Opciones De Tratamiento

Treatment Options
Presumptive |
Patient group | Línea de tratamiento | Tratamientoshow all |
adrenal crisis | 1st | glucocorticoid and supportive therapy * Corticosteroids should be given topatients with a suspected but unconfirmed diagnosis of adrenal insufficiency. * Saline should be administered to correct hypotension and dehydration. It is usually necessary to administer 1 Lrapidly and a further 2 to 4 L over the first 24 hours, to correct hypotension. Careful monitoring of BP, fluid status, and serum sodium and potassium levels should be maintained. * Glucose should beadministered when necessary to correct hypoglycaemia, but care should be taken to avoid worsening hyponatraemia. The use of normal saline supplemented with dextrose 5% is helpful in this regard. * Theunderlying cause that precipitated the crisis should be sought and treated, and once the patient is stable, normal dosing regimen can be resumed.Opciones primariasdexamethasone sodium phosphate : 4 mgintravenously once daily for 1-3 daysdexamethasone sodium phosphateChoose your formulary: * MartindaleEdit formulary settings × OR hydrocortisone sodium succinate : 50-100 mg intravenously every6-8 hours for 1-3 dayshydrocortisone sodium succinateChoose your formulary: * MartindaleEdit formulary settings × |
Ongoing |
Patient group | Línea de tratamiento | Tratamiento hide all |stable and/or after treatment of acute episode | 1st | glucocorticoid plus mineralocorticoid * Oral glucocorticoid and mineralocorticoid replacement therapy is given in physiological doses for life. *Generally, short-acting glucocorticoids such as hydrocortisone are preferred by most physicians. * Mineralocorticoid dose is impacted by mineralocorticoid potency of the glucocorticoidadministered. * Excessive mineralocorticoid replacement causes HTN, hypokalaemia, and oedema. * There may be a physiological increase in glucocorticoid and mineralocorticoid requirement during pregnancy....