Repro-Endo: Adrenal Gland Flashcards Preview

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Flashcards in Repro-Endo: Adrenal Gland Deck (42)
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1

Beclomethasone

  • Inhaled Rx
  • Beclomethasone is used to prevent and control symptoms (wheezing and shortness of breath) caused by asthma
  • Chronic Asthma in Children
  • Se: growth velocity reduction
  • Potent anti-inflammatory glucocorticoid
  • Inhibits inflammatory cells and release of Inflammatory mediators

2

Fluticasone

  • Used to treat a variety of Skin conditions (such as eczema, psoriasis, rash)
  • Reduces swelling (inflammation), itching, and redness
  • Cream, Ointment, Lotion
  • Oral inhalation is used to prevent difficulty breathing, chest tightness, wheezing, and coughing caused by Asthma. 
  • Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes
  • Se: Burning, itching, stinging, or dryness may occur when you apply this medication, but usually only lasts a short time.

3

Budesonide

  • Anti-inflammatory corticosteroid
  • Potent glucocorticoid activity and weak Mineralocorticoid activity
  • Maintenance treatment for Asthma

4

Mometasone

  • Corticosteroid
  • Anti-inflammatory properties
  • Seasonal allergic rhinitis; Prophylaxis too
  • Elicits effects on various cells, including Mast cells and Eosinophils
  • Elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

5

Prednisone

  • Corticosteroids
  • Prednisone is used to treat conditions such as Arthritis, Blood disorders, Breathing problems, severe Allergies, Skin diseases, Cancer, Eye problems, and Immune system disorders.

6

Prednisolone

  • Glucocorticosteroid
  • Decreases your Immune system's response to various Diseases to reduce symptoms such as Pain, Swelling and Allergic-type reactions
  • Elicits mild Mineralocorticoid activity and Moderate anti-inflammatory effect

7

Methylprednisolone

  • Potent Glucocorticoid with minimal to no mineralocorticoid activity
  • MS, Allergies, Pneumonia in AIDS pts., Spinal cord injury
  • Controls or prevents Inflammation by controlling rate of protein synthesis, suppressing migration of polymorphonuclear leukocytes (PMNs) and fibroblasts, reversing capillary permeability, and stabilizing lysosomes at cellular level

8

Fludrocortisone

  • Treating adrenocortical insufficiency in Addison disease and for treating salt-losing adrenogenital syndrome.
  • Corticosteroid
  • Causing the Kidneys to retain Na and acting as a replacement for Cortisone when the body does not produce enough
  • Has both Mineralcorticoid and Glucocorticoid activity

9

Dexamethasone

  • Glucocorticoid
  • Dexamethasone is used to treat many different inflammatory conditions such as Allergic disorders, Skin conditions, Ulcerative colitis, Arthritis, Lupus, Psoriasis, or breathing disorders

10

Clobetasol

11

What causes Addison's Disease?

  • Clobetasol
  • Adrenal insufficiency
  • Tx: 5 mg Prenisone in the morning to replace lack of production in Addison's disease, after Adrenalectomy, or when other therapy inhibits Steroid biosynthesis

12

What is Apparent Mineralocorticoid Excess
(AME) disease?

  • Disorder of Adrenal Steroid Metabolism
  • Mutation in HSD11B2 gene (Kidney's form of
    11β-hydroxysteroid dehyrodgenase)
    --> Aldosterone
     like Effect in Kidney
    --> Decreased conversion of Coritisol --> Cortisone
    --> Severe HTN (Na+)
     and Hypokalemia (K+) through 
    MR occupation by Cortisol
  • Similar to Licorice Poisoning where Glycyrrhetinic acid inhibits the enzyme

13

What steroids are Prohormones?

  • Cortisone
  • Prednisone
  • Both require first pass metabolism by the Liver to become activated

14

Congenital Adrenal Hyperplasia?

  • Disorder of Adrenal Steroid Metabolism

  • Enzymatic defect (usually 21-hydroxylase)
    --> Decreased Lvls of Cortisol and Aldosterone
    --> Increased Angdrogens (precocious puberty)
    --> Increased ACTH production and DHEA
  • Increased Sex Hormones (DHT and Estrogens)
  • Increased Renin
  • Hypotension
  • Hperkalemia
  • Tx: Hydrocortisone & Fludrocortisone (if Mineralcorticoids are also low)

15

Cushing's Syndrome a/w?

  • Disorder of Adrenal Steroid Metabolism

  • Hypercortisolism

16

Conn's Syndrome a/w?

  • Disorder of Adrenal Steroid Metabolism
  • Hyperaldosteronism

17

What is Glucocorticoid-remediable Aldosteronism?

  • Disorder of Adrenal Steroid Metabolism
  • Crossover placing Aldosterone synthase under the control of the Promoter for 11β-hydroxylase in the Zone Fasciculate
  • Effectively placing Aldosterone synthesis under the control of ACTH

18

What is Hereditary Primary Cortisol Resistance?

  • Disorder of Adrenal Steroid Response
  • Due to a mutation in the Glucocorticoid receptor

19

What is Steroid-resistant Asthma?

  • Disorder of Adrenal Steroid Response
  • Mechanism unknown

20

Mifepristone

  • Glucocorticoid antagonist 
  • Approved for the Tx of Hyperglycemia in Cushing's syndrome pts. w Diabetes WHO ARE NOT canidates for Sx
  • Early term Abortions (anti-progestational activity)

21

Spironolactone

  • Competitive inhibitor to Aldosterone
  • Binding to Mineralcorticoid receptor
  • Tx: HTN and Congestive Heart Failure after MI
  • Se:
    • Hyperkalemia (antimineralocorticoid)
    • Gynecomastia and Impotence (antiandrogen)
    • Mentrual disturbances (antiprogestin)

22

Eplerenone

  • selective Mineralocorticoid receptor antagonist w/ fewer antiandrogenic and antiprogestin side effects
  • Tx: HTN and Heart failure

23

Dexamethasone

  • Inhibitor of Adrenal Steroid biosynthesis
  • Inhibit ACTH and Endogenous Corticosteroid production

24

Metyrapone

  • Inhibits Adrenal Steroid biosynthesis
  • Inhibits 11β-hydroxylation reaction in Biosynthetic pathway
  • Glucocorticoid and Cortisol suppression
  • The deficiency is compensated to some extend by Deoxycorticosterone, the precursor for the Hydroxylase

25

Aminoglutethimide

  • Inhibits the first committed step in Adrenal Steroid biosynthesis
  • Inhibits Conversion of Cholesterol --> Pregnenalone
  • Inhibiting the enzyme Desmolase
  • No Salt, Sugar, Sex

26

Ketoconazole

  • An antifungal antibiotic that inhibits side chain cleavage and 11β-hydroxylase

27

ACTH

  • Adrenocorticotrophic hormone (ACTH, corticotropin)
  • B-LPH (Lipotropic hormone)
  • Basophil via Corticotroph cell
  • Activated by CRH from Hypothalamus
    • Negative feedback by Cortisol
  • Target organ: Adrenals
  • Increases Cortisol (adrenal cortex glucocorticoids)
  • Stress Metabolism

28

CRF

  • Corticotropin Releasing Factor (CRF) or Corticotropin Releasing Hormone (CRH)
  • Paraventricular nucleus
  • Stress response
  • Negative Feedback by Cortisol
  • Stimulates Pituitary ACTH synthesis and secretion
  • CRH can suppress appetite, increase subjective feelings of anxiety, and perform other functions like boosting attention

29

Aldosterone

  • Mineralcorticoid
  • Adrenal Cortex: Fasiculata cells
  • Activated by ACTH --> Positive activates Desmolase
    --> Increases Cholesterol to Prenenolone
  • Targets the Kidney
  • Increased Na and H2O uptake in the Distal Convoluted Tubule

30

Estradiol

  • Primary estrogen in nonpregnant women
  • Derived from ovaries  or via Aromatase in the Adrenal Cortex (Reticularis)
  • Stimulates growth of the Stroma in the Endometrium
  • Causes cervical mucus to become copius and watery
  • Stimulates growth and development of the female reproductive system
  • Breast development, Prolactin secretion, maintaining Pregnancy