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11 Cards in this Set
- Front
- Back
Cortrophin
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- pig ACTH
- must administer iv or im - half life: 15 mins - can increase skin pigmentation and lipolysis in the absence of glucocorticoids - repository injection: gelatin or zinc hydroxide complexes; slow absorption; longer acting; painful swelling at the site of injection (zinc hydroxide>gelatin) |
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Cosyntrophin
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- synthetic human ACTH
- 1-24 aa only, reduces immunogenesis - half life: 15 mins - can increase skin pigmentation and lipolysis in the absence of glucocorticoids - repository injection: gelatin or zinc hydroxide complexes; slow absorption; longer acting; painful swelling at the site of injection (zinc hydroxide>gelatin) - contraindication: sensitivity to pig ACTH |
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Chronic Glucocorticoids Replacement
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- oral cortisol (5-10 mg t.i.d., more when stress)
- mineralocorticoids (deoxycorticosterone, fludrocortisone) |
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Acute (Addisonian) Crisis
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- cortisol (100 mg q.i.d. until patient is stable)
- iv fluid and NaCl - glucose |
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Cortricorelin
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- ovine CRH
- used to test for pituary vs. ectopic source of ACTH |
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Dexamethasone
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- a synthetic glucocorticoids
- use for supression test, to document hypersecretion |
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Metyrapone
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- a cortisol synthesis antagonist
- inhibits 11beta-hydroxylase (final enzyme in cortisol synthesis) - administered orally - used for diagnosis of HPA axix function and to treat Cushing's syndrome - adverse effect: dizziness, GI disturbance, with chronic use: elevated mineralocorticoids and androgens |
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Mitotane
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- general adrenocorticoid antagonist
- o,p-DDD (isomer of DDT) - selective toxicity for adrenal cortex - MOA not understood; cause mitochondrial degeneration - sometimes used as anti-tumor agent for adrenal carcinoma - need life-long glucocorticoid and mineralocorticoid after use - adverse effects: GI disturbance, CNS depression, skin rashes |
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Aminoglutethimide
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- general steroidogenesis antagonist
- inhibits P450scc - used to: reduce gonadal hormone in breast cancer patient, reduce adrenal cortical hormones in adrenal carcinoma - must add cortisone to block ACTH eleveation |
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Ketoconazole
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- widely used steroidogenesis antagonist
- antifungal agent - at higher dose, inhibit glucocorticoid synthesis - block P450scc and other enzymes - used to treat: Cushing's syndrome |
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Trilostane
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- steroid hormone antagonist
- reversible inhibitor of 3beta-HSD - block cortisol and aldesterone synthesis - used when a more definitive treatment is not available |