20.14d Medications Affecting the Adrenal Cortex

glucocorticoids

The adrenal cortex synthesizes and secretes three classes of hormones: (?), mineralocorticoids, and androgens.

corticosteroids

The glucocorticoids and mineralocorticoids are referred to collectively as (?), adrenocorticoids, or corticoids.

gluconeogenesis

As their name implies, glucocorticoids increase the production of glucose by enhancing carbohydrate metabolism, promoting (?), and reducing peripheral glucose utilization.

cortisol

The most important glucocorticoid is (?).

aldosterone

The primary mineralocorticoid is (?).

androgens

The (?) are important hormones in regulating sexual maturation and development.

Cushing’s disease

Two diseases typify the disorders associated with the adrenal cortex: (?) and Addison’s disease.

adrenocorticotropic hormone

Cushing’s disease is characterized by hypersecretion of (?), an anterior pituitary tropic hormone that increases the synthesis of corticoids, leading to excessive glucocorticoid secretion.

hyperglycemia

Common signs and symptoms include (?), obesity, hypertension, and electrolyte imbalances.

Addison’s disease

(?) is characterized by hyposecretion of corticoids as a result of damage to the adrenal gland.

hypoglycemia

Common signs and symptoms include (?), emaciation, hypotension, hyperkalemia, and hyponatremia.

surgical

Treatment of Cushing’s disease is typically (?).

potassium-sparing diuretics

Symptomatic pharmacologic intervention with an antihypertensive ((?) such as spironolactone [Aldactone] or ACE inhibitors such as captopril [Capoten]) can be necessary.

antiadrenals

Medications that can inhibit the synthesis of corticosteroids ((?)) can also be used as an adjunct to surgery or radiation.

ketoconazole (Nizoral)

In high doses, the antifungal agent (?) is an effective temporary antiadrenal medication.

liver dysfunction

At such doses, however, it can cause (?).

replacement therapy

Treatment of Addison disease is aimed at (?).

Cortisone (Cortistan)

(?) and hydrocortisone (Solu-Cortef) are the medications of choice.

mineralocorticoid

Occasionally, a specific (?) is necessary.

Fludrocortisone (Florinef Acetate)

(?) is the only mineralocorticoid available.