===== Adrenal =====

  * [[endocrine:adrenal:start|Adrenal Pharmacology]]

The adrenal axis includes:

  * Glucocorticoids (cortisol)
  * Mineralocorticoids (aldosterone)
  * Adrenal androgens
  * Steroid synthesis pathways
  * ACTH regulation

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==== Glucocorticoids ====

===== [[endocrine:glucocorticoids:start|Glucocorticoids]] =====

Short-Acting:

  * [[endocrine:glucocorticoids:hydrocortisone|Hydrocortisone]] (Cortef®)
  * [[endocrine:glucocorticoids:cortisone|Cortisone]]

Intermediate-Acting:

  * [[endocrine:glucocorticoids:prednisone|Prednisone]] (Deltasone®)
  * [[endocrine:glucocorticoids:prednisolone|Prednisolone]]
  * [[endocrine:glucocorticoids:methylprednisolone|Methylprednisolone]] (Medrol®)
  * [[endocrine:glucocorticoids:triamcinolone|Triamcinolone]]

Long-Acting:

  * [[endocrine:glucocorticoids:dexamethasone|Dexamethasone]] (Decadron®)
  * [[endocrine:glucocorticoids:betamethasone|Betamethasone]]

Used in:

  * Adrenal insufficiency
  * Inflammatory disorders
  * Autoimmune disease
  * Cerebral edema
  * Oncology

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==== Mineralocorticoids ====

===== [[endocrine:mineralocorticoids:start|Mineralocorticoids]] =====

  * [[endocrine:mineralocorticoids:fludrocortisone|Fludrocortisone]] (Florinef®)

Used in:

  * Primary adrenal insufficiency
  * Salt-wasting congenital adrenal hyperplasia

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==== Steroid Synthesis Inhibitors ====

===== [[endocrine:adrenal:steroid_synthesis_inhibitors|Steroid Synthesis Inhibitors]] =====

  * [[endocrine:adrenal:ketoconazole|Ketoconazole]]
  * [[endocrine:adrenal:metyrapone|Metyrapone]]
  * [[endocrine:adrenal:osilodrostat|Osilodrostat]] (Isturisa®)
  * [[endocrine:adrenal:etomidate|Etomidate]] (IV for severe Cushing’s)
  * [[endocrine:adrenal:abiraterone|Abiraterone]] (Zytiga®)

Used in:

  * Cushing syndrome
  * Hypercortisolism
  * Prostate cancer (abiraterone)

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==== Glucocorticoid Receptor Antagonists ====

  * [[endocrine:adrenal:mifepristone|Mifepristone]] (Korlym®)

Used in:

  * Cushing syndrome with hyperglycemia

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==== Aldosterone Antagonists ====

(Linked in Cardiovascular but physiologically adrenal)

  * [[cardio:hf:spironolactone|Spironolactone]] (Aldactone®)
  * [[cardio:hf:eplerenone|Eplerenone]] (Inspra®)

Used in:

  * Primary hyperaldosteronism
  * Resistant hypertension
  * Heart failure

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==== ACTH & Diagnostic Agents ====

  * [[endocrine:adrenal:cosyntropin|Cosyntropin]] (Cortrosyn®)

Used in:

  * ACTH stimulation testing

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==== Adrenolytic Agents ====

  * [[endocrine:adrenal:mitotane|Mitotane]] (Lysodren®)

Used in:

  * Adrenocortical carcinoma

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==== Pheochromocytoma & Catecholamine Excess ====

Alpha Blockade:

  * [[cardio:alpha_blockers:phenoxybenzamine|Phenoxybenzamine]]
  * [[cardio:alpha_blockers:phentolamine|Phentolamine]]

Beta Blockade (after alpha):

  * [[cardio:beta_blockers:propranolol|Propranolol]]

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===== Clinical Groupings =====

Adrenal Insufficiency:
  * Hydrocortisone
  * Fludrocortisone

Cushing Syndrome:
  * Ketoconazole
  * Metyrapone
  * Osilodrostat
  * Mifepristone
  * Mitotane

Primary Hyperaldosteronism:
  * Spironolactone
  * Eplerenone

Adrenocortical Carcinoma:
  * Mitotane

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==== Glucocorticoids ====
[[endocrine:glucocorticoids:start|Glucocorticoids]]

Short-Acting:
  * [[endocrine:glucocorticoids:hydrocortisone|Hydrocortisone]] (Cortef®)
  * [[endocrine:glucocorticoids:cortisone|Cortisone]]

Intermediate-Acting:
  * [[endocrine:glucocorticoids:prednisone|Prednisone]] (Deltasone®)
  * [[endocrine:glucocorticoids:prednisolone|Prednisolone]]
  * [[endocrine:glucocorticoids:methylprednisolone|Methylprednisolone]] (Medrol®)
  * [[endocrine:glucocorticoids:triamcinolone|Triamcinolone]]

Long-Acting:
  * [[endocrine:glucocorticoids:dexamethasone|Dexamethasone]] (Decadron®)
  * [[endocrine:glucocorticoids:betamethasone|Betamethasone]]

==== Mineralocorticoids ====
[[endocrine:mineralocorticoids:start|Mineralocorticoids]]
  * [[endocrine:mineralocorticoids:fludrocortisone|Fludrocortisone]] (Florinef®)

==== Steroid Synthesis Inhibitors ====
[[endocrine:adrenal:steroid_synthesis_inhibitors|Steroid Synthesis Inhibitors]]
  * [[endocrine:adrenal:ketoconazole|Ketoconazole]]
  * [[endocrine:adrenal:metyrapone|Metyrapone]]
  * [[endocrine:adrenal:osilodrostat|Osilodrostat]] (Isturisa®)
  * [[endocrine:adrenal:etomidate|Etomidate]] (IV for severe Cushing’s)
  * [[endocrine:adrenal:abiraterone|Abiraterone]] (Zytiga®)

==== Glucocorticoid Receptor Antagonists ====
  * [[endocrine:adrenal:mifepristone|Mifepristone]] (Korlym®)

==== Aldosterone Antagonists ====
(Linked in Cardiovascular but physiologically adrenal)
  * [[cardio:hf:spironolactone|Spironolactone]] (Aldactone®)
  * [[cardio:hf:eplerenone|Eplerenone]] (Inspra®)

==== ACTH & Diagnostic Agents ====
  * [[endocrine:adrenal:cosyntropin|Cosyntropin]] (Cortrosyn®)

==== Adrenolytic Agents ====
  * [[endocrine:adrenal:mitotane|Mitotane]] (Lysodren®)