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Partial replacement of primary and secondary adrenocortical insufficiency in Addisons disease and for treatment of salt-losing adrenogenital syndrome Adrenocortical insufficiency in Addisons disease

Side effects may occur if dosage is too high or if withdrawal is too rapid. Because it possess glucocoticoid activity, fludrocorticosone may causecside effects similar to those of the glucocorticoids

Hypersenitivity to fludrocorticosterone, systemic fungal infections

Warnings- Supplemental measures- use mineralocorticoid therapy preferably in conjunction with other supplemental measures( eg. glucocorticoids, control of electrolytes, control of infection)

Adrenal insufficiency- to avoid drug-induced adrenal insufficiency, supportive dosage may be required in times of stress ( eg, trauma, syrgery, severe illness ) both during treatment with fludrocortosone and for a year afterwards

Partial replacement of primary and secondary adrenocortical insufficiency in Addisons disease and for treatment of salt-losing adrenogenital syndrome

Adrenocortical insufficiency in Addisons disease Addisonian- like syndrome ( 1728 )

 Adrenocortical hypofunction includes all conditions in which the secretion of adrenal steroid hormone falls below the requirements of the body.

Adrenal insifficiency may be divided into two general catogeries-

1. those associated with primary inability of the adrenal to eloborate sufficient quantites of the hormone

2. those associated with the secondary failure due in the elaboration of ACTH This disorder is called Addisons disease or chronic glcocorticoid defiency. Addisons description in 1855 namely, -general languor, and debility, remarkable feebleness of the heats action, irritability of the stiomach, and a peculiar change of the color of the skin summarizes the dominant features of the disease Drugs causin Advese reaction-

Busulfan

Pharmacology-

Fludrocorticosone is an adrenal cortical steroid with mineralocorticoid activity anfd high glucocorticoid activity ( about 15 times as potent asp[otent as hydrocortisone ) but is used only for its minewralocorticoid effects. Mechanism -mineralocorticoids act on the renal distal tubules to enhance the reabsorption of sodium.

Pharmacokinetics-

Fludrocortisone is readily absorbed from trhe GI tract with peak concentrations in 1.7 hrs . Plasma half-life is approximately 3.5 hrs.but biological half-life from 18 to 36 hours.

Pregnancy-

Safety for use during pregnancy has not been established. Use only when clearly needed and when the potential outweigh the potential hazards to the fetus. It is necesary to give steroids during pregnancy, observe the newborn infant for signs of adrenocortical insufficiency and institute appropriate therapy,if necessary.

Lactation-

Corticosteroids are found in the breast milk of lactaing women. Excercise caution when administering to nursing women.

Children-

Safety and efficacy for use in children have not been established. Monitor growth and development of infants and children on prolonged therapy.