When assessing therapeutic effects of mitotane in a patient with adrenocortical carcinoma, which outcome should the nurse expect?

Mitotane is an adrenocortical agent used primarily in the treatment of adrenocortical carcinoma. It acts by inhibiting steroidogenesis and reducing cortisol production from the adrenal glands. One of the significant effects of mitotane is the reduction of cortisol levels in the body.

In patients with adrenocortical carcinoma, elevated cortisol levels can lead to increased blood pressure due to its effects on fluid retention and vascular resistance. Therefore, when mitotane reduces cortisol production, a corresponding decrease in blood pressure is expected as the excessive stimulation of the cardiovascular system and retention of sodium and water diminishes.

This response is particularly relevant for managing the symptoms and complications associated with hypercortisolism, which is common in patients with adrenocortical tumors. Therefore, the nurse would expect a decrease in blood pressure as a beneficial therapeutic effect of mitotane treatment. This outcome reflects the drug's action in targeting the overproduction of cortisol and its systemic effects, including on blood pressure regulation.