1. How to deal with bleeding at the injection site after the patient has been injected with growth hormone?
Answer: a. When there is only extracutaneous bleeding at the eye of the needle after the syringe is pulled out, it means that the small capillaries of the skin were pierced during the injection. The next day, apply a warm towel for 5-10 min (no hot compress is needed in summer), and the bleeding will disappear in 3-5 consecutive days. The needle should be pulled out quickly because it is easy to bleed too slowly after injection.
2. How to deal with patients who have bulging packs when injecting growth hormone into the skin?
Answer: a. When the patient injects growth hormone, the angle of the needle is too small and the drug is injected into the skin.
3.Mistake the check date of the product manual for the production date?
Answer: The check date of the product manual is not the production date of growth hormone, but the production date of growth hormone is on the outer package.
4.Will the water injection cause pain or numbness after injection due to low temperature (common in autumn/winter)?
Answer: a. Take it out of the refrigerator 30 minutes before injection and warm it up with your hands; b. Pain may be caused by fast injection speed, so you should inject slowly; c. If the sharp pain is caused by the injection stimulating the peripheral nerves of the skin, you can pull out the needle and change the injection site at this time; d. Relax the child’s spirit before injection to avoid injection pain.
5.After a period of injection, does joint pain or myalgia appear?
Answer: a. It may occur after strenuous exercise or sudden increase in the amount of exercise, so the amount of exercise should be reduced and moderate exercise can be done. b. It may be caused by the strong physiological effect of sodium storage of growth hormone, the lighter pains do not need to be dealt with, and the symptoms will disappear after a few days.
6.What is hypothyroidism? How to deal with hypothyroidism during growth hormone treatment?
Answer: The diagnosis of subclinical hypothyroidism is made based on laboratory tests, when the patient has not yet shown obvious clinical symptoms or signs. Subclinical hypothyroidism is defined as serum TSH levels exceeding the upper limit of normal (0.45-4.5 mlU/L) while serum free T4 (FT4) concentrations are normal. The need for treatment depends on the specific laboratory values of the child. Treatment is mostly oral levothyroxine sodium, and thyroid function will return to normal after discontinuation of growth hormone.
7. Is there an increase in blood sugar during growth hormone treatment?
Answer: Generally, there is a transient increase in blood glucose, and it will return to normal soon; if the blood glucose is persistently high, it should be reviewed in hospital, and if the blood glucose is higher than 10 mmol/l, insulin treatment is needed.
8.Does edema appear during growth hormone treatment?
Answer: a. Symptoms of edema: edema of eyelids, face, back of hands, back of feet, lower limbs, intracranial hypertension (such as headache, nausea, vomiting); b. If tolerated, continue to use growth hormone, generally the symptoms disappear within 3-7 days; if not tolerated, need to reduce the dose of growth hormone or discontinue the drug, resume the drug after the symptoms disappear.
9.Does growth hormone treatment accelerate bone age?
Answer: Domestic and foreign medical institutions and literature report that growth hormone therapy does not accelerate bone age.
10. Will growth hormone treatment affect the fertility of children?
Answer: Growth hormone is secreted by the normal human body and is necessary for human growth and development; for women in their reproductive years, growth hormone has the effect of promoting ovulation; for men in their reproductive years, growth hormone has the effect of promoting sperm maturation; therefore, growth hormone treatment will not affect fertility.
11. Will growth hormone make children fat?
Answer: Growth hormone is a protein, not a glucocorticoid, and will not cause obesity; moreover, it has the effect of local fat reduction.
12.Why should each injection site be two centimeters apart from the previous injection site when injecting growth hormone?
Answer: Growth hormone treatment can locally degrade subcutaneous fat, especially the fat in the abdomen and large intestinal omentum is sensitive to catecholamine-mediated lipolysis (e.g. GHD has increased subcutaneous fat, especially abdominal fat accumulation, and growth hormone treatment can make abdominal fat ablate). Growth hormone increases muscle tissue at the same time as fat reduction. Because growth hormone can degrade subcutaneous fat, the injection site should be changed frequently.
13. Can growth hormone treatment cause diabetes?
Answer: At present, the relevant literature at home and abroad reports that growth hormone therapy does not cause diabetes.
14.Does growth hormone therapy increase the risk of tumor recurrence?
Answer: a. For those whose tumors have been cured, current data do not indicate that growth hormone therapy increases the risk of tumor recurrence; b. For those who are suffering from tumors and are receiving treatment, the incidence of original tumors and secondary tumors increases significantly; c. Risk of new tumors: It does not increase the incidence of new tumors such as leukemia.
15.What is the weight gain of the child after growth hormone treatment?
Answer: a. Whether there is occult edema (with occult edema weight gain >500g/w); b. Because growth hormone promotes anabolism, height growth will be accompanied by weight gain.
16.Can growth hormone be used for vaccination during treatment? Can it be used in the treatment of general medical diseases?
Answer: Because growth hormone is secreted by the normal human body itself, growth hormone can be used for vaccination during treatment; growth hormone can also be used during the treatment of general medical diseases.
17.Do I need to stop taking growth hormone when treating a cold?
Answer: The general cold treatment drugs do not affect the efficacy of growth hormone.
18. Is growth hormone used for children with asthma or allergic rhinitis?
Answer: The dosage of glucocorticoids should be adjusted under the guidance of a professional pediatric endocrinologist. (Note: Glucocorticoids are growth hormone antagonist drugs, which will affect the efficacy of growth hormone.)
19.Will the efficacy of growth hormone be affected if the child forgets to inject it on a certain day? Do I have to make up for the missed injection?
Answer: Forgetting to inject growth hormone once in a while for one day will not affect the efficacy of the treatment, and there is no need to make up the missed injection; try to avoid interruption of the medication.
20.How long does it take for growth hormone to take effect?
Answer: Growth hormone is used for 3 months as a course of treatment, so GH treatment should be reviewed at the hospital for 3 months to evaluate its efficacy in terms of height, weight, nail function and blood sugar.
21. What are the reasons for the poor efficacy of growth hormone therapy?
Answer: a. Whether the dose of growth hormone is sufficient; b. Antibodies produced by growth hormone powder; c. Low metabolic function; d. Use of glucocorticoids; e. Epiphyseal plate closure; f. Inaccurate measurement; g. Systemic chronic diseases; h. Ineffective growth hormone treatment; i. Whether the children with residential school adhere to growth hormone.
22.How old can growth hormone treatment be discontinued at the age of bone?
Answer: When a girl is 14 years old and a boy is 15-16 years old, the growth rate is generally less than 2cm/y, and growth hormone can be discontinued to reduce the economic burden on parents.
23.What is the age of bone that growth hormone cannot be used?
Answer: At the first visit, when a girl is 14 years old and a boy is 15 years old, the growth rate is less than 2cm/y; at this time, the growth space of the child is very limited and growth hormone therapy is generally not recommended.
24.Will growth hormone inhibit its own secretion?
Answer: For children who cannot secrete or have insufficient secretion of growth hormone, exogenous supplementation is required; secondly, since the supplementation amount is 0.1-0.15IU/kg/d, which is the smallest effective dose, it will not form a negative feedback effect and inhibit the secretion of its own growth hormone; 0.15-0.2IU/kg/d will not inhibit the secretion of its own GH.
25.When to stop the combination of GnRHa and GH in children with CPP?
Answer: If BA ≥ 12.5 years old for girls and 13.5 years old for boys, GnRHa should be stopped and only GH should be used.
26.What is the situation that GnRHa is not suitable for children with CPP?
Answer: a. Girls with bone age ≥ 12.5 years, boys with BA ≥ 13.5 years; b. Girls after menarche or boys 1 year after ejaculation; the above cases use growth hormone alone.
27, the injection site of the child appeared red, swollen, painful, feverish, scratchy, the area has peanuts to eggs between the size of the?
Answer: a. rhGH is produced by secretory gene expression technology of E. coli, and the purity of growth hormone is very high, so there is usually no allergic reaction. b. The above cases are mostly caused by allergy to sterilization methods such as alcohol or iodophor.
28. Why did the child have a low fever when injecting growth hormone?
Answer: a. Foreign literature reports that growth hormone treatment can make a very small number of children susceptible to upper respiratory tract infection and otitis media and develop low fever, but the symptoms are generally mild and will disappear with prolonged medication.
29. Why do children with growth hormone injections show symptoms of nail resistance?
Answer: a. Foreign literature reports that a very small number of children treated with growth hormone show symptoms of hyperthyroidism, because these children themselves have Choban’s thyroiditis, an autoimmune disease. One of the physiological effects of growth hormone is to enhance immunity (humoral and cellular immunity), which is related to the appearance of hyperthyroidism, but not to Choban’s thyroiditis caused by growth hormone. b. The treatment plan for such children should be carried out under the guidance of an endocrinologist.
30. Can children with hepatitis B and C who are short be treated with growth hormone?
Answer: a. Hepatitis B and C are at high risk of liver cancer, and IGF-I has the effect of promoting cell mitosis and inhibiting apoptosis, so growth hormone therapy is generally not recommended. b. Hepatitis B and C in the active stage must not be treated with growth hormone. c. Hepatitis B and C in the stable stage with normal AST and ALT can be treated with growth hormone.
Conclusion: More than ninety-five percent of growth hormone on the market is produced using the fifth generation of growth hormone technology, and its molecular weight and spatial structure are exactly the same as the growth hormone secreted by itself, plus the high-tech production level determines the high purity of growth hormone.