Mineralocorticoids

Mineralocorticoids

Mineralocorticoids affect electrolyte and water balance. Thesedrugs include:

§    fludrocortisone acetate, a synthetic analogue of hormones se-creted by the adrenal cortex

§    aldosterone, a natural mineralocorticoid (the use of which has been curtailed by high cost and limited availability).

Pharmacokinetics

Fludrocortisone acetate is absorbed well and distributed to all parts of the body.

Metabolism and excretion

Fludrocortisone acetate is metabolized in the liver to inactive metabolites. The drug is excreted by the kidneys, primarily as in-active metabolites.

Pharmacodynamics

Fludrocortisone acetate affects fluid and electrolyte balance by acting on the distal renal tubule to increase sodium reabsorption and potassium and hydrogen secretion.

Pharmacotherapeutics

Fludrocortisone acetate is used as replacement therapy for pa-tients with adrenocortical insufficiency (reduced secretion of glu-cocorticoids, mineralocorticoids, and androgens).

Seasoning reasoning

Fludrocortisone acetate may also be used to treat salt-losing con-genital adrenogenital syndrome (characterized by a lack of corti-sol and deficient aldosterone production) after the patient’s elec-trolyte balance has been restored.

Drug interactions

As is the case with adverse reactions, the drug interactions associ-ated with mineralocorticoids are similar to those associated with glucocorticoids.