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What is Adrenal suppression is caused by all of the following drugs EXCEPT and explain in detail?
Adrenal insufficiency: Metabolic failure in hormone production Congenital adrenal hyperplasia. Enzyme inhibitors (e.g. metyrapone, Ketoconazole, aminoglutethimide) Cytotoxic agent - (Mitotane) Primary adrenal insufficiency: Acquired etiologies Drugs: Ketoconazole, an antifungal drug, can cause adrenal insufficiency by inhibiting adrenal enzymes. Rifampicin and anticonvulsant drugs such as phenytoin & Phenobarbital reduce the effectiveness and bioavailability of coicosteroid replacement therapy by inducing steroid metabolizing enzymes in the liver. Mitotane used in the treatment of adrenal carcinoma and refractory Cushing syndrome, is cytotoxic to the adrenal coex and may also alter extra adrenal Coisol metabolism. Signs of adrenal insufficiency occur in a substantial percentage of patients treated with Mitotane. Addisonian - like syndrome seen with: Busulfan Etomidate Ketoconazole