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Addisonian Crisis
- due to insufficient glucocorticoids and mineralocorticoids
- commonly adrenal suppression secondary to long-term steroids
- often intercurrent infection
Emergency Management
- one litre normal saline over 30-60 mins
- may need several litres of saline over 24 hours
- Hydrocortisone 100mg IV + 100mg IM 6 hourly until stable
- dextrose if hypoglycaemia
Later
- hydrocortisone 20mg 8-hourly reducing to 20-30 mg / day over a few days
- fludrocortisine
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