Normal Biological Pathway
In a normal biological pathway, aldosterone is regulated through the renin-angiotensin system and cortisol is regulated through the pituitary gland and the hormone ACTH, or adrenocorticotropin hormone. Aldosterone is released when renin, an enzyme, is secreted when blood pressure is low. The increase in renin stimulates the protein angiotensinogen (Robert Utiger).Angiotensin I is then converted into Angiotensin II, which stimulates aldosterone to be secreted (Robert Utiger).
(en.wikipedia.org)
(en.wikipedia.org)
The pituitary gland releases ACTH, which activates cortisol secretion. Once too much cortisol is produced, it results in a negative feedback system, inhibiting the release of ACTH. ACTH under stress and a lot of cortisol is produced until the stresses die down (Robert Utiger).
(faculty.clintoncc.suny.edu)
(faculty.clintoncc.suny.edu)
Affected Biological Pathway
In Addison's disease, the adrenal cortexes are 90 percent destroyed, causing these systems to not work efficiently and produce very little cortisol or aldosterone (medical-dictionary). This causes an excess of ACTH to be in the blood stream and the body is unable to maintain a stable heart rate or blood pressure. The lack of aldosterone causes the blood pressure to drop due to the imbalance in sodium and potassium levels in the blood (medical-dictionary).
(clinicalscience.files)
(clinicalscience.files)
Florinef Pathway
Florinef acts on the receptor cells of aldosterone in order to stimulate sodium uptake; however, Florinef only helps with sodium uptake and potassium supplements will most likely need to be taken along with hydrocortisone in order to have the same effects as aldosterone does on the body. The side effects of Florinef are the opposite to the deficiency in aldosterone because it is trying to counteract those symptoms. It specifically works on the vasopressin V1a receptor, which is the receptor that aldosterone directly affects (ajprenal.physiology.org).