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adrenal pharm
Pharmacology of the adrenals
| Question | Answer |
|---|---|
| ketoconazole | antifungal agent that at high doese inhibits several P450 enzymes involved in steroidogenesis; useful for hirsutism and cushings |
| trilostane | synthetic steriod with no hormonal activity that interees with steriodogenesis; used to treat hyperaldosteronism and refractory cushings syndrome |
| trilostane | causes mostly GI side effects such as nausea, vomiting, diarrhea |
| metyrapone | blocks 11 hydroxylase, used to asses adrenal and pituitary function |
| aminoglutethimide | blocks conversion of cholesterol to pregnenolone reducing production of aldosterone, cortisol, and androgens; compensatory increase in ACTH can be presented by co administration of cortisol |
| aminoglutethimide | useful in adrenal carcinoma or CAD; adverse effects include drowsiness, skin raches, and nausea |
| mitotane | causes selective atrophy of zona fasc. and ret. |
| mitotane | use is limited to adrenal carcinomas when other therapies are not feasable |
| mitotane | sever adverse effects are not unusual and include GI distress, mental confussion, lethargy, dermal toxicity |
| mineralocorticoids | affects kidney regulating sodium and water balance |
| mineralocorticoids | fludrocortisone is the agent of choice |
| minerlaocrticoids | adverse effects- sodium retention, hypokalemia, edema, and hypertension |
| glucocorticoids | iatrogenic cushings disease, Na retention, K loss, adrenal suppression, hyperglycemia, osteoporosis, peptic ulcer, cataracts and glaucoma, hypertension, increased susceptibility to infections and poor wound healing, muscle weakness and tissue loss |
| glucocorticoids | inhibits plamsa ACTH, inhibits fibroblast growth and collagen synthesis, stimulates acid and pepsin secretion, |
| glucocorticoids | altered CNS responses, influincing mood and sleep patterns, enhanced neuromuscular transmission, inducts surfactant production |
| immunologic effects of glucocorticoids | decreases circulating lymphocytes, monocytes, eosinophils, and basophils; increases circulating neutrophils, results in involution and atrophy of all lymphoid tissue |
| anti-inflammatory effects of glucocorticoids | inhibits the antigenic response of macrophages and leukocytes; inhibits vascular premeablility by reducing histamine release and actions of kinins; inhibits arachadonic acid and prostaglandin production; inhibits of cytokine production |
| glucocorticoids | increase protein breakdownleading to a negative nitrogen balance; increased blood glucose levels by stimulation of gluconeogenesis,; increases synthesis of several key enzymes involved in glucose and amino acid metabolism; increased plasma fatty acids |
Created by:
swohlers
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