Hypoadrenalism

Hypoadrenalism is a topic covered in the Pocket ICU Management.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:

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First Things First (assess & treat for the following)

  • Is pt in adrenal crisis or shock?
    • Start stress-dose steroid replacement immediately.
      • Hydrocortisone: first-line agent
      • Dexamethasone: does not interfere w/ future cortisol assays
    • If possible, draw random cortisol level before treatment.
      • Consider drawing ACTH level as well.
      • Short corticotrophin test can be postponed.
    • Ensure adequate fluid resuscitation.
    • Inotropic agents can be initiated but will be less effective in the absence of glucocorticoids.
  • Does pt have electrolyte abnormalities that require immediate attention?
    • Potassium >6.0 mEq/L
    • Sodium < 120 mEq/L
    • Glucose < 60 mg/dL

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First Things First (assess & treat for the following)

  • Is pt in adrenal crisis or shock?
    • Start stress-dose steroid replacement immediately.
      • Hydrocortisone: first-line agent
      • Dexamethasone: does not interfere w/ future cortisol assays
    • If possible, draw random cortisol level before treatment.
      • Consider drawing ACTH level as well.
      • Short corticotrophin test can be postponed.
    • Ensure adequate fluid resuscitation.
    • Inotropic agents can be initiated but will be less effective in the absence of glucocorticoids.
  • Does pt have electrolyte abnormalities that require immediate attention?
    • Potassium >6.0 mEq/L
    • Sodium < 120 mEq/L
    • Glucose < 60 mg/dL

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Last updated: May 4, 2010