Secondary adrenal insufficiency secondary prevention: Difference between revisions
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==Secondary Prevention== | ==Secondary Prevention== | ||
Effective measures for the secondary prevention of [disease name] include: | |||
* Patient and family members involved in patient care should be properly educated about risks of hormone replacement therapy.<ref name="pmid24766944">{{cite journal |vauthors=Tucci V, Sokari T |title=The clinical manifestations, diagnosis, and treatment of adrenal emergencies |journal=Emerg. Med. Clin. North Am. |volume=32 |issue=2 |pages=465–84 |year=2014 |pmid=24766944 |doi=10.1016/j.emc.2014.01.006 |url=}}</ref><ref name="pmid24755997">{{cite journal |vauthors=Napier C, Pearce SH |title=Current and emerging therapies for Addison's disease |journal=Curr Opin Endocrinol Diabetes Obes |volume=21 |issue=3 |pages=147–53 |year=2014 |pmid=24755997 |doi=10.1097/MED.0000000000000067 |url=}}</ref> | |||
* Patient should also be educated about dose adjustments during acute illnesses.<ref name="pmid23177474">{{cite journal |vauthors=Napier C, Pearce SH |title=Autoimmune Addison's disease |journal=Presse Med |volume=41 |issue=12 P 2 |pages=e626–35 |year=2012 |pmid=23177474 |doi=10.1016/j.lpm.2012.09.010 |url=}}</ref><ref name="pmid22907517">{{cite journal |vauthors=Quinkler M |title=[Addison's disease] |language=German |journal=Med Klin Intensivmed Notfmed |volume=107 |issue=6 |pages=454–9 |year=2012 |pmid=22907517 |doi=10.1007/s00063-012-0112-3 |url=}}</ref> | |||
* | * Asymptomatic patients can also wear an identification bracelet stating the name of the disease to ensure proper emergency treatment during an adrenal crisis.<ref name="pmid16259572">{{cite journal| author=Hahner S, Allolio B| title=Management of adrenal insufficiency in different clinical settings. | journal=Expert Opin Pharmacother | year= 2005 | volume= 6 | issue= 14 | pages= 2407-17 | pmid=16259572 | doi=10.1517/14656566.6.14.2407 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16259572 }} </ref> | ||
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==Secondary Prevention== | ==Secondary Prevention== | ||
Revision as of 18:12, 10 October 2017
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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 [disease name].
OR
Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
Secondary Prevention
Effective measures for the secondary prevention of [disease name] include:
- Patient and family members involved in patient care should be properly educated about risks of hormone replacement therapy.[1][2]
- Patient should also be educated about dose adjustments during acute illnesses.[3][4]
- Asymptomatic patients can also wear an identification bracelet stating the name of the disease to ensure proper emergency treatment during an adrenal crisis.[5]
Secondary Prevention
Acute adrenal insufficiency is fatal. When patients with adrenal insufficiency experience the following stress, they must be very careful.
- Surgery: People who are not currently taking glucocorticoids but who have taken long-term glucocorticoids in the past year, and people with chronic adrenal insufficiency should tell their doctor before surgery. These patients must be treated with intravenous glucocorticoids and saline before surgery and continues until the patient is fully awake after surgery and able to take medication by mouth.
- Illness: Patients with adrenal insufficiency should know the essentiality of increasing medication during such periods of stress. During illness, oral dosing of glucocorticoid needs to be adjusted to mimic the normal response of the adrenal glands on the body. When significant fever or injury happen, the patients may require triple oral dosing. Once recovery from the stress event, doses can be returned to maintenance levels. Be careful, when the conditions of severe infections, vomiting, or diarrhea occur, these signs suggest the possibility of addisonian crisis.
- Pregnancy: If nausea and vomiting in early pregnant woman with adrenal insufficiency interfere with taking medication by mouth, injections of the hormone may be necessary. During delivery, treatment is similar to that of people needing surgery.
References
- ↑ Tucci V, Sokari T (2014). "The clinical manifestations, diagnosis, and treatment of adrenal emergencies". Emerg. Med. Clin. North Am. 32 (2): 465–84. doi:10.1016/j.emc.2014.01.006. PMID 24766944.
- ↑ Napier C, Pearce SH (2014). "Current and emerging therapies for Addison's disease". Curr Opin Endocrinol Diabetes Obes. 21 (3): 147–53. doi:10.1097/MED.0000000000000067. PMID 24755997.
- ↑ Napier C, Pearce SH (2012). "Autoimmune Addison's disease". Presse Med. 41 (12 P 2): e626–35. doi:10.1016/j.lpm.2012.09.010. PMID 23177474.
- ↑ Quinkler M (2012). "[Addison's disease]". Med Klin Intensivmed Notfmed (in German). 107 (6): 454–9. doi:10.1007/s00063-012-0112-3. PMID 22907517.
- ↑ Hahner S, Allolio B (2005). "Management of adrenal insufficiency in different clinical settings". Expert Opin Pharmacother. 6 (14): 2407–17. doi:10.1517/14656566.6.14.2407. PMID 16259572.