Term
| What does the zona fasciculata of the adrenal gland produce? |
|
Definition
| The glucocorticoid Cortisol |
|
|
Term
| What does the zona glomerulosa of the adrenal gland produce? |
|
Definition
| The mineralocorticoid Aldosterone |
|
|
Term
| What region of the adrenal cortex produces androgens? What androgen does the adrenal cortex produce? |
|
Definition
Zona reticularis
Dehydroepiandrosterone (DHEA) |
|
|
Term
What is the short-acting glucocorticoid?
What is the intermediate-acting glucocorticoid?
What is the long-acting glucocorticoid? |
|
Definition
Short-acting glucocorticoid? Hydrocortisone
Intermediate-acting glucocorticoid? Prednisolone
Long-acting glucocorticoid? Dexamethasone |
|
|
Term
| In the diagnosis of Cushing's syndrome, what drug is administered? |
|
Definition
| Dexamethasone - in the Dexamethasone suppression test |
|
|
Term
| What drug has an UNLABELED USE of treating Cushing's syndrome? |
|
Definition
| Although Ketoconazole* is mainly used as an antifungal agent, at higher doses it also inhibits steroid synthesis, so it has been used to treat hirsutism, adrenal cancer, and Cushing's syndrome |
|
|
Term
| What are the drugs used to treat Cushing's syndrome? |
|
Definition
Metyrapone
Aminoglutethimide
Spironolactone*
Ketoconazole*
Mifepristone*
Pasireotide |
|
|
Term
| What is the DOC for ectopic ACTH syndrome? |
|
Definition
|
|
Term
|
Definition
| It reduces corticosteroid biosynthesis by inhibiting the final step in the pathway (11-hydroxylation) |
|
|
Term
| What else is Metyrapone the DOC for? |
|
Definition
| DOC for treatment of pregnant women with Cushing's syndrome |
|
|
Term
| Adverse effects of Metyrapone? |
|
Definition
Hirsutism
Salt & water retention
Dizziness |
|
|
Term
| What is the DOC for treatment of Cushing's syndrome associated with adrenal carcinoma? |
|
Definition
|
|
Term
| MOA of Aminoglutethimide? |
|
Definition
| Inhibits conversion of cholesterol to pregnenolone (the initial step in production of all steroid produced in the adrenal cortex) |
|
|
Term
| What is the MOA of Spironolactone* in treating Cushing's syndrome? |
|
Definition
| Spironolactone* antagonizes the mineralocorticoid receptor. Spironolactone* is also a diuretic and decreases resorption of Na+ and secretion of K+. |
|
|
Term
| What is the MOA of Mifepristone* |
|
Definition
| Mifepristone* antagonizes the glucocorticoid receptor. There is not effect on cortisol concentration. |
|
|
Term
| Adverse effects of Mifepristone*? |
|
Definition
Heavy bleeding (vaginal)
Endometrial changes
Nausea
Fatigue
Headache |
|
|
Term
| CIs for use of Mifepristone*? |
|
Definition
Pregnancy (it is an abortifacient)
Drugs metabolized by CYP3A (Simvastatin, Lovastatin)
Corticosteroid therapy (this is a corticosteroid antagonist) |
|
|
Term
| What drug is used in adults with Cushing's disease that are not candidates for surgery (or surgery was not curative)? |
|
Definition
|
|
Term
|
Definition
| Agonist at somatin receptor (sst-5). It inhibits the release of ACTH |
|
|
Term
| Adverse effects of Pasireotide? |
|
Definition
Hypocortisolism
Hyperglycemia/diabetes
QT prolongation
Liver test elevations
Cholelithiasis
Decreased pituitary function |
|
|
Term
| What drug is administered to test for primary adrenal insufficiency (Addison's disease)? |
|
Definition
| Cosyntropin (it is a synthetic ACTH) |
|
|
Term
| What type of drug is Cosyntropin? |
|
Definition
|
|
Term
| What drug is given in acute adrenal insufficiency? |
|
Definition
| Hydrocortisone (cortisol) |
|
|
Term
| What drug is used as a glucocorticoid replacement in a fetus? |
|
Definition
|
|
Term
| What two drugs may be used as GC replacements? |
|
Definition
Hydrocortisone
Dexamethasone |
|
|
Term
| What one drugs may be used as a MC replacement? |
|
Definition
|
|
Term
| What class of drugs are used to prevent aromatization of androgens to estrogens? |
|
Definition
|
|
Term
| What two drugs are aromatase inhibitors? |
|
Definition
|
|
Term
| What drug is an anti-androgen? |
|
Definition
Flutamide*
(Nonsteroidal drug that acts as a competitive antagonist at the androgen receptors) |
|
|
