[Deviation in cortisol metabolism induced by rifampicin. Therapeutic consequences in adrenal failure (author's transl)].
Deviation of cortisol metabolism in favour of its 6 beta-hydroxylated derivative was demonstrated in two patients with adrenal failure receiving substitution corticosteroid therapy and rifampicin. The existence of a frank increase in the metabolic clearance antipyrin was in favour of an hepatic enzyme induction. After rifampicin treatment was stopped, the 24 hour urinary excretion of 6 beta-OH-F returned to normal, demonstrating the responsability of the drug. This enzyme induction results in a need to increase the dose of hydrocortisone substitution therapy in patients with Addison's disease treated with rifampicin.
D000224:Addison Disease / Q000188:drug therapy; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000309:Adrenal Insufficiency / Q000188:drug therapy* / Q000378:metabolism; D000328:Adult; D000368:Aged; D000983:Antipyrine / Q000378:metabolism; D004790:Enzyme Induction / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000378:metabolism*; D006889:Hydroxycorticosteroids / Q000652:urine; D008099:Liver / Q000378:metabolism; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects; D012293:Rifampin / Q000494:pharmacology* / Q000627:therapeutic use; D013250:Steroid Hydroxylases / Q000096:biosynthesis; D014376:Tuberculosis / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D006889:Hydroxycorticosteroids; D013250:Steroid Hydroxylases; D000983:Antipyrine; D012293:Rifampin; D006854:Hydrocortisone
Déviation du métabolisme du cortisol induite par la rifampicine. Conséquences thérapeutiques au cours de l'insuffisance surrénalienne.