During an addisonian crisis, low blood pressure, low blood glucose, and high levels of potassium can occur. Treatment for these symptoms involves intravenous (IV) injections of:
- Saline (salt water)
- Dextrose (sugar).
These treatments usually bring rapid improvement.
When the patient can take fluids and medications by mouth, the amount of hydrocortisone is decreased until a maintenance dose is achieved. If aldosterone is deficient, maintenance therapy also includes oral doses of fludrocortisone acetate.
(To learn more, click Addisonian Crisis Treatment.)
While it is not always possible to prevent an addisonian crisis, there are some things that a person can do in order to reduce the chances of needing treatment:
- A person with adrenal insufficiency should know how to increase medication during periods of stress or mild upper respiratory infections.
- Immediate medical attention is needed when severe infections, vomiting, or diarrhea occur. These conditions can precipitate an addisonian crisis. A patient who is vomiting may require addisonian crisis treatment.
- When traveling, a needle, syringe, and an injectable form of cortisol should be carried for emergencies.
- A person who has adrenal insufficiency should always carry identification stating his or her condition in case of an emergency. The card should alert emergency personnel about the need to inject 100 mg of cortisol if its bearer is found severely injured or unable to answer questions. The card should also include the doctor's name and telephone number and the name and telephone number of the nearest relative to be notified.
- People with medical problems may wish to wear a descriptive warning bracelet or neck chain to alert emergency personnel. A number of companies manufacture medical identification products.