406 E3 - addisonian crisis

Question 1

Addison’s disease patho

Answer 1

adrenal gland is destroyed -> symptoms when 90% non functional -> ACTH and MSH are secreted in large amounts

Question 2

addison’s disease CM

Answer 2

-hypotension, dec vascular tone, CO & circulating BV
-salt craving
-inc K+
-dehy
-hypoglycemia
-weakness&fatigue
-hyperpigmentation

Question 3

addison’s disease pharm

Answer 3

life long corticosteroid replacement therapy
-glucocorticoids: hydrocortisone (drug of choice), prednisone, dexamethasone
-some may need mineralocorticoid: fludrocortisone

Question 4

important pharm teaching points

Answer 4

-timing is important to mimic natural hormone release
-never stop abruptly
-inc doses during stress (3x3)
-always maintain emergency supply

Question 5

Addisonian crisis

Answer 5

not enough cortisol in the body resulting from sudden loss of adrenal gland, sudden increase in stress, sudden cessation of long term steroid use or primary adrenal insufficiency

Question 6

Addisonian crisis CM

Answer 6

-pain in lower back, abdomen or legs
-severe V/D
-dehydration
-low BP
-decreased CNS
-hyperkalemia & hyponatremia

Question 7

Addisonian crisis treatment

Answer 7

-IV hydrocortisone then switch to PO when stable
-saline
-dextrose