Adrenal insufficiency secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There are no established measures for the secondary prevention of adrenal insufficiency.

Secondary Prevention

There are no established measures for the secondary prevention of adrenal insufficiency. However, adrenal crisis is a major cause of death in patients with adrenal insufficiency. Measures to prevent the development of adrenal crisis in patients with adrenal insufficiency include: [1]

  • Educate the patient and family to increase the dose of hydrocortisone during psychological stress, physical exercise, illness, undergoing a procedure.
  • Educate the patient to adjust the dose of hydrocortisone during shift to time of wakefulness.
  • Educate the patient to increase fludrocortisone dose (by 0.1-0.2 mg) or salt intake in hot climate.
  • Educate the patient to always carry hydrocortisone emergency kit and self administration.
  • Advice to carry 'steroid emergency card'/ medical emergency bracelets for early identification and treatment of adrenal crisis.

References

  1. Dineen, Rosemary; Thompson, Christopher J; Sherlock, Mark (2019). "Adrenal crisis: prevention and management in adult patients". Therapeutic Advances in Endocrinology and Metabolism. 10: 204201881984821. doi:10.1177/2042018819848218. ISSN 2042-0188.

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