title: Supplementation with hydrocortisone on the 3rd-5th day following dexamethasone premedicated chemotherapy eliminated severe dizziness and postural hypotension.
abstract: We present the case of a 60 year-old woman with a stage III fallopian tube cancer submitted to hysterectomy and bilateral  salpingo-oophorectomy with partial omenectomy, followed by six courses of chemotherapy and revision surgery. After each  course of chemotherapy (paclitaxel + carboplatin) preceded by premedication with dexamethasone, she suffered from side-  -effects, of which the most unpleasant was severe dizziness appearing on the third, fourth and fifth day following the listed  combination of drugs. It was revealed that dizziness with concomitant sweating and rapid pulse, noted in the standing position,  was combined with marked postural hypotension. Considering the possibility of a temporary pituitary-adrenal axis suppression  caused by premedication with a very large dose of dexamethasone, during those three days she was supplemented with small  doses of hydrocortisone, which caused almost complete disappearance of the mentioned symptoms. Our conclusion is that  postural hypotension causing severe dizziness initially linked with chemotherapeutic drugs can be eliminated or markedly  reduced by three days supplementation with hydrocortisone applied after the expected wash out of the dexamethasone.
authors.affiliation: Department of Endocrinology, Centre for Postgraduate Medical Education, Warsaw, Poland. jeske.wojciech@gmail.com
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jeske
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Gawrychowski
authors.forename: Wacław
authors.initials: W
authors.lastname: Smiertka
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects*; D004244:Dizziness / Q000139:chemically induced* / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005185:Fallopian Tube Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D007024:Hypotension, Orthostatic / Q000139:chemically induced* / Q000188:drug therapy; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D011292:Premedication; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D003907:Dexamethasone; D016190:Carboplatin; D017239:Paclitaxel; D006854:Hydrocortisone