Replacement Therapies in Adrenal Insufficiency provides a thorough understanding of the conditions which result in adrenal insufficiency. Never before has one source of information combined all updates on current causes and mechanisms of adrenal sufficiency to allow for quick reference and subsequent treatment decisions. Scientific data on this broad condition includes specific disease coverage of Addison's disease, hypopituitarism, congenital adrenal hypoplasia and adrenalectomy. Practical points in diagnosis, dosing, drug interactions, replacement therapies and emergency situations are also provided as guidance for overall management.…mehr
Replacement Therapies in Adrenal Insufficiency provides a thorough understanding of the conditions which result in adrenal insufficiency. Never before has one source of information combined all updates on current causes and mechanisms of adrenal sufficiency to allow for quick reference and subsequent treatment decisions. Scientific data on this broad condition includes specific disease coverage of Addison's disease, hypopituitarism, congenital adrenal hypoplasia and adrenalectomy. Practical points in diagnosis, dosing, drug interactions, replacement therapies and emergency situations are also provided as guidance for overall management.
Peter Hindmarsh is Professor of Pediatric Endocrinology at University College London and Consultant in Pediatric Endocrinology and Diabetes at University College London Hospitals and Great Ormond Street Hospital for Children. Currently, he is applying Chronic Care Models to the delivery of care for patients with Congenital Adrenal Hyperplasia. His research interests are in the physiology and pharmacology of drugs used to manage Congenital Adrenal Hyperplasia and novel ways of delivery Hydrocortisone using pump therapy to mimic the circadian rhythm.
Inhaltsangabe
1. Why do we need to get hydrocortisone replacement right? 2. Mortality and morbidity data 3. Side effects and survey results of quality of life 4. Oral Glucocorticoid replacement 5. What is dosing regimen 6. How to calculate daily dose 7. How to distribute the dose 8. Drug interactions including drugs that alter liver metabolism 9. Specific problems with hormone replacement - oral or transdermal estrogens 10. Interplay of cortisol and vasopressin - diagnosis of diabetes insipidus and DDAVP replacement 11. Pituitary replacement that may modify hydrocortisone dosing - thyroxine and growth hormone 12. Monitoring replacement 13. What's missing what are we replacing what should we check 14. Ways of checking 17OHP, ACTH cortisol 15. Single sample versus multiple samples 16. Around dose sampling 17. Effects of OCP 18. Adjusting doses for events 19. Illness and the boxes 20. Stressful events 21. Surgery 22. Dental and the boxes 23. Travel and time zones 24. Adjustments and effects on other hormones e.g. DDAVP 25. Glucocorticoid replacement using pump therapy 26. Pump therapy to mimic circadian rhythm 27. Principles of the pump 28. Setting the system up, clearance studies 29. Monitoring replacement 30. Quality of life 31. Managing an Adrenal Crisis 32. Presentation as new diagnosis or following diagnosis 33. What it is and what it is not 34. Biochemical changes 35. How to manage a crisis - at home, in A&E after admission 36. Hydrocortisone requirements in a crisis 37. Glucose requirements during a crisis 38. Sodium and fluid balance - the importance of subacute or chronic hyponatraemia 39. Hyperkalaemia 40. Weaning Glucocorticoids 41. Factors influencing adrenal suppression dose, type of steroid, how long given, potency and whether given during day or night 42. The role of alternate day treatments 43. Principles in weaning 44. How to wean depending on duration of exposure, disease activity steroid used 45. What tests to use to determine axis recovery
1. Why do we need to get hydrocortisone replacement right? 2. Mortality and morbidity data 3. Side effects and survey results of quality of life 4. Oral Glucocorticoid replacement 5. What is dosing regimen 6. How to calculate daily dose 7. How to distribute the dose 8. Drug interactions including drugs that alter liver metabolism 9. Specific problems with hormone replacement - oral or transdermal estrogens 10. Interplay of cortisol and vasopressin - diagnosis of diabetes insipidus and DDAVP replacement 11. Pituitary replacement that may modify hydrocortisone dosing - thyroxine and growth hormone 12. Monitoring replacement 13. What's missing what are we replacing what should we check 14. Ways of checking 17OHP, ACTH cortisol 15. Single sample versus multiple samples 16. Around dose sampling 17. Effects of OCP 18. Adjusting doses for events 19. Illness and the boxes 20. Stressful events 21. Surgery 22. Dental and the boxes 23. Travel and time zones 24. Adjustments and effects on other hormones e.g. DDAVP 25. Glucocorticoid replacement using pump therapy 26. Pump therapy to mimic circadian rhythm 27. Principles of the pump 28. Setting the system up, clearance studies 29. Monitoring replacement 30. Quality of life 31. Managing an Adrenal Crisis 32. Presentation as new diagnosis or following diagnosis 33. What it is and what it is not 34. Biochemical changes 35. How to manage a crisis - at home, in A&E after admission 36. Hydrocortisone requirements in a crisis 37. Glucose requirements during a crisis 38. Sodium and fluid balance - the importance of subacute or chronic hyponatraemia 39. Hyperkalaemia 40. Weaning Glucocorticoids 41. Factors influencing adrenal suppression dose, type of steroid, how long given, potency and whether given during day or night 42. The role of alternate day treatments 43. Principles in weaning 44. How to wean depending on duration of exposure, disease activity steroid used 45. What tests to use to determine axis recovery
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