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This chapter will be most useful after having a basic understanding of the material in Chapter 42, ACTH, Adrenal Steroids, and the Pharmacology of the Adrenal Cortex in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

  • A detailed discussion of the chemistry, actions, and regulation of the secretion of adrenocorticotropic hormone (ACTH)

  • A description of the physiological functions of the adrenocorticosteroids

  • A detailed description of the pharmacological effects of the adrenocorticosteroids

  • A depiction of the chemical structures of the adrenocorticosteroids and their synthetic derivatives

  • A discussion of inhibitors of the biosynthesis and action of the adrenocorticosteroids


  • Understand the mechanisms of action and the physiological effects of the adrenocorticosteroids.

  • Describe the differences in the anti-inflammatory and sodium-retaining potencies of the glucocorticoids.

  • Describe the side effects of prolonged therapy with glucocorticoids.

  • Understand the effect of abrupt cessation of glucocorticoid therapy.


Aminoglutethimide (CYTADREN)

Corticorelin (ACTHREL)


Etomidate (AMIDATE)

Human corticotropin-releasing hormone (CRH)

Ketoconazole (NIZORAL; see also Chapter 43)

Metyrapone (METOPIRONE)

Mifepristone (MIFUPREX, RU-486; see also Chapter 28)

Mitotane (LYSODREN)

Table 29-1 lists available preparations of adrenocortical steroids and their synthetic analogs

Table 29-1Available Preparations of Adrenocortical Steroids and Their Synthetic Analogs

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