florinef

Q: Fludrocortisone works via?

A) increase in blood volume
B) enhanced sensitivity of blood vessels to circulating catecholamines 
C) enhanced norepinephrine release from sympathetic neurons
D) all of the above
E) none of the above


Answer: D

Fludrocortisone is a synthetic mineralocorticoid commonly used in ICU patients particularly with renal failure, and presumed renal insufficiency. Its mechanism of action is through various mechanisms including an increase in blood volume, enhanced sensitivity of blood vessels to circulating catecholamines, and enhanced norepinephrine release from sympathetic neurons.

#hemodynamics
#pharmacology




References:


1. Davies IB, Bannister RG, Sever PS, Wilcox CS. Fludrocortisone in the treatment of postural hypotension: altered sensitivity to pressor agents [proceedings]. Br J Clin Pharmacol 1978; 6:444P.

2. Chobanian AV, Volicer L, Tifft CP, et al. Mineralocorticoid-induced hypertension in patients with orthostatic hypotension. N Engl J Med 1979; 301:68.