Due to the diverse and potentially dangerous effects of GC, patients should be closely monitored during therapy. Abrupt discontinuation of the exogenous source of these hormones will precipitate a state of acute adrenal insufficiency, placing the patient at risk. Therefore, patients should be slowly withdrawn from therapy, allowing the adrenal gland time to recover. This effect may be minimised by using the lowest effective dose and alternate day therapy. Mineralocorticoids Aldosterone, its mechanism of action, and its physiologic effects have been discussed in the diuretic section.
Hyperaldosteronism presents as hypertension, polyuria, polydipsia, weakness, tetany, and alkalosis.
The treatment is spironolactone, an aldosterone antagonist. Adverse effects of fludrocortisone are essentially the same effects as hyperaldosteronism. It is not effective for chronic treatment of these patients.