The Sound of Evolution
Fludrocortisone
Mechanism of action:
Fludrocortisone is a synthetic mineralocorticoid and belongs to the class of fluorinated corticosteroid derivatives. In epithelial cells of the distal convoluted tubule and collecting duct of the kidney, fludrocortisone activates cytoplasmic mineralocorticoid receptors and subsequently enters the nucleus to regulate the transcription of specific genes, increasing the expression of epithelial sodium channels (ENaC) and Na⁺/K⁺-ATPase. This promotes sodium reabsorption from urine back into the bloodstream, thereby increasing blood volume and blood pressure, and can be used in conditions related to hypovolemia or hypotension.
Reference(s):
1. Agarwal MK et al. (1977). Physiological activity and receptor binding of 9 alpha fluorohydrocortisone. Biochem Biophys Res Commun.
2. Lan NC et al. (1982). Binding of steroids to mineralocorticoid receptors: implications for in vivo occupancy by glucocorticoids. J Clin Endocrinol Metab.
3. Diederich S et al. (2002). 11beta-hydroxysteroid dehydrogenase types 1 and 2: an important pharmacokinetic determinant for the activity of synthetic mineralo- and glucocorticoids. J Clin Endocrinol Metab.