A Synopsis of Endocrinology and Metabolism by David G. Ferriman

By David G. Ferriman

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Per day for 3 days will suppress the 17-oxogenic steroid excretion to 5 mg. per 24 hours or less in normal subjects. Alternatively, 1 mg. m. ; this will be reduced to 3 μg. per 100 ml. or less in normal subjects. d. —Metyrapone inhibits the enzyme 11-hydroxylase (Fig. 5). If given orally in 750-mg. doses every 4 hours for 24 hours it effectively inhibits the production of cortisol, and plasma levels fall towards zero. This induces a sharp increase in the output of corticotrophin and consequent increase in steroid production by the adrenals, the products lacking 11-hydroxyl groupings.

On release from the gland, thyroxine is carried in the blood-stream attached to serum proteins, notably thyroid-binding protein (TBP) found between the oc1 and a2 globulin fractions on eleetrophoresis. Thyroxine is METHODS OF INVESTIGATION 27 readily extractable from serum by butanol (BEI). Thyroxine is more firmly bound to T B P than tri-iodothyronine, probably accounting for the more rapid action of tri-iodothyronine (24 hours compared with 1 week for thyroxine). —lodothyronine derivatives such as T3 or T4 acetic acids are formed in tissues and may be the ultimately active forms of these hormones.

Followed by 500 mg. 6-hourly by mouth. 3. —100 mg. , followed by 15 mg. 6hourly by mouth. 4. —Sodium amytal 2-400 mg. , repeated as often as necessary. Chlorpromazine with hypothermie as well as sedative action advocated; hypotensive action undesirable and dose should not exceed 25-50 mg. by mouth 6-8-hourly. Morphine 10 mg. or pethidine 50 mg. useful in exceptional cases. 42 DISEASES OF T H E THYROID Thyrotoxic Crisis—Treatment, continued. 5. REDUCTION OF F E V E R by tepid sponging, or by covering in wet blanket and use of a fan in hyperpyrexia.

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