化合物详情

While data specific to fludrocortisone were not located(SRC, 2007), the literature suggests that some pharmaceutically active compounds originating from human and veterinary therapy are not eliminated completely in municipal sewage treatment plants and are therefore discharged into receiving waters(1). Wastewater treatment processes often were not designed to remove them from the effluent(2). Selected organic waste compounds may be degrading to new and more persistent compounds that may be released instead of or in addition to the parent compound(2). Studies have indicated that several polar pharmaceutically active compounds can leach through soil(1).

Corticosteroids may be distributed into milk ... . /Corticosteroids/

* Vaccines: Fludrocortisone's immunosuppressive properties may compromise vaccine efficacy. Therefore, it is recommended that vaccines be avoided during fludrocortisone use.

There is no antidote for fludrocortisone toxicity, making conservative management the mainstay of treatment. Reduction of dose, strict blood pressure control, and potassium supplementation may be given.

/CASE REPORTS/ A severe metabolic alkalosis with compensatory respiratory acidosis and hypokalemia were reported in a 71-yr-old female patient following one yr of treatment with fludrocortisone, 0.2 mg/day, for postural hypotension. Following therapy which included diuretic administration, potassium supplementation and administration of spironolactone, the patient's clinical condition improved.

References: DOI:10.1016/j.drudis.2019.09.022

Glucocorticoids may cause fetal damage when administered to pregnant women. One retrospective study of 260 women who received pharmacologic dosages of glucocorticoids during pregnancy revealed 2 instances of cleft palate, 8 stillbirths, 1 spontaneous abortion, and 15 premature births. Another study reported 2 cases of cleft palate in 86 births. Occurrence of cleft palate in these studies is higher than in the general population but could have resulted from the underlying diseases as well as from the steroids. Other fetal abnormalities that have been reported following glucocorticoid administration in pregnant women include hydrocephalus and gastroschisis. Women should be instructed to inform their physicians if they become or wish to become pregnant while receiving glucocorticoids. If g...

/SRP:/ Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in severe respiratory distress. Positive-pressure ventilation techniques with a bag valve mask device may be beneficial. Consider drug therapy for pulmonary edema ... . Consider administering a beta agonist such as albuterol for severe bronchospasm ... . Monitor cardiac rhythm and treat arrhythmias as necessary ... . Start IV administration of D5W /SRP: "To keep open", minimal flow rate/. Use 0.9% saline (NS) or lactated Ringer's if signs of hypovolemia are present. For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload ... . Treat seizures with diazepam or lorazepam ... . Use...