Hypopituitarism Treatment

Submitted by Health Studies on Wed, 04/29/2009 – 20:59
Endocrine Diseases
Hypopituitarism
Treatment for Hypopituitarism include as follow:

1. Glucocorticoid:
Hydrocortisone, a dose is 5 ~ 30mg / d. Medication: if small doses, take after breakfast; if the middle doses, can take 2 / 3 after breakfast, take 1 / 3 in the afternoon. Also use cortisone, a dose is 6.25 ~ 37.5mg / d, or prednisone 2.5 ~ 7.5mg / d. In case of fever, infection, surgery, may be appropriate in amount. After mitigation of complications, down to the normal dose.

2. Thyroid tablets:
Should be started by a small dose, 10 ~ 40mg / d, 2 ~ 4 weeks later increased to 40 ~ 80mg / d. Thyroid tablets with glucocorticoids or with a few days later to prevent crisis-induced. Or levothyroxine tablets (L-T4) 25µg / d, and gradually increase, in the maintenance is about 100 ~ 200µg / d.

3. Artificial cycle treatment for Young women:
Oral diethylstilbestrol 0.25 ~ lmg / night, a total of 20d, after 16 days since taking progesterone intramuscular injection 10mg / d, a total of 5d. If have menstruation period after discontinuation, can take the next cycle after five day; if without menstruation after stopping, can take the next cycle after seven day. Generally consecutive three cycle, then stop for 1 month. Or oral contraceptives, drug withdrawal induced menstruate. If necessary, Ues HMG (human menopausal gonadotropin in urine) to trigger ovulation, after 2 ~ 3 weeks, observat estrogen, if have ovarian response, can use human chorionic gonadotropin.

4. Keto acid pill Sim:
Males can inject with 25mg, 1 ~ 2 / week, women should not exceed monthly dose 250mg.

5. Surgery or radiotherapy:
If Hypopituitarism is caused by pituitary chromophobe cell tumors or intracranial tumor, treatment is surgery or radiation therapy.

6. Crisis management:
1) 50% glucose solution intravenously 40 ~ 60ml rapidly, followed by a 10% glucose infusion to maintain;
2) intravenous hydrocortisone, 300mg / d or more;
3) patient with infected can use antibiotics to control infection, and peripheral circulation failure, should add blood volume, use step-up drug;
4) patient with low-temperature can use thyroid agents, started a small dose for fast-action preparations, such as three-triiodothyronine (T3);
5) inducement of crisis treatment.

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