Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spironolactone (Aldactone) appears to have potential as a treatment for androgen-excess syndromes, including hirsutism. In both men and women, spironolactone decreases the rate of testosterone production and increases its metabolic clearance. The 1st indication that this agent has an effect on hirsutism was serendipitous--an incidental finding in a patient who was being treated for hypertension. Subsequent studies have largely confirmed that women who are administered spironolactone exhibit no further progression in hair darkening and coarsening, a slowed growth rate of existing hair, and decreased hair shaft diameter. When combined with dexamethasone or an oral contraceptive, spironolactone seems to increase the intervals between hair growth treatments. It has been suggested, but not documented, that spironolactone could correct hyperandrogenic ovulation. This use should be avoided, however, due to potential anti-androgenic effects on the fetus. Minor side effects of treatment with spironolactone include time-limited lethargy, stomach upset, and menstrual irregularity. There is concern, however, that this agent may stimulate the breast and contribute to the development of breast cancer. Thus, it should not be used by patients with a family history of breast malignancies. In addition, the drug should not be used in pregnancy and users of reproductive age should be supplied with an effective contraceptive method. The present dosage recommendation is 100-200 mg of spironolactone/day in 2 divided doses combined with either 35 mcg ethinyl estradiol and 0.5 mg of norethindrone or with 50 mg of ethinyl estradiol and 1 mg of ethynodiol diacetate.
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PMID:Use of spironolactone in treatment of hirsutism. 235 84

A 15 year old female began to suffer from a headache 12 hours prior to admission to a hospital in Broken Hill, N.S.W., Australia. Several hours after the onset of the headache, she had a generalized tonic-clonic seizure. Upon arrival at the hospital, she was lethargic, but did respond to commands. Her speech was slurred and the right side of her body was paralyzed. She had no fever and blood pressure was normal. Despite attempts to treat her with intravenous dexamethasone, she slipped into an unconscious state. A CT scan uncovered a left parietal hypodense lesion. Her pupils quickly dilated the next day. The right pupil did respond slightly to light, however. Physicians made a burr hole in the parietal area of her skull which exposed underlying necrotic tissue. After the operation, her brain stem failed to function. She died the following day, 3 days after the symptoms began. Other than a febrile convulsion at 10 months, she had been in good health. She had been taking a combined oral contraceptive (COC) made of 125mcg levonorgestrel and 50mcg ethinyl estradiol for 2 weeks. Pathologists found an area of necrosis in the left temporo-parietal region of the brain and an occlusive thrombosis near the left middle cerebral artery. Further, a pronounced segmental necrotizing vasculitis of the left middle cerebral and right posterior cerebral arteries existed. Based on other documented cases and this case, the physicians point to evidence that vessel size in vasculitis has an effect on the severity of the disease. Vasculitis in small vessels has a tendency to cause a gradual progression of the disease, while this disease in medium and large vessels may cause a rapid progression of the disease, as in this case. The researchers suspect that the COC may have precipitated the disease.
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PMID:Isolated angiitis of the brain in a young female on the contraceptive pill. 345 Dec 35