Dosing Cares Foundation. Donate. Join our community. Medication Dosing. Research has shown Congenital Adrenal Hyperplasia to be a spectrum disease. That is, a condition that manifests itself in varying degrees the severe form being Classical Salt wasting CAH and the mild form being Non classical CAH with Simple Virilizing CAH somewhere in between. In all cases, however, CAH is caused by an adrenal insufficiency resulting in impaired production of hormones. All individuals affected by Classical CAH require glucocorticoid hydrocortisone, prednisone, dexamethasone replacement therapy. Those with a salt wasting component to their insufficiency also require mineralocorticoids fludrocortisone and sodium. The following pages outline medication dose guidelines for all individuals with CAH as agreed upon by the leading pediatric endocrinologists in the United States and Europe in 2. As always, this information is provided for your reference to help you better understand decisions made regarding medication dosing and in no way should be taken to be the provision or practice of medical, nursing or professional healthcare advice or services. This information should not be considered complete or exhaustive and should not be used in place of the visit, call, consultation or advice of your physician or other healthcare provider. Dosing of Medications. From the Joint LWPESESPE 2. EgNXjgntlHBRbUVtG16gOSux9Xd5NM4mvyHRLHex1J33gGMRJmCpPDXZjg6PKEYxmRM=h900' alt='Paediatric Dosage Handbook' title='Paediatric Dosage Handbook' />CAH Consensus Statement pages 4. Optimal Glucocorticoids Dosing. During infancy, initial reduction of markedly elevated adrenal sex hormones may require up to 2. HCm 2. d, but typical dosing is 1. HC oral suspension is not recommended divided or crushed tablets of HC should be used in growing children. HC is considered the first drug of choice. Excessive doses, especially during infancy, may causes persistent growth suppression, obesity and other Cushingoid features. Insufficient data exist to recommend higher morning or evening dosages. Whereas HC is preferred during infancy and childhood, long acting glucocorticoids may be an option at or near completion of linear growth. Prednisone and prednisolone need to be given twice daily. The dose 2 4 mgm 2. HC. The dosage of Dexamethasone is 0. Monitoring of these more potent glucocorticoids should include BP, in addition to weight, and other clinical and laboratory variables. Paediatric Dosage Handbook' title='Paediatric Dosage Handbook' />NOW AVAILABLE The 2017 SickKids Drug Handbook and Formulary includes extensive information on drug selection, dosage guidelines for neonates, infants, and older. More than 4,500 ebooks and many book collections, including archive collections of critical historical material, as well as publisher and topical collections. PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full. PDF printable version of 4. Hepatitis B of the 10th edition of the Handbook. This chapter has been amended on July 2016. Features Of Adobe Connect Pro User. Virology 4. 5. 2 Clinical features. Cotrimoxazole reference guide for safe and effective use from the American Society of HealthSystem Pharmacists AHFS DI. These steroids have minimal mineralocorticoid effect, compared with HC. In children with advanced bone age, such as boys with non salt losing CAH, initiation of therapy may precipitate central precocious puberty, requiring treatment with a Gn. RH agonist. Mineralocorticoid use. All classic CAH patients should be treated with fludrocortisone at diagnosis in the newborn period. Dosage requirements in early infancy range from 0. Sodium chloride supplements are often needed in infancy at 1 3gmd1. Eqd, distributed in several feedings. Please visit our Frequently Asked Questions page for answers to common questions related to medication dosing. General Guidelines to Calculate Med Doses. To calculate youryour childs doses according to the formulas set forth above, please see the web site, body surface area calculator for medications. Remember, however, that the above are just general guidelines and each patient may require variations. Ongoing monitoring of blood steroid levels is necessary. Never adjust medication doses on your own You must consult with your doctor This information is for your educational purposes only. Please also see section on Monitoring for CAH on this web site for more information. The CAH Consensus Statement, 2. We have attempted to keep all information on this web site in line with the recommendations in the Consensus Statement on 2. Hydroxylase Deficiency from the Lawson Wilkins Pediatric Endocrine Society and European Society for Paediatric Endocrinology, Journal of Clinical Endocrinology and Metabolism 8. September 2. 00. 2. We strongly recommend that all CAH affected individuals and all parents print out a copy of the Consensus Statement and refer to it often for guidance and answers to common questions. The full text of article. References. Consensus Statement on 2. Hydroxylase Deficiency from The Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology, JCEM 8. Congenital Adrenal Hyperplasia Due to Steroid 2. Hydroxylase Deficiency An Endocrine Society Clinical Practice Guideline, Speiser PW, Azziz R, Baskin LS, Ghizzoni L, Hensle TW, Merke DP, Meyer Bahlburg HFL, Miller WL, Montori VM, Oberfield SE, Ritzen M, White PC. JCEM 9. 5 4. 13. Congenital Adrenal Hyperplasia A Guide For Patients and Their Families, Migeon, C. Wisniewski, A. Gearhart, J. Saucier, C. Congenital Adrenal Hyperplasia, A Handbook for Parents, Gonzalez, J. Prentice, L. Ponder, S. Texas Department of Health. High Frequency of Nonclassical Steroid 2. Hydroxylase Deficiency, Am. J Hum Genet 3. 7 6. Speiser, P. New, M.