Post Head Injury Endocrine Complications Medication

Updated: Feb 12, 2016
  • Author: Milton J Klein, DO, MBA; Chief Editor: Consuelo T Lorenzo, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Hormone replacements

Class Summary

Because most endocrinopathies following traumatic brain injury (TBI) are due to failure at the anterior pituitary level, treatment involves hormonal replacement. Individual hormonal replacement also is indicated, depending on the specific endocrine gland involved. Posterior pituitary failure also is treated by replacement therapy.

Levothyroxine (Levoxyl, Synthroid)

In the active form, this drug influences growth and maturation of tissues. Involved in normal growth, metabolism, and development. Primary use is for synthetic thyroid hormone replacement.

Secondary use is for suppression of pituitary thyrotropin for management of thyroid carcinoma or thyroid nodules. Titrate to degree of hypothyroidism.

Desmopressin acetate (DDAVP)

Synthetic analogue of hypothalamic/posterior pituitary hormone 8-arginine vasopressin (ADH) for treatment of central DI. Not for treatment of nephrogenic DI. Dose should be titrated to plasma/urine osmolality and urine volume.

Testosterone (Andro-LA, Androderm, Depo-Testosterone)

For treatment of primary hypogonadism or hypogonadotropic hypogonadism.

Hydrocortisone (Cortef, Solu-Cortef)

Used for treatment of primary or secondary adrenocortical insufficiency.

Used short-term to treat flare-ups of rheumatologic conditions. Used for prolonged maintenance of collagen diseases (eg, systemic lupus erythematosus, polymyositis/dermatomyositis). Also used for dermatologic (eg, pemphigus), allergic (eg, atopic dermatitis), and respiratory diseases (eg, sarcoidosis).

Pediatric growth and development may be suppressed and should be monitored.

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Antibiotics

Class Summary

Tetracycline antibiotics are used to treat Rocky Mountain spotted fever, typhus fever, psittacosis, relapsing fever, chancroid, and gram-negative microorganism infections (depending on specific culture/sensitivity results).

Demeclocycline (Declomycin)

Primarily used as an antibiotic but also used as a nephrotoxin to induce diabetes insipidus for the treatment of resistant SIADH.

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Diuretics

Class Summary

These agents inhibit the resorption of sodium and chloride in the proximal and distal tubules and in the loop of Henle.

Furosemide (Lasix)

Potent diuretic that can cause massive diuresis and electrolyte depletion at high doses. Onset of diuresis is within 1 h, and the peak effect is during the first and second hour. Total diuretic effect is 6-8 h.

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