Addisonian crisis Flashcards
1
Q
What is it?
A
Fatal - associated with an acute deficiency in cortisol +/- aldosterone
2
Q
What can it be precipitated by?
A
Abrupt steroid withdrawal
Surgery/ sepsis - exacerbation of chronic insufficiency e.g. Addison’s/ hypopit.
MI
Pregnancy
Acute hypoglycaemia in pt with DM
3
Q
How does it present?
A
Malaise Fatigue N/V Abdo. pain Low-grade fever Muscle pain/ cramps Dehydration HYPOTN HYPOVOLAEMIC SHOCK
4
Q
How is it mx?
A
IV/IM 100mg HYDROCORTISONE!!!
1 L 0.9% saline infused over 30-60mins
+/- dextrose (if hypoglycaemic)
Continue hydrocortisone 6hrly until pt stable
Start oral replacement after 24h and reduced to maintenance dose over 3-4 days
