<prompt> Which of the following is glucocorticoid receptor blocker?AminoglutethemideMifepristoneTrilostaneKetoconazole  <response>: Ans. b Mifepristone Ref. KDT 6th310. Mifepristone is orally active glucocorticoid receptor blocker antiglucocorticoid activity, antiandrogenic as well as potent competitive anti-progesterone drug. QMIFEPRISTONE RU 486 It is a steroid with an affinity for progesterone receptors. Single dose 600 mg or 25 mg bd for 4 days if ammenorrhea is of 48 hours. It does not prevent fertilization, but by blocking action of progesterone on endometrium, causing sloughing and shedding of deciduas and brings about abortion. However, emptying is incomplete and surgical evacuation is needed. Adding PG Misoprostol on last day improves the rate of complete abortion. Metabolized by CYP 3A4 interacts with inhibitors-erythromycin, ketoconazole inducers-RMP anticonvulsants.Uses of Mifepristone:1. Termination of pregnancy Used upto 7 week only as single dose of 600 mg induces abortion in 60-85 cases. Causes slowing of follicular development and delay sfailure of ovulation. Prevents secretory changes normally brought about by progesterone. It stimulates uterine contractions. Blocks decidualization. Causes 2deg leuteolysis. Anorexia, nausea, tiredness, abdominal discomfort, uterine cramps, loose stools.02. Cervical ripening3. Postcoital contraception0 Given within 72 hrs of intercourse, Interferes with implantation, Highly effective4. Once a month contraceptive5. Induction of labour0 By blocking relaxant action of progesterone on uterus of late pregnancy. May be tried in IUD and to deliver abnormal fetuses.6. Cushing syndrome Large doses; Palliative effect7. Under evaluation for Rx of: Endometriosis Uterine fibroid Breast ca Meningioma 