Corticosteroids fludrocortisone

Fludrocortisone acetate Synthetic corticosteroid with some glucocorticoid and potent mineralocorticoid activity Administered orally to treat primary adrenal insufficiency... 

Fludrocortisone, a synthetic corticosteroid, is the most commonly prescribed salt-retaining hormone. 

Thus, in patients with Addison s disease or other forms of adrenal insufficiency, continuing oral administration of cortisone acetate or fludrocortisone acetate enables salt balance to be restored. Other corticosteriods and analogues that have been used in the hormonal control of sodium levels include aldosterone and deoxycortone acetate. Individual corticosteroids vary in the extent to which they possess the various hormonal activities so that combination therapy is usually required if, for example, mineral balances are to be maintained when corticosteroids are administered for their anti-inflammatory, antirheumatic or anti-allergic properties. 

Introduction 419 Corticosteroid Analogues 420 Cortisone 422 Hydrocortisone 423 Prednisone and Prednisolone 424 Fludrocortisone 424... 

The corticosteroids have been the subject of much controversy in the management of septic patients. Corticosteroids suppress the activation of polymorphonuclear leukocytes, complement activation, release of TNF, and activation of the coagulation system involved in the cascades of sepsis. A recent study demonstrated a decrease in mortality (absolute reduction of 10%) with lower doses of hydrocortisone and fludrocortisone in patients with adrenal insufficiency requiring high-dose or increasing vasopressor therapy within the first 8 hours of septic shock. There was no benefit for those patients without adrenal insufficiency. In summary, routine use of corticosteroids in patients with sepsis or septic shock is not recommended until further study. 

Fludrocortisone Synthetic corticosteroid high mineralocorticoid and moderate glucocorticoid activity long duration of action. 

The client diagnosed with Addison s disease asks the nurse, Why do I have to take fludrocortisone (Florinef), a mineral corticosteroid Which statement is the nurse s... 

Corticosteroids Beclometasone, Budesonide, Ciclesonide, Deflazacort, Dexamethasone, Fludrocortisone, Fluticasone, Hydrocortisone, Methylprednisolone, Prednisolone, Predisone, Triamcinolone... 

The greatest potassium loss occurs with the naturally occurring corticosteroids such as cortisone and hydrocortisone. Corticotropin (ACTH), which is a pituitary hormone, and tetracosactrin (a synthetic polypeptide) stimulate corticosteroid secretion by the adrenal cortex and can thereby indirectly cause potassium loss. Fludrocortisone also causes potassium loss. The synthetic corticosteroids (glucocorticoids) have a less marked potassium-depleting effect and are therefore less likely to cause problems. These include betamethasone, dexamethasone, prednisolone, prednisone and triamcinolone. 

Increase the corticosteroid dosage proportionately to the increase in clearance (see Table 29.2 , (see above)). With prednisolone an average increase of 100% (range 58 to 260% in 5 subjects) proved effective." A fourfold increase may be necessary with dexamethasone, and much greater increases have been required with fludrocortisone. ... 

Three of the corticosteroids considered below are fluorinated in the 9 position these are fludrocortisone, triamcinolone and dexamethasone. The principal corticosteroids are as follows ... 

For the determination of triamcinolone it is necessary to rely on an ultra-violet absorption assay the fluorine content may be determined by flask-combustion and determination of fluoride in the absorbing liquid (see p.. 300 and Appendix IV). The fluorine contents of dexamethasone and fludrocortisone may be determined in the same way. Such a determination, in conjunction with the tetrazolium assay, gives a satisfactory control of the fluorinated corticosteroids. 

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