Corticosteroids: prodrug glucocorticoids: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Corticosteroids: prodrug glucocorticoids

Sample item

A physician is choosing a glucocorticoid for a patient with severe hepatic failure. Which commonly used glucocorticoid is a prodrug that depends on hepatic conversion to the active form, and is therefore unsuitable here?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Prednisone

Prednisone is inactive until the hepatic enzyme 11-beta-hydroxysteroid dehydrogenase type 1 reduces it to prednisolone. In severe liver disease this conversion may be impaired, so prednisolone is preferred. Hydrocortisone, prednisolone and dexamethasone are given in active form.

Option by option

  • A. Hydrocortisone

    Hydrocortisone is identical to cortisol and is active as given.

  • B. Dexamethasone

    Dexamethasone is an active glucocorticoid that does not need hepatic activation.

  • C. Prednisolone

    Prednisolone is already the active form and needs no hepatic activation.

  • D. Prednisone (correct)

    Prednisone must be converted by the liver to prednisolone to act.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Prednisone. Prednisone is inactive until the hepatic enzyme 11-beta-hydroxysteroid dehydrogenase type 1 reduces it to prednisolone.

Why is "Hydrocortisone" not the answer?

Hydrocortisone is identical to cortisol and is active as given.

Why is "Dexamethasone" not the answer?

Dexamethasone is an active glucocorticoid that does not need hepatic activation.

Why is "Prednisolone" not the answer?

Prednisolone is already the active form and needs no hepatic activation.

What concept does this question test?

It tests Corticosteroids: prodrug glucocorticoids in Pharmacology. In severe liver disease this conversion may be impaired, so prednisolone is preferred. Hydrocortisone, prednisolone and dexamethasone are given in active form.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Corticosteroids: prodrug glucocorticoids?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.