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Fludrocortisone

9 Alpha Fluorohydrocortisone


Presentation

  • Cerebral salt wasting presents considerable management challenges; however, fludrocortisone therapy can be an effective adjunct to treatment.[ncbi.nlm.nih.gov]
  • We herein present an 11-year-old boy who developed hyponatremic seizures after intracranial tumor resection.[ncbi.nlm.nih.gov]
  • We report 4 patients with cerebral salt wasting, all of whom presented with hyponatremia in the presence of known intracerebral pathology. All had clinically significant hyponatremia, and 3 had hyponatremic seizures.[doi.org]
Leg Edema
  • A physical examination revealed leg edema, tachycardia, tachypnea, bilateral basal crepitations, and blood pressure 110/70 mmHg.[ncbi.nlm.nih.gov]
Hypertension
  • OBJECTIVE: Primary aldosteronism (PA) is the most common form of secondary hypertension.[ncbi.nlm.nih.gov]
  • Noninvasive assessment of baroreceptor control in borderline hypertension comparison with the phenylephrine method. Hypertension 1996;28:238–243. Google Scholar 14. Wesseling KH, Jansen JRC, Settels JJ, et al.[doi.org]
Left Ventricular Dysfunction
  • BACKGROUND: Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown.[ncbi.nlm.nih.gov]
Quadriplegia
  • We report a case of a 28-year-old woman with C5 quadriplegia, unresponsive to conservative treatment for orthostatic hypotension. Ergotamine, daily combined with fludrocortisone, successfully prevented symptomatic hypotension.[ncbi.nlm.nih.gov]
Akinesia
  • Echocardiography revealed a reduced left ventricular systolic function with an ejection fraction of 30 %, and septal, apical, and anterior wall akinesia.[ncbi.nlm.nih.gov]

Workup

Nephrolithiasis
  • BACKGROUND AND OBJECTIVES: Incomplete distal renal tubular acidosis is a well known cause of calcareous nephrolithiasis but the prevalence is unknown, mostly due to lack of accepted diagnostic tests and criteria.[ncbi.nlm.nih.gov]

Treatment

  • The responses of plasma renin activity and aldosterone to orthostatic stress prior to treatment were subnormal and became even lower after treatment.[ncbi.nlm.nih.gov]
  • The selected patients had one 24-h blood pressure recording immediately prior to treatment with fludrocortisone and one recording at least 2 months after starting the treatment.[ncbi.nlm.nih.gov]
  • Reasons for discontinuing treatment were hypertension, five; cardiac failure, four; depression, three; oedema, three; and unspecified, two.[ncbi.nlm.nih.gov]
  • In this report, we describe the treatment of 2 patients with spontaneous intracranial hypotension who failed conservative treatment and went on to have complete and sustained resolution of their symptoms after the administration of oral fludrocortisone[ncbi.nlm.nih.gov]
  • INTERVENTIONS: All participants were scheduled to receive fludrocortisone acetate (0.1-0.2 mg) or a placebo for 6 weeks in each treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Abstract Low doses of hydrocortisone (HC) and fludrocortisone (FC) administered together improve the prognosis after septic shock; however, there continues to be disagreement about the utility of FC for this indication.[ncbi.nlm.nih.gov]
  • The prognosis is very optimistic. With the help of Florinef my daughter will be able to grow normally, the only condition is careful dosage of the medication and regular monitoring by her doctor.[cadesac.com.br]

Epidemiology

  • Página 93 - Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. ‎[books.google.es]
Sex distribution
Age distribution

Pathophysiology

  • INTRODUCTION: Hypothalamic-pituitary-adrenal (HPA) axis dysregulation has been linked with major depression, particularly psychotic major depression (PMD), with mineralocorticoid receptors (MRs) playing a role in HPA-axis regulation and the pathophysiology[ncbi.nlm.nih.gov]
  • Physiology and pathophysiology of heart rate and blood pressure variability in humans: is power spectral analysis largely an index of baroreceptor gain? Cli Sci 1995;88:103–109. Google Scholar 28. Freitas J, Almeida J, Azevedo E, et al.[doi.org]

Prevention

  • Fludrocortisone is commonly used to prevent recurrences of syncope but with little evidence to support its use. A placebo-controlled clinical trial of fludrocortisone for the prevention of neurally mediated syncope is needed.[ncbi.nlm.nih.gov]
  • Abstract BACKGROUND: There is limited evidence whether being on fludrocortisone prevents vasovagal syncope.[ncbi.nlm.nih.gov]
  • Ergotamine, daily combined with fludrocortisone, successfully prevented symptomatic hypotension. In this report, neural, renal, and hormonal blood pressure regulatory mechanisms are described.[ncbi.nlm.nih.gov]
  • Larger controlled trials are needed to ascertain the impact of fludrocortisone on prevention of cerebral ischemia in patients with SAH.[ncbi.nlm.nih.gov]
  • […] of vasovagal syncope Acronym POST II Study hypothesis Fludrocortisone prevents recurrences of vasovagal syncope.[isrctn.com]

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