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Opt 222 Pharmacology
Chang 1 Steroid Drugs
44
Other
Not Applicable
03/01/2008

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Cards

Term
What zone of the adrenal cortex has the highest concentration of enzyme to produce mineral corticoids?  Most common mineral corticoid?
Definition

glomerulosa

aldosterone

 

Term
Aldosterone acts on the kidney to cause the release of ____ and ____ in the urine and the retention of ____ and _____
Definition

K+ and H+

Na+ and H2O

Term
The production of aldosterone is regulated by the _____ ______ system.
Definition
Renin-Angiotensin
Term
Glucocorticoids are responsible for normal _____ and _______.
Definition
  1. metabolism
  2. resistance to stress
Term
The inner layer of the adrenal cortex secretes androgens via ________
Definition
dehydroepiandrosterone
Term

Corticotropin (ACTH) acts mainly on the zona _____ and zona _______ and to a lesser extent on the zona ______ of the adrenal cortex.

Definition

fasciculata

reticularis

glomerulosa

Term
The ________ bind to specific intracellular cytoplasmic receptors.  The _______ than translocates into the nucleus where it acts upon _____ to activate or inhibit the transcription of genes for protein synthesis.
Definition

adrenocorticosteroids

receptor-hormone complex

transcription factors

Term
What are the two types of adrenocorticosteroids?
Definition

mineral corticoids

glucocorticoids

Term
The glucocorticoids have other effects such as mediating vascular dilation and the bronchiolar musculature through ______ or ______, whose effects are _____.
Definition

catecholamines

lipolysis

immediate

Term
Glucocorticoids promote ______ by increasing _____ _____ uptake by the liver and kidneys and by upregulating the enzymes for _______.
Definition
  1. gluconeogenesis
  2. amino acid
  3. gluconeogenesis
Term
Glucocorticoids stimulate protein _____ (except for the liver) as well as lipolysis.
Definition
catabolism
Term
Glucocorticoids can cause an increase in blood pressure due to vasoconstrictive effects of certain _____.
Definition
catecholamines
Term
Glucocorticoids cause a decrease in eosinophils, basophils, monocytes, and lymphocytes by redistributing them to the _____ ____.
Definition
lymphoid tissue
Term
Glucocorticoids increase serum levels of ______, ______, ______, ______.
Definition

hemoglobin

erythrocytes

platelets

polymorphonuclear lymphocytes

Term
What are two ways glucocorticoids inhibit inflammation?
Definition

1)  inhibition of phospholipase A, which breaks down arachidonic acid

2)  inhibition of decrease in the number of peripheral lymphocytes

Term
Elevation of glucocorticoids exerts negative feedback on _____ production in the _____ _____ but an increase in ______ hormone production.
Definition

corticotropin (ACTH)

growth

Term
Glucocorticoids have been know to have CNS effects of _____ and _____.
Definition

psychosis

euphoria

Term
High doses of glucocorticoids can lead to excess ____ _____ and _____ production exacerbating gastric ulcers.
Definition

gastic acid

pepsin

Term
Chronic glucocorticoid therapy can also lead to ______ and _____.
Definition

osteoporosis

myopathy

Term
Aldosterone acts on the ____ portion of the convoluted tubule.
Definition
distal
Term
What drug is used to treat hyperaldosteronism?
Definition
spironolactone
Term
Addison's disease is a disease of the ____ _____ and is diagnosed by lack of response to ______.
Definition

adrenal cortex

corticotropin administration

Term
Addison's disease is treated by the administration of _____, ____in the am and ____ in the afternoon.
Definition

hydrocortisone

2/3 in the am and 1/3 in the afternoon

Term

_____, a mineral corticoid with some glucocorticoid activity is administered concomittantly with hydrocortisone to _____ ______ to a normal level

Definition

Fludrocortisone

increase the mineral corticoid activity

Term
In secondary and tertiary adrenocortical insufficiency, ______ corticoid production is impaired more than _____ production
Definition

glucocorticoid

mineral

Term
Administration of dexmethasone supresses adrenal _____  release in individuals with a/an _____ dependent Cushing's syndrome but does not suppress _____ release from a/an ______ tumour
Definition

cortisol

pituitary

cortisol

adrenal

 

Term
______ refers to a group of diseases that are the result of an enzyme defect in the synthesis of one or more adrenal steroid hormones.
Definition
Congenital adrenal hyperplasia
Term
Therapy for congenital adrenal hyperplasia consists of administering sufficient _____ to normalize the patients hormone level
Definition
corticosteroids
Term
The effect of glucocorticoids on the inflammatory response is due to their ability to decrease the amount of ______ released from the _____ and _____ and decrease the amount of ____.
Definition

histamine

mast cells and basophils

kinin

Term
More than ___% of absorbed glucocorticoids are bound to plasma proteins, most to ______ and the balance to ____.
Definition

corticosteroid globulin

albumin

Term
Glucocorticoids are metabolized by the _____.
Definition
liver mixed function oxidase system
Term
What factors must be considered when administering adrenal steroids, as the dosage must be individualized?
Definition

1. glucocorticoid vs. mineral corticoid activity

2.  duration of action

3.  preparation

4.  time of administration

Term
Dosage regimens that excede two weeks may need to be given on alternating days to avoid suppression of the _______
Definition
hypothalamic-pituitary axis
Term
Abrupt withdrawl of a steroid can cause _____ ______ ______, which can be lethal.
Definition
acute adrenal insufficiency
Term
Long term adrenal corticosteroid treatment can cause _____ _____ _____.
Definition
posterior subcapsular cataracts
Term
Metyrapone, aminoglutethimide, ketoconazole, trilostane, spironolactone, and eplerenone mechanism of action is to
Definition
inhibit corticosteroid synthesis
Term
______ inhibits corticosteroid synthesis by blocking the final step (11-hydroxylation) in glucocorticoid synthesis.
Definition
Metyrapone
Term
What inhibitor of corticosteroid synthesis has the side effects of increased water and salt retention, hirsutism, GI disturbances, and transient dizziness.
Definition
metyrapone
Term
What drug is used in breast cancer to inhibit the synthesis of all hormonally active steroids and works by inhibiting the conversion of cholesterol to pregnenolone?
Definition
aminoglutethimide
Term
What other corticosteroid is administered concurrently with aminoglutethimide?
Definition
dexmethasone
Term
What inhibitor of adrenocorticoid biosynthesis is used in the treatment of Cushings syndrome and works by inhibiting all gonadal and adrenal steroid biosynthesis?
Definition
Ketoconazole
Term
Which drug works by competing with the mineral corticoid receptor resulting in inhibition of sodium reabsorption?
Definition

spironolactone, also used to treat hyperaldosteronism

Term
What drug is used to treat hirsutism in women and probably works by interfering with the androgen receptor of the hair follicle?
Definition
spironolactone
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