effect depression by a principle

effect depression by a principle of a negative feedback. Normal rising of level 11-dezoksikortizola specifies in ability gipotalamo-gipofizarnoj axes to react to blockade of effect of steroids on a feedback mechanism. The changed reaction speaks nothing about defect localisation. At illness reaction intensifying whereas at the patients receiving buy voltaren exogenous steroids or suffering adenoma of a cortex of adrenals, this reaction is broken is observed. Risk. In the course of assay carrying out there are no appreciable dangers as the patient is in a prone position and receives an isotonic solution of Sodium chloridum. Assay cannot be spent, if the patient receives glucocorticoid therapy, it should not be applied at patients with primary insufficiency of a cortex of adrenals. Assay with , entered inside. A technique. Daily urine collect within four consecutive days. in a dose 0,75 prescribe through a mouth everyone 4 in 6 portions, beginning after the termination of the collecting of the second daily assay of urine. In each assay define the maintenance of 17-Construction Department or 17-ketogennyh steroids (17-KGS) and a creatinine (for check of completeness of the collecting of urine). Not changed indicators. The maintenance of 17-Construction Department or 17-KGS for 3rd or 4th day should be in 2,5-3 times more than in 1st or 2nd day. Intensifying and reaction weakening is observed in the same cases, as at intravenous introduction of a preparation. Risk. Assay, as a rule, is safe.
However at patients only with the minimum residual secretion of a hydrocortisone irrespective of the reason in the course of assay carrying out can easily arise or moderately expressed symptoms of insufficiency of a cortex of adrenals that can demand the research termination. Assay with a vasopressin. A technique. Intravenously enter 10 a vasopressin aqueous solution, and assays of plasma for definition of the maintenance of a hydrocortisone receive on 0, 30 and 60th minute. Not changed indicators. In norm level of a hydrocortisone or in 2 times exceeds initial, or its maximum concentration makes more than 250 mkg/l. Interpreting of results. Though the vasopressin can immediately stimulate secretion by a pituitary body, its dose applied in clinic, operates and through a hypothalamus. This test cannot be used for differentiation subthalamic and disorders though the vasopressin stimulates secretion by means of the mechanism differing from those at action of insulin and . Risk. Abdominal pains concern by-effects, a nausea and vomiting narrowing of vessels of a skin, sometimes. Assay should not be spent at patients with a lesion of coronary arteries. Assays on suppression of function of a pituitary body Night assay with dexamethasone. A technique. In a dose of 1 mg prescribe dexamethasone through a mouth in 11 evenings, and hydrocortisone level in plasma define in 8 mornings next day. Not changed indicators. Hydrocortisone level in plasma should make 50 mg/l or less. Interpreting of results. This test is most widely applied to an exception of syndrome . Absence of depression of level etodolac 400 mg of a hydrocortisone demands carrying out of the standard test with dexamethasone. In cases of acute diseases, in a condition of depression or stress of depression of level of a hydrocortisone also is absent. Standard assay with dexamethasone. A technique. This test demands the collecting of daily urine within 6 days. Dexamethasone 6 everyone prescribe to 3rd and 4th day and on 2 mg through a mouth on 0,5 mg everyone 6 for 5th and 6th day. In each assay of urine define 17-Construction Department, 17-KGS or (that is more preferable) a free hydrocortisone, and also a creatinine for check of completeness of the collecting of urine. Not changed indicators. At healthy faces the egestion 17-KGS decreases, reaching level below 7 mg/sut, 17-OKS-is lower 3 mg/sut and a free hydrocortisone-is lower of 20 mkg/sut at introduction of a small dose of dexamethasone (2 mg/sut). Interpreting of results. Not changed reaction excludes the syndrome or illness diagnosis. At illness the small dose of dexamethasone reduces an egestion of steroids insufficiently, but the big dose reduces it on 50 . At patients with tumours of a cortex of adrenals of depression of secretion of steroids it is not observed even at introduction of the big dose of dexamethasone. Absence of depression of secretion of steroids under the influence of a small dose of a preparation is observed also at patients with an acute disease, depressive reactions and at being in a condition of acute stress. Sometimes for depression of an egestion of steroids at illness the big doses of dexamethasone (to 32 mg/sut) are required still. Definition of a free hydrocortisone in urine allows to differentiate not changed and pathological reactions accurately.