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Deoxycorticosterone Acetate

Deoxycorticosterone acetate (DOXA, Desoxycorticosteronum aceticum; list B ) is a mineralocorticoid (see Corticosteroids). Get synthetically. Deoxycorticosterone-acetate has a biological effect of the natural hormone of the adrenal cortex, affects water and electrolyte metabolism (causing a delay of Na ions and increasing the release of K ions); at the same time the volume of plasma increases, blood pressure increases. Apply intramuscularly at 0.005-0.01 g 1 time in 1-2 days with Addison's disease, addisonism, myasthenia, muscle weakness, hypotension . Contraindicated in hypertension , edema, angina , etc. Higher doses: single 0.01 g (2 ml of 0.5% solution), daily 0.02 g (4 ml of 0.5% solution). Produced in ampoules of 1 ml of 0.5% oil solution.

See also Hormone therapy .

Deoxycorticosterone acetate. DOXA (Desoxycortico-steronum Aceticum. DOHA). Acetic acid Δ-pregnene-21-ol-3,20-dione. White or white with a cream shade odorless crystalline powder, resistant to air. Soluble in alcohol, acetone, ether, vegetable oils; insoluble in water. Melting point 154-160 °.

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Deoxycorticosterone is one of the most active hormones of the adrenal cortex, its synthetic analogue, deoxycorticosterone acetate, has the properties of a natural hormone and prolongs the life of animals after the removal of the adrenal glands. The hormone retains sodium ions in tissues and increases the release of potassium ions. This leads to an increase in tissue hydrophilicity. The hormone increases the volume of plasma and raises the arterial blood pressure. Its overdose can lead to the development of edema.

Indications. Addison's disease. Addisonism. Myasthenia gravis. Asthenia. Adynamia. Hypochloremia. Burns Reconvalescence. Surgical interventions.

Mode of application. It is used intramuscularly in oil solutions. When addison's disease is administered from 5 mg three times a week to 10 mg daily until the symptoms decrease, then 5 mg 1-2 times a week.

When patients are removed from the state of addisonic crisis, it is necessary to administer 10-15 mg of deoxycorticosterone-acetate daily for 2–3 days daily with simultaneous administration of glucose and hypertonic sodium chloride solutions into the vein (2–3 l per day). As the state of patients improves, the amount of deoxycorticosterone acetate decreases to 2-5 mg per day.

When addisonizm appoint 5 mg of the drug every other day (15 - 20 injections per course of treatment).

In hypotonic conditions on the basis of reduced function of the adrenal cortex, 5 mg every other day or two days (a total of 12-15 injections).

In the amount of 5-10 mg per day, the drug is used for the prevention and treatment of shock, with surgical interventions, burns, and asthenic conditions in convalescents.

In Addison's disease, it is recommended to administer cortisone simultaneously with deoxycorticosterone acetate (0.01-0.025 per day). Sodium chloride is also prescribed (4.0–10.0 per day in powder form, in capsules, tissue paper, or as Addison elixir — an aqueous solution of 10.0 sodium chloride and 5.0 sodium citrate and fruit juice).

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Deoxycorticosterone acetate can also be placed under the skin in the form of implantation tablets of 0.05 and 0.1 deoxycorticosterone acetate, produced in sterile form in sealed ampoules.

Implantation is performed surgically. Place for 10 minutes in a solution of alcohol ampoule with a tablet. The patient is placed on the operating table. In the area of ​​the border of the chest and abdomen (where pressure is applied from the belt), the skin is treated with a disinfecting solution, local anesthesia is performed with a 0.5% solution of novocaine and a 2-3 cm long incision is made. Then a vascular clamp is made in the subcutaneous tissue 5 —6 cm. The ampoule is opened and the tablet is injected with anatomical forceps into the subcutaneous tunnel. After that, Michel stitches or brackets are put on, and a labeling bandage is applied on top, which is removed after five days.

After implantation, the tablets slowly dissolve (within 3-4 months). This provides a long-term entry into the blood of the drug, which fills in the body of patients with an insufficient amount of the hormone. The daily intake of 0.0007 hormonal substances is absorbed into the body.

The dose of deoxycorticosterone-acetate in the application of tablets should also be individualized, depending on the nature and severity of the patient's condition. When Addison's disease implanted 0.1-0.2, and with hypotonic syndrome, asthenia, etc., 0.05-0.1.

Higher doses of deoxycorticosterone acetate (for intramuscular administration) for adults: single 0.01 (2 ml of a 0.5% solution), daily 0.02 (4 ml of a 0.5% solution).

Apply the drug with careful monitoring by the doctor.

Side effects Increased plasma volume. Increased arterial blood pressure. Significant retention of sodium chloride and a decrease in potassium in the blood, arthritis.

During treatment with deoxycorticosterone acetate, it is necessary to carefully regulate the intake of potassium, sodium and water:

Contraindications. Hypertonic disease. Heart failure with edema. Cardiosclerosis. Nephritis. Nephrosclerosis. Cirrhosis of the liver. Peripheral artery lesions.

Form release. The oil solution in ampoules containing in 1 ml of 0.005 drug. Tablets for implantation contain 0.05-0.1 in a glass ampoule.
- Recently, the drug began to produce in sublingual tablets of 0.001 and 0.005 of the drug.

Trimethyl acetate deoxycorticosterone in the form of a 2.5% saline suspension is used for intramuscular injections, which ensures slow absorption of the drug with a prolonged release of activity in the period up to a month
Keep with caution in sealed ampoules in a dark place.

Refers to list B.
Rp. Sol. Desoxycorticosteroni Acetici oleosae 0.5% 1.0.
D. td N. 10 in ampulis.
S. Muscle 1 ml every other day.