Adrenal Insufficiency

also see Adrenal insufficiency in pregnancy

Pathophysiology

Diagnosis

Laboratory tests 

Differential Diagnosis

Treatment

  1. Monitors, O2, ABCs
  2. Glucose, thiamine naloxone (if coma/AMS/shock)
  3. D5/NS IV: 1-2 L rapidly to restore CVP to 10-12 mmHg 
  4. If patient critical/in shock
  5. If initiation of steroid therapy not immediately critical: 
  6. Initiate steroid therapy 
  7. Mineralcorticoid Rx not required in initial therapy with these high doses of hydrocortisone
  8. Vasopressors as required, supportive measures

Disposition

  1. Admit to ICU
  2. Consult endocrinologist