Steroid induced addisonian crisis

People who experience a sudden hearing loss (SSNHL) are often treated with systemic steroids, which are taken orally. Studies however show that people with sudden sensorineural hearing loss (SSNHL) who do not respond to this treatment can benefit from intratympanic steroid injections. Studies carried out at universities in USA and Thailand show intratympanic steroid injections to be very effective and that the treatment does not have any side-effects.

Dr. David Haynes from Vanderbilt University Medical Center, Nashville, USA, carried out the study of 40 people who had experienced sudden sensorineural hearing loss (SSNHL). Overall, 40% showed some kind of improvement when treated with intratympanic steroid injections.

Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.

The ‘Two-Pin’ technique increases sanitation for multiple dose vial users. They draw with the first pin, and then shoot/inject into the body with a new one. This procedure prevents any residual contaminants that may have remained on the drawing pin from being transferred into the body via the injection site. It also makes injection less painful since the drawing needle is necessarily dulled during passage through the rubber stopper atop the vial. A dulled needle increases injection pain because it doesn’t pierce the body as cleanly as an unused one. The protocol below is followed by AAS users who draw from multiple dose vials, but steps 4 - 8 are routinely disregarded by those users who draw from ampoules (also called ampules) and sachets.

Steroid induced addisonian crisis

steroid induced addisonian crisis

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