Increase dose with stress and illness Carry with you at all times Daily

Increase dose with stress and illness carry with you

This preview shows page 25 - 30 out of 30 pages.

Increase dose with stress and illness Carry with you at all times Daily mineralocorticoid replacement Fludrocortisone (Florinef) Salt added to diet WHY? This is the natural progression of cortisol levels in the body WHY? Because they don’t have the capability of the HPA axis to identify stress and push out additional cortisol, risk for adrenal crisis WHY? Same as diabetic patients, because if they experience stress or emergency they will need a shot of the cortisone otherwise they will experience adrenal crisis
Image of page 25
Acute Adrenal Insufficiency – ADRENAL CRISIS Etiology: Possible Causes Abrupt withdrawal of corticosteroids in persons who have a suppressed hypothalamic-pituitary axis due to chronic exogenous steroid use. Inadequate intake of corticosteroids in persons with Addison's disease. Hypopituitarism due to hypothalamic-pituitary disease. ??? Do patients with Addison’s disease require dose adjustments during periods of stress?
Image of page 26
Acute Adrenal Insufficiency – ADRENAL CRISIS ??? Do patients with Addison’s disease require dose adjustments during periods of stress? YES! YES! Adrenal crisis can be triggered by: STRESS Injury, infection, surgery, emotional stress SUDDEN WITHDRAWAL OF CORTICOSTEROID THERAPY ADRENAL SURGERY PITUITARY INJURY/DESTRUCTION
Image of page 27
Acute Adrenal Insufficiency – ADRENAL CRISIS Symptoms (often develop rapidly) Profound fatigue Salt craving (hyponatremia) Abdominal pain, nausea, vomiting and diarrhea Confusion Shock (↓BP and ↑HR) that is unresponsive to fluid resuscitation Hypotension and tachycardia Treatment Administer corticosteroids ASAP (e.g., I.V. dexamethasone) Aggressive isotonic fluid and electrolyte resuscitation Monitor for hypoglycemia, hyponatremia and hyperkalemia
Image of page 28
Terms to know (On exam)…. Cushing’s Excess Adrenal Addison’s Adrenal insufficiency Hashimoto’s Hypothyroid, autoimmune Graves’ Hyperthyroid Diabetes Insipidus Polyuria/Excess ADH/ Pituatary (1)What endocrine gland is it related to? (2)What hormone(s) involved? (3)Is the hormone in excess or deficit?
Image of page 29
Terms to know…. Cushing’s Addison’s Hashimoto’s Graves’ Diabetes Insipidus (1)What endocrine gland is it related to? (2)What hormone(s) involved? (3)Is the hormone in excess or deficit?
Image of page 30

You've reached the end of your free preview.

Want to read all 30 pages?

  • Fall '20
  • Cortisol, Adrenal insufficiency

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture