Addisonian Crisis Treatment

Addisonian crisis treatment typically involves intravenous injections of hydrocortisone, saline, and dextrose. These specific injections counteract the low blood pressure, low blood glucose, and high levels of potassium that occur in a person during an addisonian crisis. These different types of addisonian crisis treatment usually bring rapid improvement in the patient.

 

Addisonian Crisis Treatment: An Overview

For people with Addison's disease, a stressful event like an illness or an accident can cause an addisonian crisis. In about 25 percent of patients, symptoms of Addison's disease first appear during an addisonian crisis. Without addisonian crisis treatment, the crisis can be fatal.
 

Specific Addisonian Crisis Treatment

During an addisonian crisis, low blood pressure, low blood glucose, and high levels of potassium can occur. Specific addisonian crisis treatment for these symptoms involves intravenous (IV) injections of:
 
  • Hydrocortisone
  • Saline (salt water)
  • Dextrose (sugar).
     
These addisonian crisis 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.
 

Preventing an Addisonian Crisis

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 requiring addisonian crisis treatment:
 
  • A person with Addison's disease 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 Addison's disease 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.
     
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD