Pharmacology - Adrenocorticosteroids And Adrenocortical Antagonists

Front 1

1. What are the Mineralcorticoids?

2. Which is the precursor to aldosterone?

3. Which is for salt-retaining ability after adrenalectomy?

Back 1

1.Aldosterone
Deoxycorticosterone - Precursor of aldosterone
Fludrocortisone

2. Deoxycorticosterone

3. Fludrocortisone

Front 2

1. What class of drugs are:
Aminoglutethimide
Ketoconazole
Metyrapone
Aldosterone antagonists
Mifepristone (RU-486)

2. What is the MOA of Aminoglutethimide?

3. What i Aminoglutethimide given with and why?

4. What is the result of this block and how does this help in cancer?

5. If the patient has breast cancer, which drug replaces Aminoglutethimide?

Back 2

1. Glucocorticoid antagonists

2. Blocks Cholesterol --> Pregnenolone conversion (rate limiting step in steroid synthesis)

3. Hydrocortisone replacement dose - Prevents override of block by ACTH (which would normally increase)

4. Reduction of all hormonally active steroids - Eliminates the influence of hormones in hormone dependent cancers

5. Tamoxifen

Front 3

Glucocorticoid antagonists --> Ketoconazole

1. MOA

2. Use

3. Tox

Back 3

1. Inhibits P450 (no steroid synthesis)
Inhibits Ergosterol synthesis (antifungal)

2. Cushing's
Adrenal Carcinoma
Hirsutism
Breast and Prostate cancer

3. Hepatotox
Drug interactions
Gynecomastia and anti-androgen effects

Front 4

Glucocorticoid Antagonists --> Metyrapone

1. MOA

2. Use

3. Tox

Back 4

1. Inhibits 11Beta-Hydroxylation
Interferes with Cortisol and Corticosterone Synthesis

2. Tx Cushing's
Tests the feedback loop and pituitary function
CAN BE USED IN PREGNANCY

3. Salt and H2O retention
Hirsuitism

Front 5

Aldosterone Antagonists --> Spironolactone, Eplerenone

1. MOA

2. Use

3. Tox

Back 5

1. Antagonize Aldosterone at collecting tubule

2. CHF
Antagonist of Mineralcorticoid and Androgen Receptors

3. HyperK+
Gynecomastia
Antiandrogen Effects

Front 6

Glucocorticoid Antagonists --> Mifepristone (RU-486)

1. MOA

2. Use

3. Tox

Back 6

1. Glucocorticoid and progesterone receptor antagonist

2. Cushing's
Abortifacient

3. GI effects
Vaginal bleeding