Adrenocortical Disorder Pharm

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  1. dexamethasone
    • low dose used as a suppression test of cortisol
    • screening test for Cushing's syndrome
    • high dose (8mg) used to determine pituitary vs ectopic ACTH-dependent Cushing's
    • - >50% suppression in pts with pituitary Cushing's, no suppression seen with ectopic Cushing's
  2. metyrapone and ketoconazole
    • enzyme inhibitors - direct inhibition of cortisol synthesis
    • used as medical therapy for Cushing's syndrome
  3. mifepristone
    • cortisol receptor blocker used as medical therapy for Cushing's syndrome
    • approved for pts who also have DMII
  4. spironolactone
    • Mineralocorticoid receptor (MR) antagonist
    • high affinity for progesterone and androgen receptors
    • used in the treatment of primary hyperaldosteronism¬†
    • adverse effects: breast tenderness and enlargement, sexual dysfunction
  5. eplerenone
    • selective MR antagonist
    • low affinity for progesterone and androgen receptors
    • used in the treatment of primary hyperaldosteronism
  6. amiloride
    • blocks epithelial sodium channel: indirect MR antagonist
    • no sex-hormone related adverse effects
    • used in the treatment of primary hyperaldosteronism
  7. cosyntropin or cortrosyn
    ACTH analogue used for testing purposes with adrenal insufficiency
  8. prednisone, hydrocortisone, cortisone acetate, dexamethasone
    • glucocorticoid therapy for treating adrenal insufficiency (primary and secondary)
    • used in conjunction with mineralocorticoids in treating primary adrenal insufficiency
  9. fludrocortisone
    mineralocorticoid used in conjunction with glucocorticoids in treating primary adrenal insufficiency
  10. bisphosphonates
    • antiresorptive drug that decreases bone resorption
    • used as medical therapy in primary hyperparathyroidism, where Ca2+ levels are not too high but patient has osteoporosis
  11. cinacalcet
    • calcimimetic that decreases PTH secretion, thus decreasing Ca2+ levels
    • used as medical therapy in primary hyperparathyroidism where Ca2+ levels are very high

Card Set Information

Author:
jboi
ID:
320167
Filename:
Adrenocortical Disorder Pharm
Updated:
2016-05-17 20:37:06
Tags:
MOHD3 pharmacology adrenocortical
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Description:
MOHD3 Lecture 98-100
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