NURS 572 Pharm 59 Word Scramble
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Question | Answer |
The adrenal cortex produces three classes of hormones | *glucocorticoids (hypothal/pituitary control *mineralocorticoids (RAAS control) *Androgens (hypotha/pit control) |
what is the feedback look for glucocorticoids and androgens | they feed back to both hypothalamus and pituitary |
MOA glucocorticoids (major actions) | *CHO metab; increase glucose bwo gluconeogenesis (opposes insulin, worsens diabetes). *pro catabolism (including gluconeogenesis) *fat metabolism (lipolysis, fat redistribution) |
MOA glucocorticoids (minor actions) | *maintain CV integrity *increase RBCs, neutrophils *DECREASE lymphocytes, monocytes (immunosupp) *CNS maintain mood, excitability *neonatal lung maturity |
name the 4 glucocorticoids that also have mineralcorticoid action - from strong dose to weak dose | *cortisone *hydrocortisone *prednisone *prednisolone |
name 4 glucocorticoids WITHOUT mineralcorticoid action - from strong to weak dose | *methylprednisolone *triamcinolone *betamethasone *dexamethasone |
name 1 mineralcorticoid | aldosterone |
MOA of mineralcorticoid - aldosterone | maintain Na/H20 and K balance (in collecting duct, mediated by RAAS) |
adrenal hormone disorder - Cushing's | too much cortisol, too much aldosterone (?) |
adrenal hormone disorder - Addison's | too little cortisol, too little aldosterone |
how do we treat hyperaldosteronism | surgery, or tx with spironolactone or amiloride |
how do we treat adrenal insufficiency | treat with glucocorticoid that has mineralcorticoid action (so we address both the cortisol and aldosterone components of insufficiency) |
so, if I have adrenal insufficiency, what 4 corticosteroids would I administer | you would administer the corticosteroids that have mineralcorticoid action *cortisone *hydrocortisone (prednisone/prednisolone have less mineralcorticoid action, so aren't preferred) |
But what if my adrenal insufficiency treatment doesn't offer enough mineralcorticoid dosage | then need to treat with fludrocortisone |
hydrocortisone is preferred to treat adrenal insufficiency. Why? | because it has significant mineralcorticoid activity in addition to its glucocorticoid actions |
how do we dose hydrocortisone | important to dose based on diurnal pattern of endogenous secretion --- 2/3 total dose in a.m., 1/3 total dose in p.m. |
ADRs of hydrocortisone | *HPA axis suppression --> decreased cortisol, aldosterone *if admin too much, could lead to Cushing's |
When is fludrocortisone used | used in conjunction with glucocorticoid tx when additional mineralcorticoid action is needed |
fludrocortisone indicated for these patients | *Addison's *primary hypoaldosteronism *congenital adrenal hyperplasia |
ADRs fludrocortisone | *Na/H20 retention *edema *HTN *hypokalemia |
Created by:
lorrelaws
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