Adrenal Pharmacology

  1. Two main pharmacological purposes of cortisol:
    • Suppress inflammation and immune response
    • Adrenal insufficiency
  2. When there is adrenal insufficiency, use ______ to treat
  3. When someone is having an inflammation/immune response, ie arthritis, asthma, use _____ to treat
  4. T/F: 90% of cortisol in the body is free floating and can easily cross through membrane of target cells
    False; 90% of cortisol is bound to binding protein. They can cross through membrane, and is later bound to an intracellular receptor within the cell
  5. T/F: cortisol inhibits macrophages from secreting inflammatory cytokines
  6. T/F: there is an immediate anti-inflammatory response with the use of cortisol
    False; there is delayed response for anti-inflammatory and immunosuppressive actions
  7. T/F: there is a rapid immediate response of vasoconstriction with cortisol use
    True; vasoconstriction to reverse inflammatory hyperperfusion
  8. Mineralocorticoid is a fancy name for _____, and they act on the _______ and allows for _______
    • Aldosterone
    • Collecting duct of kidney
    • Increase Na+ reabsorption
  9. T/F: mineralocorticoid receptor can be activated by cortisol
    True; in the kidney
  10. _____ converts cortisone (inactive) to cortisol (active) in the _____. Cortisol then go to the ____, which ____ converts it back to cortisone
    • 11 beta – HSD1
    • Liver
    • Kidney
    • 11 beta HSD 2
  11. Compound F is another name for _____
    • Cortisol
    • (hydrocortisone is another name too)
  12. Short-to-medium acting glucocorticoid agents include:
    • Hydrocortisone (Cortisol)
    • Prednisone
    • Methylprednisolone
  13. Most glucocorticoid can be given ___
    Orally or topically with injection
  14. Long acting glucocorticoid agent include:
  15. What is an agent of mineralocorticoids (the answer is not aldosterone):
  16. T/F: Prednisone is an active form of glucocorticoid with carbonyl group at the 11th Carbon
    False; it is inactive form because of the carbonyl group at the C11
  17. Active forms of glucocorticoid/ mineralocorticoid have _____ group at carbon position 11. These include:
    • Hydroxyl group at C11
    • Cortisol, prednisolone, methylprednisolone, dexamethasone, fludrocortisone
  18. In Addisons disease, there is a ____ in mineralocorticoid, and ____ in glucocorticoid, resulting in symptoms such as ___, ____ and ______
    • Decrease
    • Decrease
    • Bronze pigmentation of skin
    • Weakness
    • Postural hypotension
  19. What is the standard therapy for treating Addisons?
    • Hydrocortisone (15-20mg) in the morning and again in the early afternoon (5-10 mg)
    • Along with
    • Fludrocortisone 0.1 orally (for salt retaining ability
  20. T/F: diabetes can result as a side effect of glucocorticoid use
    True; due to increased gluconeogenesis
  21. What are adverse effects of corticosteroid?
    • Diabetes mellitus
    • Osteoporosis (inhibit osteoblasts)
    • Muscle atrophy (breakdown of muscle for gluconeogenesis)
    • Increased lipolysis resulting in hyperlipidemia, fat redistribution
  22. What are ways to limit corticosteroid adverse effects?
    • Local use/ topical administration as opposed to systemic IV use
    • If need to be on chronically, give it with another drug with anti-inflammatory effects and only give the minimally effective dose
  23. What can happen to the zona fasciculata and zona reticularis with secondary adrenal insufficiency?
    Atrophy can occur to those region of the adrenal gland
  24. T/F: acquired secondary adrenal insufficiency is a common clinical problem and is most often caused by a sudden cessation of exogenous glucocorticoid therapy
  25. Secondary adrenal insufficiency should be anticipated if on glucocorticoid treatment for longer than _______
    Three weeks
  26. When there is adrenal suppression from long term corticosteroid use, recovery from that may take up to _____ months. _____ level will return to normal faster because CRH recovers within weeks, however, _____ will take longer
    • 6-9 months
    • ACTH (within 3 months for ACTH to return to normal)
    • Cortisol
  27. Cushings syndrome will have these clinical symptoms:
    • Redistribution of body fat (central obesity)
    • Thinning of bones (osteoporosis)
    • Muscle wasting and weakness
    • Increased mineralocorticoid effects leading to HTN
    • Diabetes due to increased gluconeogenesis
  28. Cushing syndrome is likely when ________ test result is _______. So then you run _____ level.
    • Dexamethasone suppression
    • Abnormal (cortisol level is still increased despite the suppression test)
    • Plasma ACTH
  29. T/F: fetal aldosterone is important in lung maturation
    False; it is fetal cortisol
  30. Betamethasone acetate is used for _____
    Premature babies before 34 weeks to help with lung maturation and decreased death rates and neural impairment
Card Set
Adrenal Pharmacology
Endo Exam 2