LAWRENCE PARKER, M.D.; ALEX KUTAS, M.D.; MICHAEL BOLOGNESE, M.D.; RONALD SKOWSKY, M.D.
To the editor: There are two major reasons to measure accurately the mineralocorticoid potency of a corticosteroid preparation. First, a corticosteroid must be used for its anti-inflammatory effect without inducing excessive sodium retention that causes edema and congestive heart failure. Second, the choice of replacement therapy in a patient with primary adrenal insufficiency depends on the ratio of glucocorticoid to mineralocorticoid activity. A corticosteroid preparation with little or no sodium-retaining properties must often be supplemented with a more potent mineralocorticoid to prevent hyperkalemia, hypotension, or vascular collapse.
Comparison of the reported mineralocorticoid potencies of some widely used corticosteroids, as listed
PARKER L, KUTAS A, BOLOGNESE M, SKOWSKY R. References on Sodium-Retaining Potency of Corticosteroids. Ann Intern Med. ;90:853–854. doi: 10.7326/0003-4819-90-5-853_2
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Published: Ann Intern Med. 1979;90(5):853-854.
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