Which medications in the drug class Corticosteroids are used in the treatment of Adrenal Crisis?

Updated: Feb 14, 2018
  • Author: Lisa Kirkland, MD, FACP, FCCM, MSHA; Chief Editor: George T Griffing, MD  more...
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Answer

Corticosteroids

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body's immune response to diverse stimuli.

Dexamethasone (Decadron, Baldex, Dexone)

Used as empiric treatment of shock in suspected adrenal crisis or insufficiency until serum cortisol levels are drawn.

Hydrocortisone (Hydrocortone, Hydrocort)

DOC because of mineralocorticoid activity and glucocorticoid effects.

Cortisone (Cortone)

Oral DOC for patients with adrenocortical insufficiency.

Use in patients undergoing moderate stress surgery (eg, vascular bypass, total joint replacement) who can take PO postoperatively.

Fludrocortisone (Florinef)

Acts on renal distal tubules to enhance reabsorption of sodium. Increases urinary excretion of both potassium and hydrogen ions. The consequence of these 3 primary effects, together with similar actions on cation transport in other tissues, appears to account for the spectrum of physiological activities characteristic of mineralocorticoids. Used in adrenal insufficiency. Produces marked sodium retention and increased urinary potassium excretion.

Methylprednisolone (Medrol, Solu-Medrol, Depo-Medrol)

Usually third-line DOC for adrenal crisis because of lack of mineralocorticoid activity.

Consider use in patients with fluid overload, edema, or hypokalemia.


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