Tratamiento de la insuficiencia suprarrenal

Abstract

Adrenal insufficiency is an endocrine disorder with a low prevalence, though it can potentially be severe if not treated. Hemodynamic collapse and refractory hypotension characterize an acute adrenal crisis. Treatment must never be delayed while awaiting biochemical results in these cases. Hydrocortisone, the pharmacological name for cortisol, is the drug of choice, as it has greater mineralocorticoid activity than other synthetic glucocorticoids. During an acute crisis, clearly supraphysiological doses should be used together with aggressive fluid replacement until hemodynamic stabilization is achieved. In patients with chronic manifestations, the maintenance dose is 15 to 25mg, accompanied by mineralocorticoid replacement if the origin of the AI is primary. Clinical response is the best indicator of treatment response. Patient education is fundamental and should be aimed at recognizing an acute crisis and how to act in stressful situations in order to prevent them.