Addisonian crisis

Question 1

causes of Addison disease

Answer 1

idiopathic, autoimmune

Question 2

the most severe effects of addisons is caused by

Answer 2

lack of cortisol

Question 3

pathogenesis of addison disease

Answer 3

adrenal gland destroyed
symptoms start when 90% destroyed
ACTH and MSH are secreted in large amounts

Question 4

clinical manifestations of addison disease

Answer 4

hypoaldosteronism (water and salt retention)
EVERYTHING LOW
decreased vascular tone, decreased cardiac output, decreased circulating blood volume
Salt cravings
low serum sodium
high serum potassium
dehydration
Hypocortisolism (Lack of stress hormone- NO ENERGY)
hypoglycemia
weakness, fatigued
Hyperpigmentation

Question 5

pharmacotherapy for Addison disease

Answer 5

adrenal insufficency requires lifelong replacement
all require a glucocorticoid
some require mineralcorticoid

Question 6

glucocorticoid meds

Answer 6

hydrocortisone (cortef) drug of choice
prednisone
dexamethasone

Question 7

mineralcorticoid

Answer 7

fludrocortisone (florinef)

Question 8

what should the dosing of meds minic?

Answer 8

natural release of hormones

NEVER stop abruptly, and increase dose during stress

Question 9

causes of addisonian crisis

Answer 9

sudden insufficiency of serum corticosteroids
caused by:
sudden loss of adrenal function
sudden increase in stress
sudden stop of corticosteroids
most common primary adrenal insufficiency

Question 10

complications of addisonian crisis

Answer 10

sudden penetrating pain in low back, abdomen, or legs
hyponatremia
severe n/v
dehydration
low BP
loss of consciousness, confusion, slurred speech
HYPERkalemia and hyponatremia

Question 11

How to tx addisonian crisis

Answer 11

IV hydrocortisone (initial IV bolus 100mg, then 50mh every 6 hours)
saline
dextrose
when able switch to PO meds and fluids
taper dose until maintenance achived.