Adrenal Crisis in Emergency Medicine Medication

Updated: Oct 10, 2017
  • Author: Kevin M Klauer, DO, EJD, FACEP; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Medication

Medication Summary

One of the goals in treating adrenal insufficiency is glucocorticoid replacement. [12] Electrolyte and metabolic abnormalities, as well as hypovolemia, must also be corrected. In addition, address the event precipitating abrupt decompensation.

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Corticosteroids

Class Summary

These agents are primarily used to correct glucocorticoid deficiencies. The drugs of choice are hydrocortisone, cortisone, and prednisone.

Hydrocortisone (Cortef, Solu-Cortef)

DOC because of mineralocorticoid activity and glucocorticoid effects.

Cortisone (Cortone Acetate)

Considered the DOC by some practitioners.

Prednisone (Deltasone, Liquid Pred)

Treats various diseases including adrenocortical insufficiency. Agent is inactive and must be metabolized to active metabolite prednisolone. Conversion may be impaired in patients with liver disease.

Dexamethasone (Decadron, AK-Dex, Alba-Dex, Dexone)

Alternative to hydrocortisone to avoid interference with testing of cortisol levels.

Fludrocortisone acetate (Florinef Acetate)

Partial replacement therapy for primary and secondary adrenocortical insufficiency.

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