GH Deficiency in Adults Patient Care and Monitoring

1. Assess patient's clinical signs and symptoms to determine severity of GH deficiency.

2. Perform a provocative test to measure GH and IGF-I levels.

3. Evaluate the patient for the presence of metabolic abnormalities and cardiovascular and fracture risks.

4. Initiate GH replacement therapy based on patient preference. Make sure that the patient does not have any contraindications to GH therapy.

5. Develop a plan to assess the efficacy and adverse effects of GH therapy, and consider if the patient's therapy requires any dose adjustments based on IGF-I level, patient response, and adverse effects.

6. Provide patient education in regard to disease state and drug therapy. Discuss with the patient:

• Possible complications of GH deficiency

• How to reduce the modifiable cardiovascular and metabolic risk factors

• Potential disadvantages and effectiveness of existing GH replacement therapy

• Importance of adherence to therapy

• Potential for adverse effects or need for lifelong replacement

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