علاج قصور الغدة الكظرية الأولي في حالة أزمة الغدة الكظرية أو الأعراض الشديدة لقصور الغدة الكظرية

References

• In patients with severe adrenal insufficiency symptoms or adrenal crisis, we recommend immediate therapy with iv hydrocortisone at an appropriate stress dose prior to the availability of the results of diagnostic tests.
• We recommend that patients with suspected adrenal crisis should be treated with an immediate parenteral injection of 100 mg (50 mg/m2 for children) hydrocortisone, followed by appropriate fluid resuscitation and 200 mg (50–100 mg/m2 for children) of hydrocortisone/24 hours (via continuous iv therapy or 6 hourly injection); age- and body surface-appropriate dosing is required in children (see Table 3).
• If hydrocortisone is unavailable, we suggest prednisolone as an alternative. Dexamethasone is the least-preferred alternative and should only be given if no other glucocorticoid is available.