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Mineralocorticoids: Classification, Mechanism, Uses, and Side Effects
Classification of Mineralocorticoids
Mineralocorticoids are a class of corticosteroids that primarily regulate electrolyte and water balance. The main endogenous mineralocorticoid is aldosterone, while fludrocortisone is a synthetic example.
Mechanism of Action
- Increases sodium reabsorption in the kidneys, leading to water retention, increased blood volume, and blood pressure.
- Promotes potassium and hydrogen ion excretion.
- Acts on the mineralocorticoid receptor (MR) to regulate sodium transport proteins.
Therapeutic Uses
- Addison’s Disease: Used to replace deficient aldosterone.
- Orthostatic Hypotension: Used to increase blood pressure.
- Congenital Adrenal Hyperplasia (CAH): Treats salt-wasting forms of CAH.
Adverse Effects
- Hypertension: Due to sodium and water retention.
- Hypokalemia: Excessive potassium loss causing muscle weakness and arrhythmias.
- Edema: Fluid retention leading to swelling.
- Alkalosis: Due to potassium loss and hydrogen ion excretion.
- Weight Gain: Resulting from fluid retention.
- Hyperglycemia: Increased blood glucose levels with prolonged use.
Contraindications
- Hypertension: Avoid in uncontrolled high blood pressure.
- Heart Failure: Can worsen due to fluid retention.
- Severe Renal Impairment: Increases the risk of kidney dysfunction.
- Hypersensitivity: Contraindicated in individuals with known allergies.
- Cushing’s Syndrome: Should not be used in patients with excess corticosteroid production.
