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Exam 4
Chapter 26: Glucocorticoids - multipurpose treatments
16
Pharmacology
Pre-School
04/19/2011

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Term

Number 1. slow
gene expression by acting upon nuclear regulatory factors. 
More recently steroids have been found to have plasma membrane receptors that cause somewhat quicker actions too.


Definition
Correct Answer: Steroids receptors cause (fast or slow) effects by changing (blank)
Term

Number 2. glucocorticoids 
Addison's.


Definition
Correct Answer: Adrenal cortex atrophy causes lose of (blank) = (blank) disease.
Term

Number 3. The adrenal cortex is maintained by the trophic actions of (blank) (peptide hormone) from the anterior pituitary.


Definition
Correct Answer: ACTH
Term

Number 4. ACTH injection is a diagnostic test for (blank) disease. If plasma cortisol rises then there is (blank) (tertiary, secondary, primary) deficiency. If cortisol does not rise then there is (blank) deficiency.


Definition
Correct Answer: Addison's // secondary // primary
Term

Number 5. short acting natural glucocorticosteroids // alter gene expression in many cells to raise plasma glucose and lipids, and lower immune response by reducing the synthesis of inflammatory mediators // hormone replacement in Addison's disease at low doses, to mimic normal levels and circadian rhythm -give 2/3 dose in morning and 1/3 dose in the late afternoon. These steroids have 
antiinflammatory activities at high doses and are used to treat inflammatory conditions like pulmonary edema, cerebral edema, cardiac tamponade, asthma, transplant rejection, autoimmune diseases.

Definition
Correct Answer: hydrocortisone, cortisone
Term

Number 6. A tumor of the adrenal cortex that produces excessive glucocorticoids is called (blank).


Definition
Correct Answer: Cushing's syndrome
Term

Number 7. Glucocorticoids given as drugs for antiinflammatory actions cause side effects that mimic adrenal cortex excess; this is called (blank)


Definition
Correct Answer: iatrogenic Cushing's disease
Term

Number 8. Central obesity, moon face, buffalo hump, muscle wasting, osteoporosis, hirsutism, hyperglycemia, hyperlipidemia, impaired immunity to infection, bruising, stria, thin skin, pyschosis


Definition
Correct Answer: symptoms of cushing's disease
Term

Number 9. If plasma cortisol levels are reduced by a (blank) test then a tumor in the (blank) is over producing ACTH = (tertiary, secondary, primary) Cushings syndrome.


Definition
Correct Answer: dexamethasone suppression // anterior pituitary // secondary
Term

Number 10. If cortisol levels remain high after a dexamethasone suppression test then a tumor in the (blank) is causing (blank) (tertiary, secondary, primary) Cushings syndrome.


Definition
Correct Answer: adrenal cortex // primary
Term

Number 11. long acting synthetic glucocorticosteroids // alter gene expression in many cells to raise plasma glucose and lipids, and lower immune response by reducing the synthesis of inflammatory mediators // Therapeutic uses are // 1) 
hormone replacement in Addison's disease at low doses // 2)
antiinflammatory at high doses, for inflammatory conditions like anaphylactic shock (used with epinephrine fast acting - steroids are slow), pulmonary edema, cerebral edema, cardiac tamponade, asthma, transplant rejection, autoimmune diseases. Other drugs are used with steroids to combat the immediate emergency and steroids slowly reduce the inflammatory reactions causing the emergency to prevent reoccurrence.

Definition
Correct Answer: prednisone, prednisolone, triamcinolone, dexamethasone
Term

Number 12. limited or no fever, suppressed white blood cell count (neutrophils elevated initially) no pain of inflammation, no pus, negative x-ray for infection without inflammatory reaction causing white areas, hyperglycemia without diabetes, hyperlipidemia without atherosclerosis


Definition
Correct Answer: diagnostic signs altered by steroids
Term

Number 13. mineralocorticoids = aldosterone receptor agonists // mimic the actions of aldosterone to increase salt and water retention at the renal collecting duct // TUs are replacement therapy for atrophy of the adrenal zona glomerulosa (hypoaldosteronism) or replacement therapy along with a glucocorticoid for complete adrenal cortex atrophy (Addison's disease)


Definition
Correct Answer: fludrocortisone, deoxycorticosterone
Term

Number 14. inhibitors of adrenocorticoid biosynthesis by inhibiting the aromatase enzyme // metyraprone blocks synthesis of glucocoricoids - used for inoperable Cushing syndrome // aminoglutethimide blocks synthesis of estrogens by the adrenal used to treat postmenopausal breast cancer and malignancies of the adrenal cortex. // ketoconazole (antifungal) inhibits gonadal and adrenal steroid synthesis

Definition
Correct Answer: metyrapyrone, aminoglutethimide, ketoconazole
Term

Number 15. aldosterone structural analog // inhibits aldosterone and androgen synthesis // inhibits hyperaldosteronism and hirsutism in women overproducing androgens // also a K sparing diuretic // used to treat CHF in later stages of congestive heart failure.


Definition
Correct Answer: spironolactone
Term

Number 16. progesterone receptor antagonist also glucocorticoid receptor antagonist // 
used for inoperable Cushing syndrome // also medical abortion often with misoprostol- in other countries it is a postcoitalor "morning after" or "emergency" contraceptive.


Definition
Correct Answer: mifepristone
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