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In generaldose selection for an elderly patient should be cautioususually starting at the low end of the dosing rangereflecting the greater frequency of decreased hepaticrenalor cardiac functionand of concomitant disease or other drug therapy.
Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles andif exposedto obtain medical advice.
In generaldose selection for an elderly patient should be cautioususually starting at the low end of the dosing rangereflecting the greater frequency of decreased hepaticrenalor cardiac functionand of concomitant disease or other drug therapy.
Prolonged use of corticosteroids may produce posterior subcapsular cataractsglaucoma with possible damage to the optic nervesand may enhance the establishment of secondary ocular infections due to fungi or viruses.
The physiologic action of fludrocortisone acetate is similar to that of hydrocortisoneHoweverthe effects of fludrocortisone acetateparticularly on electrolyte balancebut also on carbohydrate metabolismare considerably heightened and prolongedMineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasmathey increase the urinary excretion of both potassium and hydrogen ionsThe consequence of these three primary effects together with similar actions on cation transport in other tissues appear to account for the entire spectrum of physiological activities that are characteristic of mineralocorticoidsIn small oral dosesfludrocortisone acetate produces marked sodium retention and increased urinary potassium excretionIt also causes a rise in blood pressureapparently because of these effects on electrolyte levels.
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