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Fludrocortisone: profile and news
An Update on Septic Shock Feb 16, 2006 Research Provides More Evidence That Chronic Fatigue Syndrome Is A ... Jan 9, 2006 It Is Time to "SALVAGE" Patients with Severe Sepsis Sep 23, 2005 Establishing a Comprehensive, Evidence-based Protocol for the Care ... Sep 1, 2005 Drug treatment mimics circadian rhythms Jul 25, 2005 Adrenal-gland failure can cause a blood-pressure drop Jun 23, 2005 Salt and Fludrocortisone Not Effective for Recurrent Syncope Jun 1, 2005 Adrenal-gland failure can cause blood-pressure drop Jun 24, 2005 CME Questions Jun 1, 2005 King Pharmaceuticals Reports First-Quarter 2005 Financial Results May 9, 2005 Chronic Fatigue Patients Show Lower Response To Placebos Mar 22, 2005 King Pharmaceuticals Reports Fourth-Quarter and Year-End 2004 ... Mar 17, 2005 Journal Scan Mar 15, 2005 Other information Indication For partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome. Pharmacology Fludrocortisone is a synthetic adrenocortical steroid possessing very potent mineralocorticoid properties and high glucocorticoid activity. It is indicated as partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison’s disease and for the treatment of salt-losing adrenogenital syndrome. The physiologic action of fludrocortisone acetate is similar to that of hydrocortisone. However, the effects of fludrocortisone acetate, particularly on electrolyte balance, but also on carbohydrate metabolism, are considerably heightened and prolonged. Mineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasma; they increase the urinary excretion of both potassium and hydrogen ions. Mechanism Of Action Fludrocortisone binds the mineralocorticoid receptor (aldosterone receptor). This binding (or activation of the mineralocorticoid receptor by fludrocortisone) in turn causes an increase in ion and water transport and thus raises extracellular fluid volume and blood pressure and lowers potassium levels. Drug Category Anti-inflammatory Agents; Adrenergic Agents; ATC:H02AA02 Brand Names/Synonyms 9 .Alpha. Ff; 9 Alpha Ff; 9.Alpha.-Fluorocortisol; 9.Alpha.-Fluorohydrocortisone; 9alpha-Fludrocortisone; 9alpha-Fluorocortisol; Alflorone; Astonin-H; BRN 3014278; F-COL; F-Cortef; Florinef; Fludrocortisona [Inn-Spanish]; Fludrocortisone; Fludrocortisone Acetate; Fludrocortisonum [Inn-Latin]; Fludrocortone; Fludrone; Fludronef; Fluodrocortisone; Fluohydrisone; Fluohydrocortisone; Fluorocortisol; Fluorocortisone; HSDB 3332; NSC 11318; Stc 1400; U 5963; ZK5 Dosage Forms TABLET Absorption Not Available Interactions Interactions for Fludrocortisone: When administered concurrently, the following drugs may interact with adrenal corticosteroids. Amphotericin B or potassium-depleting diuretics (benzothiadiazines and related drugs, ethacrynic acid and furosemide)óenhanced hypokalemia. Check serum potassium levels at frequent intervals; use potassium supplements if necessary . Digitalis glycosidesóenhanced possibility of arrhythmias or digitalis toxicity associated with hypokalemia. Monitor serum potassium levels; use potassium supplements if necessary. Oral anticoagulantsódecreased prothrombin time response. Monitor prothrombin levels and adjust anticoagulant dosage accordingly. Antidiabetic drugs (oral agents and insulin)ódiminished antidiabetic effect. Monitor for symptoms of hyperglycemia; adjust dosage of antidiabetic drug upward if necessary. Aspirinóincreased ulcerogenic effect; decreased pharmacologic effect of aspirin. Rarely salicylate toxicity may occur in patients who discontinue steroids after concurrent high-dose aspirin therapy. Monitor salicylate levels or the therapeutic effect for which aspirin is given; adjust salicylate dosage accordingly if effect is altered. Barbiturates, phenytoin, or rifampinóincreased metabolic clearance of fludrocortisone acetate because of the induction of hepatic enzymes. Observe the patient for possible diminished effect of steroid and increase the steroid dosage accordingly. Anabolic steroids (particularly C-17 alkylated androgens such as oxymetholone, methandrostenolone, norethandrolone, and similar compounds)óenhanced tendency toward edema. Use caution when giving these drugs together, especially in patients with hepatic or cardiac disease. Vaccinesóneurological complications and lack of antibody response . Estrogenóincreased levels of corticosteroid-binding globulin, thereby increasing the bound (inactive) fraction; this effect is at least balanced by decreased metabolism of corticosteroids. When estrogen therapy is initiated, a reduction in corticosteroid dosage may be required, and increased amounts may be required when estrogen is terminated. -->Drug/Laboratory Test InteractionsCorticosteroids may affect the nitrobluetetrazolium test for bacterial infection and produce false-negative results.
Chemical IUPAC Name 9-fluoro-11,17-dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-1,2,6,7,8,9,10,11,12,13,14,15,16,17-tetradecahydrocyclopenta[a]phenanthren-3-one Chemical Formula C21H29FO5 Half Life 3.5 hours Drug Type Approved Drug # Accession No APRD00756 CAS Registry Number 127-31-1 |
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