Addisons Disease Flashcards
(12 cards)
What is Addisons disease?
Primary adrenal insufficiency
- caused by destruction of adrenal cortex
- results in less glucocorticoids and androgens
What can cause secondary adrenal insufficiency?
Adrenal glands are not producing enough steroids
- e.g. from abruptly withdrawing steroids after long course
Symptoms of Addisons disease
Fatigue
Hyperpigmentation
GI disturbances- weight loss, nausea, salt craving
Musculoskeletal- muscle weakness, muscles cramps and joint pain
CV symptoms- postural dizziness and hypotension
Treatment of Addisons disease
Replace both glucocorticoid and mineralocorticoids
- Gluco: Hydrocortisone or prednisolone
- Mineral: fludracortisone
Treatment if adrenal crisis
MEDICAL EMERGENCY
IV hydrocortisone + IV saline
What can excessive ADH secretion cause?
Body stores more water -> This dilutes salt in the body -> HYPONATRAEMIA
What is the treatment for Hyponatraemia (in treatment of excessive ADH secretion)?
- Fluid restriction
- Demeclocycline (tetracycline)
- Tolvaptan
what is the main caution of treatment with tolvaptan?
- If you treat the hyponatreamia too quickly…
Rapid correction of Hyponatraemia can lead to osmotic demyelination
- this can cause serious neurological events
What is diabetes insipidus?
Reduced ADH (vasopressin) production
- kidneys do not retain as must water
- more water is passed as dilute urine
- this causes extreme THIRST and POLYURIA
What is cranial (pituitary) ADH deficiency?
What is the treatment of cranial diabetes insipidus
Lack of vasopressin
- pituitary does not make enough
TX: Desmopressin
What is nephrogenic (partial) ADH resistance?
What is the treatment of nephrogenic diabetes insipidus?
Kidneys fail to respond to ADH
TX: Thiazide diuretics
- this has a paradoxical effect
What is the main side effect of desmopressin?
Hyponatraemia and fluid retention
- so interacts with other drugs causing Hyponatraemia (SSRIs carbamazepine and diuretics)
