Hormonotherapy is the treatment with hormonal preparations made from animal raw materials or synthetically.
It is used not only for lesions of endocrine glands , but also for non-endocrine pathologies (for example, insulin in mental illnesses). In the treatment of endocrine diseases, hormone therapy can be a substitute, stimulating and inhibitory.
Replacement hormone therapy is indicated with partial or complete loss of function of the endocrine gland (for example, with diabetes, addison's disease, etc.). Since the use of this or that hormone does not eliminate the lesion of the endocrine gland, then hormone therapy should be used constantly. The second condition for hormone replacement therapy is the establishment of the optimal dose for each patient. It is also necessary to take into account the reactivity of the patient to the hormonal drug in connection with various factors (age, pregnancy , etc.) and the cumulative properties of the hormone drug used.The
Stimulating hormonotherapy is used to stimulate the decreased function of the endocrine gland (thyroid-stimulating hormone - in hypothyroidism, gonadotropic - with a decrease in the function of the sexual glands).
Braking hormone therapy is used for excessive activity (hyperfunction) of a particular gland. Large doses of sex hormones are prescribed in some cases in the treatment of malignant tumors of the prostate and mammary glands, etc.
In addition to endocrine pathology, hormone therapy is used in other diseases. Corticosteroids (cortisone, prednisolone , etc.) are widely used in diseases of allergic nature, collagen diseases, ulcerative colitis, etc .; insulin in psychiatry; anabolic steroids - to stimulate protein synthesis during depletion of various origins.
Methods of hormone therapy and the route of administration of drugs. Inside apply hormonal preparations, little exposed to the secretion of the digestive glands (prednisolone, thyroidin , sinestrol , etc.). Sublingually (under the tongue) prescribe drugs that are quickly absorbed by the mucous membrane of the mouth ( pregnin , methyltestosterone). Intranasal adyurecrin is taken (preparation of the posterior lobe of the pituitary gland). The most common route of hormone administration is subcutaneous and intramuscular. If necessary, their rapid action is used by the intravenous method (for example, intravenous insulin for diabetic coma, hydrocortisone - for arresting the crisis with addison's disease, etc.).
Complications can occur with an overdose of the hormonal drug used (increased blood pressure - with an overdose of corticosteroids, hypoglycemic shock - with an overdose of insulin, etc.). With a decrease in the dose, these symptoms disappear. The second type of complications is associated with oppression of the function of the corresponding endocrine gland with prolonged use of the hormonal drug, therefore, when it is canceled, signs of functional gland failure appear (for example, acute adrenocortical failure with prolonged use of corticosteroids and their cancellation). To prevent this complication, it is recommended that the dose be gradually reduced by the end of the course of treatment. See also articles on the name of hormones.The
Hormonotherapy in pediatrics
The following hormonal drugs are most often used in children: corticosteroids (prednisolone, hydrocortisone, triamsinolone, dexamethasone, deoxycorticosterone-DOC), thyroidin, adiurecrin, insulin, lipocaine, anabolic hormones .
Corticosteroids affect all types of metabolism. They are prescribed for children not only for substitution therapy (for example, with adreno-genital syndrome), but also for many other pathological conditions ( rheumatism , nephritis , pneumonia , bronchial asthma , hemorrhagic diathesis, collagen diseases, infections, etc.). In the case of replacement therapy, the dose of prednisolone is selected individually. Assign it only in the morning hours (from 6 to 10 hours.) At the same time or in two sessions at intervals of 3 hours. In the latter variant, 2/3 of the dose is given at the first reception. For hydrocortisone, the dose is 5 times greater, and the interval between the two methods is 1.5 hours. When changing the drug, remember that 5 mg of prednisolone by biological action is equivalent to 4 mg of triamsinolone and 0.75 mg of dexamethasone.
Contraindicated in the use of corticosteroid drugs in the evening because of the danger of suppressing the adrenal cortex of the child and other complications. In severe childhood infections, pneumonia, bronchial asthma, surgical interventions drugs are also prescribed only in the morning hours at doses 2-3 times higher than physiological, 1-1.5 mg / kg (according to prednisolone). To suppress the infectious allergic process, immune reactions of the body, corticosteroid drugs are prescribed throughout the day until 19 hours. every 3 hours at a dose of 1-2 mg / kg (according to prednisolone), with 2/3 of the daily dose given up to 10 hours. With edematic syndrome, a good therapeutic effect is detected with a uniform distribution of hormones during the day. After the disappearance of edema, the daily dose of the hormone is redistributed (2/3 in the morning, 1/3 of the dose after lunch). After weakening the inflammatory process, the dose of the drug gradually decreases. First, the evening dose is canceled, then daytime and more slowly morning. In some diseases, an intermittent course of treatment is performed during incomplete remission . For this purpose, it is expedient to give two physiological doses every morning, 2 days, ie 0.8 mg / kg of prednisolone. The duration of this course is different (sometimes within 2 years).