Ambulatory-Adrenal

Card Set Information

Author:
fallcloud13
ID:
145292
Filename:
Ambulatory-Adrenal
Updated:
2012-04-02 17:25:35
Tags:
Adrenal
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Description:
Ambulatory-Adrenal
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  1. Metyrapone
    • 11b hydroxylase inhibitor, 2-3g/day
    • Increase in ACTH due to sudden cortisol drop
    • SE: N/V/H, dizziness, hirsutism, acne, BP/electrolyte changes
  2. Aminoglutethimide
    • Aromatase inhibitor, 1g/day
    • 11b hydroxylase inhibitor
    • Used with metyrapone to use lowest dose
    • SE: Severe sedation, nausea
  3. Ketoconazole
    • 17a hydroxylase, 17,20 desmolase inhibitor, Nizaral
    • Takes weeks to start working
    • SE: CYP3A4 inhibitor, gynecomasta, low testosterone, GI
  4. Etomidate
    • General Anesthetic-not for chronic use
    • Similar to Ketoconazole
    • Parenteral only
  5. Mifepristone
    • Progesterone, androgen, glucocorticoid receptor antagonist
    • Incease cortisol and ACTH
    • 300-1200mg/day-Korlym, 600mg limite if renal, hepatic inpairment
  6. Mitotane
    • Reducese cortisol/corticosterone synthesis
    • Hospitalize due to SE
    • Long-term adrenal atrophy possible
    • Supple with additional corticosteroids
    • SE: sever CNS-lethargy, somnolence, N/D
  7. Cyproheptadine
    • Decrease ACTH secretion
    • SE: sedation, increased appetite
    • Last line
  8. Pasireotide
    • somatostatin analog
    • investigational

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