Mineralocorticoids and mineralocorticoid antagonists
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Mineralocorticoids and mineralocorticoid antagonists
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Mineralocorticoids and mineralocorticoid antagonists
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Adrenal insufficiency p. 355
fludrocortisone for p. 362
Edema
fludrocortisone p. 362
Fludrocortisone p. 362
Heart failure p. 318
fludrocortisone and p. 362
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fludrocortisone p. 362
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Transcript
Content Reviewers
Yifan Xiao, MDContributors
Alaina Mueller
Kaia Chessen, MScBMC
Maria Emfietzoglou, MD
Sam Gillespie, BSc
With mineralocorticoids, “corticoids” refers to the steroid hormones produced by the adrenal cortex, and “mineral” refers to how these hormones regulate sodium reabsorption and potassium excretion in the distal convoluted and collecting tubules of the kidney.
Aldosterone is the major natural mineralocorticoid in humans and there are two major classes of medications targeting the actions of mineralocorticoids: mineralocorticoid-receptor agonists, which mimic the role of aldosterone; and mineralocorticoid-receptor antagonists, that block the action of aldosterone.
Alright, but first things first.
Aldosterone is part of a hormone family, or axis, that works together and is called the renin-angiotensin-aldosterone system.
Normally, when the blood pressure is low, the kidney gets less blood, which causes it to release renin into the blood.
Renin converts a prohormone called angiotensinogen into angiotensin I, and another enzyme called angiotensin converting enzyme, or ACE, converts angiotensin I into angiotensin II.
Angiotensin II has many effects like causing vasoconstriction and stimulating the release of antidiuretic hormone from the pituitary glands.
In the adrenal glands, it triggers the secretion of aldosterone.
In the kidneys, aldosterone affects two types of cells along the distal convoluted and collecting tubule of the nephron.
First, it binds to mineralocorticoid receptors in the cytoplasm of principal cells, forming an aldosterone-receptor complex.
This complex is translocated to the nucleus of the cell, where it enhances two types of cells along the distal convoluted and collecting tubule of the nephron.
Summary
Mineralocorticoids are hormones that play an important role in the regulation of salt and water balance. They are produced in the adrenal cortex and control the activity of sodium and potassium channels in the kidney tubules, which affects the reabsorption of salt and water. Mineralocorticoid antagonists are drugs that block the action of mineralocorticoids, and they are used to treat conditions such as hypertension, congestive heart failure, and chronic renal failure. Mineralocorticoid antagonists include drugs like spironolactone and eplerenone
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "The renin‐angiotensin‐aldosterone system and its suppression" Journal of Veterinary Internal Medicine (2019)
- "An Update on Addison’s Disease" Experimental and Clinical Endocrinology & Diabetes (2018)
- "Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline" The Journal of Clinical Endocrinology & Metabolism (2016)
- "A Comparison of the Aldosterone-blocking Agents Eplerenone and Spironolactone" Clinical Cardiology (2008)
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