Exam 3 - Addisonian Crisis Flashcards
(9 cards)
1
Q
what is Addison’s disease
A
- disease of the adrenal cortex that causes hypo secretion of all 3 adrenocortical hormones
- most severe effects come from the lack of cortisol
2
Q
Addison’s disease pathogenesis
A
- adrenal gland destroyed
- symptoms when 90% non-functional
- ACTH and MSH are secreted in large amounts
3
Q
Addison’s disease clinical manifestations
A
- hypoaldosteronism
- hypotension: decreased vascular tone, decreased CO, decreased circulating blood volume
- salt craving: decreased sodium levels, increased potassium levels, dehydration
- hypocortisolism (no energy)
- hypoglycemia
- weakness and fatigue
- unsuppressed ACTH production
- hyperpigmentation
4
Q
Addison disease pharmacotherapy
A
- requires lifelong corticosteroid replacement therapy
- all require glucocorticoid: hydrocortisone, prednisone, dexamethasone
- some require mineralocorticoid: fludocortisone
5
Q
important issues of pharmacotherapy
A
- dosing mimics natural release of hormones
- NEVER stop abruptly
- doses need to be increased in times of stress: 3x3 rule
- always maintain emergency supply
- wear medic alert bracelet
6
Q
what causes addisonian crisis
A
- sudden insufficiency of serum corticosteroids
7
Q
what does addisonian crisis result from
A
- sudden loss of adrenal gland
- sudden increase in stress in chronic condition
- sudden cessation of long-term corticosteroid drug therapy
- most common with primary adrenal insufficiency
8
Q
symptoms of addisonian crisis
A
- sudden penetrating pain in lower back, abdomen, legs
- hyponatremia
- vomiting and diarrhea
- dehydration
- low blood pressure
- CNS: loss of consciousness, confusion, slurred speech
- hyperkalemia
9
Q
treating addisonian crisis
A
- IV: hydrocortisone, saline, dextrose
- when stable: switch to PO meds and fluids
- taper dose until maintenance dose is achieved
