Addisonian Crisis

Question 1

definition of Addison’s disease

Answer 1

disease of adrenal cortex that causes hyposecretion of all 3 adrenocortical hormones

Question 2

“sugar” hormone

Answer 2

cortisol

Question 3

“salt” hormone

Answer 3

aldosterone

Question 4

“sex” hormones

Answer 4

androgens

Question 5

where do the most severe effects of Addison’s disease come from?

Answer 5

from lack of cortisol

Question 6

patho of Addison’s disease

Answer 6

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

Question 7

symptoms of Addison’s disease

Answer 7

–hypoaldosteronism
–hypotension (decreased vascular tone, CO, circ. BV)
–salt craving (decreased NA levels, increased K levels, dehydration)
–hypocortisolism
–hypoglycemia
–weakness and fatigue
–unsuppressed ACTH production
–hyperpigmentation

Question 8

pharm for Addison’s disease

Answer 8

–lifelong corticosteroid replacement therapy
–all patients require glucocorticoid (hydrocortisone, prednisone, dexamethasone)
–some require mineralcorticoid (fludrocortisone)

Question 9

important issues in Addison’s pharm

Answer 9

–dosing mimics natural release of hormones
–never abruptly stop therapy
–dose will need to be increased during stress (3X3 rule)
–always maintain emergency supply
–wear a Medic Alert bracelet

Question 10

cause of Addisonian Crisis

Answer 10

–sudden insufficiency of serum corticosteroids
–sudden loss of adrenal gland
–sudden increase in stress in chronic condition
–sudden cessation of long-term corticosteroid drug therapy
most common with primary adrenal insufficiency

Question 11

symptoms of Addisonian crisis

Answer 11

–sudden penetrating pain in lower back, abdomen, or legs (hyponatremia)
–severe vomiting and diarrhea
–dehydration
–low BP
– + LOC, confusion, slurred speech
–hyperkalemia

Question 12

treating Addisonian crisis

Answer 12

–IV hydrocortisone
–IV saline
–IV dextrose
–switch to PO when patient is able