ACTH Action

Krieger, Dorothy T.

doi:10.1007/978-3-642-81659-8_3

Cited by 1 publication

(1 citation statement)

References 53 publications

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“…Figure 1 shows the circadian rhythm (medians) of cortisol and 17-OH-progesterone levels in the serum of all 15 patients on conventional therapy. The step-shaped line, which shows considerable diurnal variation, gives the threshold levels of cortisol concentration when ACTH is released by healthy persons (drawn after Krieger [3] and Gallagher et al [2]). Between 03:00 and 06:00 h the cortisol concentrations were below the threshold for ACTH release and followed by a pathologically high 17-OH-progersterone peak (median 11 ~tg/dl, maximum 25 gg/dl) falling to lower levels as late as 15:00 h. At 15:00 h the cortisol concentrations again touched the treshold.…”

Section: Methodsmentioning

confidence: 99%

Chronopharmacology of hydrocortisone and 9?-fluorhydrocortisone in the treatment for congenital adrenal hyperplasia

Moêller

1985

Eur J Pediatr

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The conventional treatment of CAH with hydrocortisone (16-19 mg/m2 per day) and 9 alpha-F-cortisol (just enough to normalise renin concentrations, started at 07:00 h) was ineffective in suppressing the early morning rise of 17-OH-progesterone and in turn androgens in about 20% of our patients. The present work explored the effect of a modified dosage regimen of the drug in five patients. The schedule was: 03:00 h F 33% + 9 alpha-F-F 33%; 07:00 h F 30%; 12:00 h F 22% + 9 alpha-F-F 33%; 17:30 h F 15% + 9 alpha-F-F 33%. Monitored levels of circulating 17-OH-progesterone, testosterone, and individual urinary 17-ketosteroids showed significant improvement, which was not achieved by giving higher or later evening doses. Menarche was induced in two girls (bone age 15 years). The modified dosage schedule offers on the one hand the possibility of better management of CAH, and on the other, cuts down the risk of enhanced Cushing-like effects, which in animal models have been related frequently to dosage schedules not corresponding to the circadian rhythm. The difficulty of administering the drugs at 03:00 h should be overcome by the development of a late-releasing preparation.

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Section: Methodsmentioning

confidence: 99%

Chronopharmacology of hydrocortisone and 9?-fluorhydrocortisone in the treatment for congenital adrenal hyperplasia

Moêller

1985

Eur J Pediatr

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show abstract

ACTH Action

Cited by 1 publication

References 53 publications

Chronopharmacology of hydrocortisone and 9?-fluorhydrocortisone in the treatment for congenital adrenal hyperplasia

Chronopharmacology of hydrocortisone and 9?-fluorhydrocortisone in the treatment for congenital adrenal hyperplasia

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