
clinical use of aldosterone receptor antagonists?
potassium-sparing diuretics
competitive inhibitor of glucocorticoid receptors and progesterone receptors?
Mifepristone (RU-486)
clinical use of mifepristone?
treat Cushing's syndrome, emergency contraceptive
drugs used in treatment of adrenal cancer?
aminoglutethimide, metyrapone, ketoconazole
MOA of ketoconazole?
inhibits P450 enzymes necessary for steroid synthesis
clinical uses of ketoconazole?
adrenal carcinoma, hirsutism, breast and prostate cancer
MOA of aminoglutethimide?
blocks chol --> pregnenolone (desmolase)
inhibits all steroid synthesis
clinical use of aminoglutethimide?
used with other drugs for tx of steroid-producing adrenocortical cancer
MOA of metyrapone
blocks cortisol synthesis by inhibiting 11b-hydroxylase
clinical use of metyrapone?
used in diagnostic tests of adrenal fxn
what is a glucocorticoid response element?
a specific nucleotide sequence on DNA recognized by steroid hormone receptor-hormone complex
mineralocorticoid loss in acute adrenal insufficiency can lead to what?
dehydration
TxOC for acute adrenal insufficiency?
cortisol + fludrocortisone