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Replacement therapies in adrenal insufficiency /

Replacement Therapies in Adrenal Insufficiency, authored by Peter C. Hindmarsh and Kathy Geertsma, provides an in-depth exploration of adrenal insufficiency, its causes, and treatment strategies. The book addresses both primary and secondary adrenal insufficiencies, detailing the physiological aspec...

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Bibliographic Details
Main Authors: Hindmarsh, P. C. (Peter C.) (Author), Geertsma, Kathy (Author)
Corporate Author: ScienceDirect (Online service)
Format: eBook
Language:English
Published: London : Academic Press, 2024.
Subjects:
Adrenal glands > Diseases > Hormone therapy.
Adrenal glands > Diseases > Treatment.
Surrénales > Maladies > Hormonothérapie.
Surrénales > Maladies > Traitement.
Electronic books.
Online Access:Connect to the full text of this electronic book
Table of Contents:
  • Front Cover
  • Replacement Therapies in Adrenal Insufficiency
  • Replacement Therapies in Adrenal Insufficiency
  • Copyright
  • CONTENTS
  • PREFACE
  • ACKNOWLEDGEMENTS
  • SECTION 1
  • 1
  • Adrenal Insufficiency
  • GLOSSARY
  • GENERAL
  • HOW COMMON IS ADRENAL INSUFFICIENCY?
  • CAUSES OF PRIMARY ADRENAL INSUFFICIENCY
  • Autoimmune adrenalitis
  • Adrenal hypoplasia congenita
  • X-linked Adrenoleukodystrophy
  • Congenital adrenal hyperplasia
  • CAUSES OF SECONDARY ADRENAL INSUFFICIENCY
  • PRESENTATION
  • DIAGNOSTIC TESTS FOR ADRENAL INSUFFICIENCY
  • CONCLUSION
  • FURTHER READING
  • 2
  • Physiology of Cortisol Secretion
  • GLOSSARY
  • GENERAL
  • ADRENAL GLANDS
  • THE HYPOTHALAMUS AND PITUITARY GLAND
  • PITUITARY DEVELOPMENT
  • Corticotropin-releasing hormone, Arginine vasopressin and Adrenocorticotropin
  • CIRCADIAN RHYTHM AND CIRCADIAN CLOCKS
  • Amplification System and Input from Stress and Glucose
  • CONCLUSION
  • FURTHER READING
  • 3
  • What are Steroids?
  • GLOSSARY
  • GENERAL
  • CHOLESTEROL
  • STEROID BIOSYNTHESIS
  • BIOCHEMICAL STRUCTURE OF THE STEROIDS
  • STEROIDAL TRANSPORTATION
  • CORTISOL AS AN EXAMPLE
  • STEROID RECEPTORS
  • CONCLUSION
  • FURTHER READING
  • 4
  • Biochemical Tests Used in Adrenal Insufficiency
  • GLOSSARY
  • GENERAL
  • MEASURING CORTISOL
  • Immunoassays of cortisol
  • Mass spectroscopy
  • TYPES OF SAMPLE
  • VARIATION IN MEASUREMENTS
  • Biological variation
  • Pre-analytic variation
  • Analytical variation
  • TESTS TO ESTABLISH ADRENAL INSUFFICIENCY
  • URINE AND SALIVARY MEASUREMENTS IN IDENTIFYING ADRENAL INSUFFICIENCY
  • STIMULATION TESTS MEASURING CORTISOL SYNTHESIS AND RELEASE
  • Synacthen stimulation test
  • Modified or physiological synacthen test
  • Insulin induced hypoglycaemia test for growth hormone and cortisol secretion
  • 24 HOUR PLASMA CORTISOL PROFILES
  • Two hourly sampling:
  • One hourly sampling:.
  • TESTING THE MINERALOCORTICOID AXIS
  • CONCLUSION
  • FURTHER READING
  • 5
  • Tests to Establish the Cause of Adrenal Insufficiency
  • GLOSSARY
  • GENERAL
  • PRIMARY ADRENAL INSUFFICIENCY
  • Autoimmune Adrenal Insufficiency
  • Adrenal hypoplasia congenita
  • X-linked adrenoleukodystrophy
  • Congenital adrenal hyperplasia
  • SECONDARY ADRENAL INSUFFICIENCY
  • Testing anterior pituitary function
  • Gonadotropin-releasing hormone tests
  • Thyrotropin-releasing hormone test
  • 24 hour profiles
  • Testing posterior pituitary function
  • Dexamethasone suppression test
  • GENETIC TESTING
  • CONCLUSION
  • FURTHER READING
  • 6
  • Principles of Pharmacology
  • GLOSSARY
  • GENERAL
  • PHARMACOKINETICS INCLUDING CLEARANCE AND HALF-LIFE
  • Half-life, Volume of Distribution and Clearance
  • Bioavailability
  • Interaction of bioavailability, half-life and the concept of plasma terminal half-life
  • PHARMACODYNAMICS
  • Comparing the Glucocorticoids
  • Structure
  • Potency
  • Duration of Action
  • Modifying the Glucocorticoids to Minimise Side Effects
  • CONCLUSION
  • FURTHER READING
  • SECTION 2
  • 7
  • Why It Is Important to Achieve Optimal Glucocorticoid Replacement
  • GLOSSARY
  • GENERAL
  • RESUME OF THE HYPOTHALAMO-PITUITARY-ADRENAL AXIS
  • MORTALITY AND MORBIDITY
  • THE ROLE OF THE ANNUAL REVIEW
  • CONCLUSION
  • FURTHER READING
  • 8
  • Problems Associated With Adrenal Insufficiency
  • 8.1
  • Bone Health
  • GLOSSARY
  • GENERAL
  • CALCIUM REGULATION
  • THE CLINICAL PROBLEM OF OSTEOPOROSIS AND GLUCOCORTICOIDS
  • GLUCOCORTICOID EFFECTS ON BONE
  • Measuring bone mineral density
  • WAYS TO IMPROVE BONE MINERAL DENSITY
  • Calcium and Vitamin D
  • Treatment for Established Osteoporosis
  • Monitoring
  • ORTHOPAEDIC BONE PROBLEMS
  • CONCLUSION
  • FURTHER READING
  • 8.2
  • Weight, Glucose and Insulin
  • GLOSSARY
  • WEIGHT GAIN
  • What to Do about Weight Gain.
  • GLUCOSE AND INSULIN METABOLISM
  • High Glucose
  • What to do about high blood glucose concentrations
  • Low Blood Glucose
  • Role of the counterregulatory hormones
  • Treating hypoglycaemia
  • CONCLUSION
  • FURTHER READING
  • 8.3
  • Gastrointestinal Problems
  • GLOSSARY
  • GENERAL
  • MOUTH
  • GASTRITIS AND GASTRIC ULCERS
  • GASTROPARESIS
  • SMALL INTESTINE AND MICROBIOME
  • LARGE INTESTINE
  • WHAT TO DO
  • CONCLUSION
  • FURTHER READING
  • 8.4
  • Fertility
  • GLOSSARY
  • GENERAL
  • HYPOGONADOTROPIC HYPOGONADISM
  • CONGENITAL ADRENAL HYPERPLASIA
  • Polycystic Ovaries
  • Adrenal Rests in Females
  • Pregnancy in a Person with Congenital Adrenal Hyperplasia
  • Thyroxine Dosing During Pregnancy
  • Fertility in Males with Congenital Adrenal Hyperplasia
  • Adrenal Rests in Males
  • CONCLUSION
  • FURTHER READING
  • 8.5
  • Skin, Muscle and Tendons
  • GLOSSARY
  • SKIN
  • Striae
  • Thin Skin and Bruising
  • Hyperpigmentation
  • Wound healing
  • Acne
  • MUSCLES AND TENDONS
  • CONCLUSION
  • FURTHER READING
  • 8.6
  • Eyes
  • GLOSSARY
  • GENERAL
  • GLAUCOMA
  • CATARACTS
  • WOUND HEALING AND INFECTION
  • CONCLUSION
  • FURTHER READING
  • 8.7
  • Dizziness, Headaches and Dehydration
  • GLOSSARY
  • DIZZINESS
  • HEADACHES
  • DEHYDRATION
  • Signs and Classification of Dehydration
  • CONCLUSION
  • FURTHER READING
  • 8.8
  • Sleep, Mood and Cognitive Affects
  • GLOSSARY
  • SLEEP
  • MOOD ALTERATIONS
  • COGNITIVE AFFECTS
  • MEMORY
  • BRAIN FOG AND POOR CONCENTRATION
  • CONCLUSION
  • FURTHER READING
  • 8.9
  • Growth and Development Issues Which Occur in Adrenal Insufficiency
  • GLOSSARY
  • OVERTREATMENT
  • Growth Hormone and Cortisol
  • DELAYED PUBERTY
  • UNDERTREATMENT
  • CONCLUSION
  • FURTHER READING
  • SECTION 3
  • 9
  • Dosing with Glucocorticoids
  • GLOSSARY
  • GENERAL
  • THE CIRCADIAN RHYTHM OF CORTISOL
  • Impact of gender and age on the Cortisol Circadian Rhythm.
  • REPLACEMENT DOSING WITH HYDROCORTISONE
  • TIMING OF EACH HYDROCORTISONE DOSE
  • ESTIMATING THE DISTRIBUTION OF CORTISOL
  • What is the difference between a Diurnal and a Circadian rhythm?
  • Circadian Dosing
  • Cortisol Stacking and the Importance of Timing of the Dose
  • Under stacking:
  • Over stacking:
  • Useful stacking:
  • CONCLUSION
  • FURTHER READING
  • 10
  • Monitoring Replacement Therapy
  • GLOSSARY
  • GENERAL
  • WHAT IS MISSING, WHAT WE ARE REPLACING WITH AND WHAT WE SHOULD CHECK
  • METHODS OF MONITORING CORTISOL REPLACEMENT
  • Saliva
  • Urine
  • Blood
  • SINGLE CORTISOL BLOOD TESTS
  • DAY CURVES AND 24 HOUR PROFILES
  • BLOOD SAMPLING INTERVALS
  • Dose Timing makes a Difference
  • Additional valuable testing and monitoring
  • CONCLUSION
  • FURTHER READING
  • 11
  • Hydrocortisone Pump Therapy to Mimic the Circadian Rhythm
  • GLOSSARY
  • GENERAL
  • PRINCIPLE OF THE HYDROCORTISONE PUMP
  • Delivery Rates
  • USE AND BENEFITS OF HYDROCORTISONE PUMP THERAPY
  • Pump use in congenital adrenal hyperplasia
  • Addison's disease
  • Hypopituitarism
  • Pump use in Adrenal Insufficiency
  • PRACTICAL POINTS WHEN USING THE PUMP
  • Siting the cannula
  • Obtaining the data to set the rates
  • Hydrocortisone preparation
  • Reservoirs and cannulas
  • Basal Settings/Patterns
  • Bolus
  • Surgery
  • Safety
  • Clock changes and travelling with the pump
  • To pulse or not to pulse hydrocortisone using a pump
  • RESULTS OF PUMP THERAPY
  • PUMPS AND CANNULA SETS
  • CONCLUSION
  • FURTHER READING
  • 12
  • Dosing for Stress, Sick Days and Surgery
  • GLOSSARY
  • GENERAL
  • STRESS AND THE STRESS RESPONSE
  • EXAMINATIONS
  • CORTISOL RESPONSE TO ILLNESS, TRAUMA AND SURGERY
  • HOW MUCH TO INCREASE THE DOSE?
  • MANAGING SICKNESS AT HOME
  • SICK DAY RULES
  • ILLNESS
  • LEVEL 1
  • LEVEL 2
  • DOSING FOLLOWING ACCIDENTS
  • MANAGEMENT IN ACCIDENT AND EMERGENCY.
  • SURGERY IN PATIENTS RECEIVING GLUCOCORTICOIDS
  • Elective Surgery
  • Minor Surgery
  • Major Surgery
  • Emergency Surgery
  • Dental Surgery
  • Vaccinations
  • SUMMARY GENERAL DOSING GUIDE
  • MEDIC ALERT
  • EMERGENCY KIT
  • HYDROCORTISONE FOR INTRAVENOUS AND INJECTION USE
  • Solu-Cortef
  • Hydrocortisone Powder for Solution in the UK (Sodium Succinate)
  • Hydrocortisone Sodium Phosphate 100 mg/1 ml and 500 mg/5 ml solution for Injection
  • Needles
  • CONCLUSION
  • FURTHER READING
  • 13
  • Glucocorticoid Replacement
  • Interaction With Other Hormones
  • GLOSSARY
  • GENERAL
  • GLUCOCORTICOIDS AND MINERALOCORTICOIDS
  • ESTROGENS AND CORTISOL
  • ARGININE VASOPRESSIN AND CORTISOL
  • GROWTH HORMONE AND CORTISOL
  • THYROXINE AND CORTISOL
  • CONCLUSION
  • FURTHER READING
  • 14
  • Sodium and Water Balance
  • GLOSSARY
  • GENERAL
  • PLASMA SODIUM AND WATER
  • SODIUM AND THE BLOOD-BRAIN BARRIER
  • REGULATION OF THE PLASMA SODIUM CONCENTRATION
  • CAUSES OF RAPID CHANGES IN PLASMA SODIUM CONCENTRATIONS
  • CORRECTION OF ABNORMAL PLASMA SODIUM CONCENTRATIONS
  • FLUDROCORTISONE
  • 9 ALPHA-FLUDROCORTISONE
  • What is 9 alpha-Fludrocortisone?
  • How Does Fludrocortisone Work?
  • Fludrocortisone Action
  • Dosing with Fludrocortisone
  • Monitoring Fludrocortisone Replacement
  • MEASURES AVAILABLE TO ASCERTAIN ADEQUACY OF FLUDROCORTISONE REPLACEMENT
  • Side Effects, Contra Indications and Drug Interactions
  • Do I need to double dose with Fludrocortisone when unwell?
  • SALT AND WATER BALANCE AND BLOOD PRESSURE
  • High Blood Pressure
  • Low Blood Pressure
  • ARGININE VASOPRESSIN AND DESMOPRESSIN
  • Desmopressin (DDAVP)
  • EXERCISE AND SODIUM AND WATER BALANCE
  • CONCLUSION
  • FURTHER READING
  • 15
  • Weaning Glucocorticoids
  • GLOSSARY
  • GENERAL
  • CUSHING'S DISEASE AND CUSHING'S SYNDROME
  • HYPOTHALAMO-PITUITARY-ADRENAL SUPPRESSION
  • Effect of dose and timing.