• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • Home
  • About
  • BCPS
  • Medicine and Media
  • Pharmacogenomics
  • Podcast
Digital PharmD

Digital PharmD

Informatics in Pharmacy

cushings

Adrenal Disorders

August 12, 2018 By Dr. G, PharmD

Acromegaly – bromocriptine or octreotide
Hyperprolactinemia – surgical resection, cabergoline or bromocriptine

Cushings Disease-

  • Diagnosed by a dexamethasone suppression test or 24-hour urinary cortisone test.
  • Symptoms: central obesity, peripheral fat, myopathies, osteoporosis, back pain, diabetes, hirsutism, hypertension
  • Treatment:
    • Surgical resection if possible
    • Pasireotide: 0.6-0.9 mg BID subQ (adverse effects: hypoglycemia, hypocortisolism, diarrhea, nausea, gallstones, headache, bradycardia)
    • Ketoconazole: Hinders cortisol production, 200 mg BID up to 400 mg TID (adverse effects: gynecomastia, abdominal discomfort, increased LFTs)
    • Mitotane: 500-1000mg daily
    • Etomidate: 0.3 mg/kg IV
    • Metyrapone: 500 mg TID

Primary Aldosteronism-

  • Spironloactone is drug of choice.  25-50 mg/day (adverse effects: hyperkalemia, gynecomastia, abdominal discomfort)
  • Eplerenone and amiloride are alternatives

Hyposecretory Adrenal Disorders or “Addison’s Disease”-

  • Hydrocortisone: 15 mg/day
  • Fludrocortisone (replaces mineralcorticoid): 0.05-0.2 mg/day
  • Dehydrocopiandrosterone: 25-50 mg/day for libido in women

Glucocorticoid Equivalent Dosing:

GlucocorticoidDose
Cortisone25
Hydrocortisone20
Prednisone5
Prenisolone5
Triamcinolone4
Methylprednisone4
Dexamathasone0.75

PCOS:

  • Improve fertility with clomiphene citrate or gonadotropin
  • Symptoms improve with estrogen and progestin combination
  • Spironolactone can help with hirsutism

Primary Sidebar

Newsletter

More to See

COVID-19 mRNA EUA Vaccine FAQs

December 29, 2020 By Dr. G, PharmD

What Makes a Good Vaccine? (Part 1)

October 20, 2020 By Dr. G, PharmD

Tags

acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia bcps Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020

Footer

Medical Disclaimer

The medical information on this website is provided “as is” without any representations or warranties, express or implied. GoPharmD makes no representations or warranties in relation to the medical information on this website.

GoPharmD does not warrant that:

  • the medical information on this website will be constantly available, or available at all; or
  • the medical information on this website is complete, true, accurate, up-to-date, or non-misleading.
  • You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider.
  • If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.

Recent

  • Johnson and Johnson Coronavirus EUA Vaccine FAQ
  • COVID-19 mRNA EUA Vaccine FAQs
  • What Makes a Good Vaccine? (Part 1)
  • COPD and Bronchitis
  • Asthma

Search

Tags

acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia bcps Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020