Nizoral

Ketoconazole

suppress cortisol synthesis

animoglutethimide

inhibits conversion of cho to pregnenolone

Mitotane

need a monitoring of adreanl hormone secresion Cortisol

Suppresses ACTH and reduces synthesis of cortisol

Metyrapone

inhibits 11 hydroxylase activity

• Chronic glucocorticoid excess
• Over production of ACTH
• DEX suppression test

Ketoconazole

pt counseling

• take with food---food stimulate gastric acid secretion
• Do not take it with antacids----Ketoconazole need stomach acid to be absorbed.
• CYP 3A4 inhibitor

Addison's disease

• adrenocortical deficiency
• destruction of the adrenal cortex
• glu and mineralocorticoid deficiency

addison's disease

Diagnosis

Adrenal crisis

DOC

cortisone

0.8

hydrocortisone

1

hydrocortisone

1

prednisone

4

prednisolone

4

prednisolone

4

methylprednisolone

5

Triamcinolone

5

Triamcinolone

5

Dexamethasone

30

dexsamethasone

30

Bethamethasone

25

Fludrocortisone

15

Drug interaction

ketoconazole

and warfarin