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Low-dose and high-dose variations of the test exist. [4] The test is given at low (usually 1–2 mg) and high (8 mg) doses of dexamethasone, and the levels of cortisol are measured to obtain the results. [5] A low dose of dexamethasone suppresses cortisol in individuals with no pathology in endogenous cortisol production.
In the high-dose 48-h DST, 2 mg of dexamethasone is given every 6 hours for 48 hours or a single dose of 8 mg is given. [8] This test is not needed if the 48-h low-dose DST has shown suppression of cortisol by over 30%. [8] These tests are based on the glucocorticoid sensitivity of pituitary adenomas compared to non-pituitary tumors. [8]
In the low-dose short test, 1 μg of an ACTH drug is injected into the patient. In the conventional-dose short test, 250 μg of drug are injected. Both of these short tests last for about an hour and provide the same information. Studies have shown the cortisol response of the adrenals is the same for the low-dose and conventional-dose tests ...
Dexamethasone is a fluorinated glucocorticoid medication [10] used to treat rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive pulmonary disease (COPD), croup, brain swelling, eye pain following eye surgery, superior vena cava syndrome (a complication of some forms of cancer), [11] and along with antibiotics in tuberculosis. [10]
Evocative/suppression testing refers to a class of tests performed where one substance is measured both before and after the administration of another substance to determine if the levels are stimulated ("evocative") or suppressed.
The fixed-dose procedure (FDP), proposed in 1992 by the British Toxicology Society, is a method to assess a substance's acute oral toxicity. [ 1 ] [ 2 ] In comparison to the older LD 50 test developed in 1927, this procedure produces similar results while using fewer animals and causing less pain and suffering. [ 3 ]
Normal dogs generally have post stimulation cortisol levels > 10 ug/dl. Post stimulation levels < 2 ug/dl is considered diagnostic and most Addison's patients are < 1 ug/dl. The ACTH stimulation test does not distinguish between primary and secondary hypoadrenocorticism, or adrenocortical destruction caused by mitotane overdose.
Threshold dose is the minimum dose of drug that triggers minimal detectable biological effect in an animal. [1] At extremely low doses, biological responses are absent for some of the drugs. The increase in dose above threshold dose induces an increase in the percentage of biological responses. [ 2 ]
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