Abstract
Fludrocortisone is a synthetic corticosteroid based on cortisol. It is rapidly and completely absorbed after oral administration. The blood level reaches a peak between 4 and 8 hours. Fludrocortisone is a very powerful steroid that has both mineralocorticoid and glucocorticoid properties. The standard dose in the newborn is 150 μg/m2 body surface area/day as a single dose. During childhood the daily dose increases until a maximum of 100 μg is reached. The dose is adjusted based on plasma sodium levels, plasma renin activity, blood pressure and haematocrit. Overdosing with fludrocortisone leads to high blood pressure and low plasma potassium levels. Under treatment can lead to hyponatremia and high potassium levels. Hyponatremia is serious and needs treatment as it can lead to seizures, low blood pressure, coma and death. A high potassium level can cause the heart to beat irregularly which is known as an arrhythmia. This can cause the heart to stop and cause sudden death.
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