In this article, we will discuss the Prevention of Further Episodes of Acute Adrenal Crisis/Insufficiency. So, let’s get started.
Prevention of Further Episodes
1. Concurrent illness: The patient is advised of excessive exercise with sweating, hot to add salt to the diet during the period weather/season and during vomiting or diarrhoea. During an episode of febrile illness, patient should double the dose of steroids for 3-5 days and consult his/her physician if the illness persists longer. Acute gastroenteritis needs immediate hospitalization for fluid and steroids therapy to prevent dehydration and shock.
2. Surgery: Minor procedures under local anaesthesia (e.g. dental extraction) do not need any change in steroid regimen. Moderate stressful procedures (e.g. endoscopy, bronchoscopy, arteriography),
need to be covered with an additional dose of 100mg of hydrocortisone I.V.just before surgery, another 100mg is given just before anaesthesia and then 100 mg IV. every 8 hourly till the patient stabilizes. The steroid dose is then tapered rapidly to maintenance dosage.