Addison's Disease: Difference between revisions
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== Medications == | == Medications == | ||
Acute Therapy : | |||
•<span class="Apple-tab-span" style="white-space:pre"> </span>Intravenously administered hydrocortisone (100 mg), repeated every 6 hours for the first 24 hours | |||
•<span class="Apple-tab-span" style="white-space:pre"> </span>Intravenously administered rapid infusion of saline (2-4L) during the first 12 hours | |||
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Maintenance Therapy4: | |||
•<span class="Apple-tab-span" style="white-space:pre"> </span>Glucocorticoid Replacement: 15-20 mg of hydrocortisone daily, divided into 3 or 4 doses to simulate normal adrenal secretions | |||
•<span class="Apple-tab-span" style="white-space:pre"> </span>Mineralocorticoid Replacement: 0.05-0.1 mg of fludrocortisones daily | |||
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== Diagnostic Tests/Lab Tests/Lab Values == | == Diagnostic Tests/Lab Tests/Lab Values == |
Revision as of 00:04, 8 March 2010
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Addison’s disease is another name for primary chronic adrenal insufficiency. It is a condition where the adrenal cortex (the outer layer of the adrenal gland that produces mineralocorticoids, glucocorticoids, and androgens) is progressively destroyed, resulting in decreased secretions of the hormones. Cortisol, a glucocorticoid, and aldosterone, a mineralcorticoid, are the primary hormones that are decreased with this disease, causing body wide metabolic disorders and fluid imbalances.
Prevalence[edit | edit source]
Addison’s disease occurs in about 4 out of 100,000 Americans each year. Even though it is seen throughout the lifespan in both genders, it most commonly occurs in middle-aged white females.
Characteristics/Clinical Presentation[edit | edit source]
Addison’s disease will develop insidiously, with the signs of the disease not developing “until at least 90% of both glands is destroyed and the levels of circulating glucocorticoids and mineralocorticoids are significantly decreased.”2 Some of the clinical signs and symptoms of Addison’s disease include:
• Darkened pigmentation of the skin, due to increased secretion of melanin-secreting hormone (MSH) corresponding with increased secretion of ACTH, which is released to try to stimulate the work of the adrenal glands1,2,
• Slowly developing weakness and fatigue2,3
• Hypotension due to increased sodium excretion from decreased aldosterone secretion1,2,3
• Severe abdominal, low back, or leg pain1
• Gastrointestinal disturbances such as nausea, vomiting, anorexia, weight loss, and diarrhea2,3
• Hypoglycemia due to decreased glucocorticoids causing decreased gluconeogenesis1,2
• Decreased stress tolerance (infections, trauma, surgery, etc.)1,2
• Salt craving
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
Acute Therapy :
• Intravenously administered hydrocortisone (100 mg), repeated every 6 hours for the first 24 hours
• Intravenously administered rapid infusion of saline (2-4L) during the first 12 hours
Maintenance Therapy4:
• Glucocorticoid Replacement: 15-20 mg of hydrocortisone daily, divided into 3 or 4 doses to simulate normal adrenal secretions
• Mineralocorticoid Replacement: 0.05-0.1 mg of fludrocortisones daily
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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