Biological and hemodynamic effects of low doses of fludrocortisone and hydrocortisone, alone or in combination, in healthy volunteers with hypoaldosteronism

Clinical Pharmacology and Therapeutics
Bruno LaviolleEric Bellissant

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. The biological and hemodynamic effects of HC (50 mg intravenously) and FC (50 microg orally) were assessed in 12 healthy male volunteers with saline-induced hypoaldosteronism in a placebo-controlled, randomized, double-blind, crossover study performed according to a 2 x 2 factorial design. HC and FC significantly decreased urinary sodium and potassium levels (from -58% at 4 h to -28% at 10 h and from -35% at 8 h to -24% at 12 h, respectively) with additive effects. At 4 h after administration, HC significantly increased cardiac output (+14%), decreased systemic vascular resistances (-14%), and slightly increased heart rate (+4 beats/min), whereas FC had no hemodynamic effect. At doses used in septic shock, HC induced greater mineralocorticoid effect than FC did. HC also induced transient systemic hemodynamic effects, whereas FC did not. New studies are required to better define the optimal dose of FC in septic shock.

References

Apr 1, 1979·Chest·M O FarberF Manfredi
Jul 12, 1979·The New England Journal of Medicine·A V ChobanianD Faxon
Aug 1, 1990·Experimental and Clinical Endocrinology·K HorkýJ Dvoráková
May 1, 1983·Clinical and Experimental Pharmacology & Physiology·J A WhitworthR Thatcher
Apr 29, 1998·Critical Care Medicine·P E BollaertA Larcan
Mar 4, 2000·JAMA : the Journal of the American Medical Association·D AnnaneE Bellissant
Oct 3, 2000·Clinical Pharmacology and Therapeutics·E Bellissant, D Annane
Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
May 16, 2002·Clinical Pharmacology and Therapeutics·Philippe SeguinYannick Mallédant
Aug 21, 2002·JAMA : the Journal of the American Medical Association·Djillali AnnaneEric Bellissant
Nov 12, 2002·American Journal of Respiratory and Critical Care Medicine·Didier KehHerwig Gerlach
Jun 6, 2003·Lancet·Wiebke Arlt, Bruno Allolio
Aug 4, 2004·BMJ : British Medical Journal·Djillali AnnaneYizhak Kupfer
Jan 11, 2005·Lancet·Djillali AnnaneJean-Marc Cavaillon
Mar 2, 2006·Critical Care : the Official Journal of the Critical Care Forum·Philippe SeguinEric Bellissant
Dec 7, 2007·Intensive Care Medicine·R Phillip DellingerJean-Louis Vincent
Jan 11, 2008·The New England Journal of Medicine·Charles L SprungUNKNOWN CORTICUS Study Group
Jun 11, 2009·JAMA : the Journal of the American Medical Association·Djillali AnnaneG Umberto Meduri
Aug 8, 2009·Critical Care Medicine·Mercedes FalcigliaMarta L Render

❮ Previous
Next ❯

Citations

Jun 22, 2017·Operative Orthopädie und Traumatologie·D PapeR Seil
Jul 16, 2016·British Journal of Clinical Pharmacology·Andrea PolitoJean-Claude Alvarez
Nov 30, 2019·The Journal of Steroid Biochemistry and Molecular Biology·Eric PussardMarc Lombès

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.