Adrenal insufficiency
- Replace glucocorticoid chronically
- hydrocortisone commonly preferred
- Primary disease also needs fludrocortisone
- Teach stress dosing + emergency injection
- Adrenal crisis → immediate IV hydrocortisone
- Give isotonic fluid ± dextrose
- Never delay crisis treatment for testing
Use at a glance
- Replace glucocorticoid chronically
- hydrocortisone commonly preferred
Practical pearls
- Primary disease also needs fludrocortisone
- Teach stress dosing + emergency injection
Safety / pitfalls
- Give isotonic fluid ± dextrose
- Never delay crisis treatment for testing
Other practical pearls
- Adrenal crisis → immediate IV hydrocortisone
Self-check
- What treats adrenal crisis immediately?
Immediate IV hydrocortisone. - Which replacement is also needed in primary adrenal insufficiency?
Fludrocortisone.
Drugs used for this (2)
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