Methods of treatment of hyperprolactiamia

Content

  • Medicate therapy hyperprolactiakiyia
  • Surgical treatment of hyperprolactiakiyia
  • Lighting therapy hyperprolaktemia

  • Treatment of hyperprolactinemia is aimed primarily on
    restoration of disturbed gonadal functions and fertility (the ability of a mature organism to produce offspring) like women,
    So in men, and if there are prolactines - a decrease in the mass of the tumor.

    With all the forms of hyperprolactinemia, the main method of treatment is
    Medical, which, if prevailing, competes from
    Surgical and radiation methods.



    Medicate therapy hyperprolactiakiyia

    Preparations that can reduce the secretion of the PRL (prolactin) can
    divided into 2 groups - derivatives of alkaloids of the ardines - ergoline and
    Preparations that are not related to derivatives of alkaloids, -
    Neergolinovye. The first includes short-acting drugs
    2-bromo-aero-cryptine and 2-bromo-a and (3-ergocriptine and ergolin
    Derivative with long and selective action (Cabergoline). Second -
    Tricyclic benzoguanolins derived, synthesized specifically
    To reduce the level of PRL (Crownagolide).

    Methods of treatment of hyperprolactiamia
    Brahrocriptine - first semi-synthetic alkaloid argot,
    Forest wide application in the clinic since 1972. Bromocriptine is a preparation of the first row, with
    the appointments of which begins the therapy of hyperprolactiasis
    states requiring medication treatment.

    Bromocriptine after oral administration is well absorbed.
    Reducing the preload level (prolactin) begins 1-2 hours after receiving the drug,
    reaches maximum, t.E. Reducing the concentration of OPR by more than 80%
    after 5-10 hours and persists close to the maximum level during
    8-12 C. Bromocriptine treatment starts, as a rule, with low doses
    (0,625; 1.25 mg usually before bed with food to prevent nausea and
    orthostatic hypotension), increasing them by 0.625-1.25 mg every 3-4
    day until the total dose of 2.5-7.5 mg per day will be reached
    (taken fractionally 2-3 times a day during meals). Dose is selected
    individually under the control of the level of PRL (prolactin) and if necessary
    Increases every two weeks.

    It is shown that the reception of bromocriptine allows you to restore
    Normal level of PRL (prolactin). At
    Macroprolactinities The level of PRL (prolactin) is normalized by more than 60% of cases. Therapy
    Bromocriptine causes dystrophic changes and necrosis (death) in tumor
    Cells, while a decrease in the size of Macroprolactin is achieved in 70%
    Cases.

    From the side effects of the drug for the first few days
    treatment in some patients is notable for light nausea or,
    less often, dizziness, weakness or vomiting, which, however, is not so
    strong to demand termination of therapy.



    Surgery

    hyperprolaktemia

    Currently, adenomectomy (removal of a diffascular tumor) is not a choice for
    Treating patients with prost-secreting tumor. In patients with S
    Microenomas manages to produce selective transfenoidal
    adenomectomy, but in a significant number of patients (20-50%) for 5
    After the operation, recurrence (re-manifestation) of hyperprolactinemia develops.

    The success of the operation is determined mainly by the size of the tumor (its
    distribution) and neurosurgeon experience. Smaller adenoma
    better succumb to surgical treatment than larger pituitary tumors
    Sizes. An indicator of the long-term effect of the operation serves
    Postoperative level of PRL (prolactin) in blood serum. If after 10-15 days
    After the operation of reducing or normalizing the level of PRL (prolactin) does not occur,
    You can think about incomplete disposal of adenoma. In such cases, shown
    Combined treatment.



    Radiation therapy

    hyperprolaktemia

    Since positive effects after irradiation prolactin
    develop gradually and until the development of the complete effect takes up to 12-18
    Mes, and also possible complications (brain tissue necrosis, damage
    visual nerves, in a remote period - hypocituitarism), radiation
    Prolactin therapy is applied in exceptional cases and not always
    Effective. Indications for radiation therapy prolactin are
    inefficiency and intolerance to drug therapy, big
    residual volume of tumor tissue after surgery, as well as availability
    Contraindications to surgical treatment or failure of a patient
    Surgical treatment.

    Thus, treatment of hyperprolactinemia requires
    differentiated (selective) approach with clinical and biochemical,
    X-ray data and includes both monotherapy with agonists
    dopamine, operational intervention or irradiation and their combination in
    Different options.

    To the treatment you need to approach strictly individually. Because I
    Medical therapy and adenomectomy effectively reduce the level of
    (prolactin) in serum, both of these methods can be used for
    Treating hyperprolactinemium tumor genesis.

    Preparations that reduce the level of PRL (prolactin) begin to act
    quickly and appointing exactly they prefer to use as
    primary treatment.

    Operation, if it is completed successfully, has an advantage
    disposable procedure, but may disrupt the normal functions of the front and
    rear lobes of pituitary, as a result of what in patients who have previously suffered
    only hyperprolactinemia, can develop transient or
    Permanent hypocituitarism and unacceptable diabetes.

    Medical and surgical treatment do not necessarily exclude
    each other. In difficult cases, when the patient has a larger tumor
    sizes may need to use dopamiomimetics as before, so
    And after adenomectomy.

    Leave a reply