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27 Cards in this Set
- Front
- Back
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Long acting GC: dosed overnight, levels of cortisol measured to diagnose cause of excess cortisol production.
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Dexamethasone
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tx of ectopic ACTH syndrome and pregnant people w/ cushing's syndrome
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Metyrapone
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Dx cushing's syndrome
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Dexathasone
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↓enzyme 11B hydroxylase (which allows production of both aldosterone and cortisol), ↑ levels of 11 deoxycorticosteroids (aldosterone path) and adrenal androgens
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Metyrapone
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SE: Na+ and H2O retention, hirsuitism and dizziness
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Metyrapone
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Tx of ectopic ACTH tumors, cushing's d/t adrenal Cancer, adrenal hyperplasia
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aminoglutethimide
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inhibits conversion of cholesterol to pregnenolone (knocks out all adrenal steroids)
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Aminoglutethimide
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SE: lethargy, drowsiness, HA, N/V
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Aminoglutethimide
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Tx of cushing's syndrome and hyperaldosteronism
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Spironolactone
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MOA: antagonist at the mineralcorticoid receptor, ↓resorption of Na+ and secretion of K+.
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SPironolactone
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Inhibits all gonadal and adrenal steroid hormone synthesis (inhibits conversion of cholesterol to pregnolone by inhibits desmolase)
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Ketoconazole
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SE: HSN, GI disturbances
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Ketoconazole
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Dx: addison's
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Cosyntropin
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Synthetic ACTH, Used to determine whether its primary or secondary insufficiency.
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Cosyntropin
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TX of addisons- GC and MC activity
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hydrocortisone (short acting GC), fludrocortisone (MC)
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TX of acute adrenal insufficiency
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hydrocortisone (short acting GC)
IV isotonic NaCl appropriate therapy for precipitating cause (infection, trauma, hemorrhage) |
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LIFE THREATENING. GI sxs (N/V/PAIN), dehydration, hyponatremia, hyperkalemia, weakness and hypotension
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Acute adrenal insufficiency
d/t abrupt w/drawal of GC or w// stress in adrenally compromised pt |
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MC, ↑androgen secretion, ↓MC secretion; think masculinization and HypOtension
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Lack of 21 hydroxylase
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↑androgen and ↑MC secretion; think masculinization and HypERtension
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Lack of 11-hydroxylase
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↓androgen and ↑MC; think demasculinization and HypERtension
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Lack of 17-hydroxylase
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TX CAH- suppress release of CRH and ACTH to ↓ production of androgens (2)
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dexamethason and hydrocortisone
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TX: CAH - replace hormones specific for enzymatic defect
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Hydrocortisone
Fludrocortisone Dexamethasone- GC replacement , esp in fetus (not bound by CBG) |
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Tx CAH to prevent aromatization of androgens to estrogens
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Aromatase inhibitors (anastrazole, letrazole)
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Tx CAH anti-androgens
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flutamide: nonsteroidal competitive inhibitor of androgens at the testosterone receptor
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W/drawal GC therapy
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Prednisolone
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Often caused by exogenous CS admin (suddent w/drawal after prolonged use)- atrophy of ant pit and hypothalamus.
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2nd adrenal insufficiency
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↓cortisol w/ inappropriate ACTH (not elevated), aldosterone= normal (d/t zona G still intact)- defective ant pit or hypothalamic fxn
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2nd adrenal insufficiency
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