A patient with Addison's disease presented with adrenal crisis. Drug of choice is:
Hydrocoisone, 100 mg intravenously every 8 hours, is the mainstay for treating adrenal insufficiency. Alternatively, dexamethasone, 0.1 mg/kg every 8 hours, may be used without disruption of diagnostic testing. Once diagnostic testing has been done, hydrocoisone is the drug of choice because it has both glucocoicoid and mineralocoicoid functions. Once patients are stable, the dose may be tapered gradually over 1-2 weeks. Patients receiving less than 50 mg/d of hydrocoisone will likely need mineralocoicoid suppo as well. Fludrocoisone, 0.05-0.2 mg/d, is the drug of choice. Ref: Huecker M.R., Danzl D.F. (2011). Chapter 43. Metabolic & Endocrine Emergencies. In R.L. Humphries, C. Stone (Eds), CURRENT Diagnosis & Treatment Emergency Medicine, 7e.
Hydrocoisone
Betamethasone
Dexamethasone
Prednisolone