Treatment of Patients with Addison Disease

Treatment of patients with Addison’s disease is carried out under the control of body weight, blood pressure, dynamometry, general health and release with
yuchoy / 7-ksi UT O & C. In case of addison disease of tuberculous etiology, streptoticin is prescribed at 0.5-1 g per day (for a course of up to 50 g) in combination with ftivazid, tubaside, PAS or other anti-tuberculosis drugs.

Anti-tuberculosis therapy is carried out 2 times a year under the supervision of an endocrinologist and a TB specialist.

Treatment for an addisonic crisis includes, first and foremost, corticosteroid replacement therapy, as well as measures aimed at combating dehydration, electrolyte Shrubs, collapse, hypoglycemia and concomitant infection. During the first 4-6 hours, 100 mg of water-soluble hydrocortisone in 500 ml of 5% glucose solution or an isotonic solution of sodium chloride are injected intravenously. At the same time, 75-100 mg of hydrocortisone is administered intramuscularly, followed by repeated injections of hydrocortisone intravenously or intramuscularly in a dose of 50-100 mg every 4-6 hours, depending on the patient’s condition.

On the first day and according to indications on the second day, 100-400 mg of hydrocortisone or 30-90 mg of prednisolone are administered intravenously. The daily dose of hydrocortisone is usually 300-600 mg, but may be higher if necessary. In the following days, when the patient’s condition improves and systolic blood pressure increases to 115–120 mm Hg. Art., and diastolic to 70- 80 mm Hg. Art. the dose of glucocorticoids is gradually reduced and hydrocortisone is administered only intramuscularly in a dose of 25 mg 4 times a day. Depending on the patient’s condition, they are gradually transferred to oral therapy (prednisone, dexamethasone, etc.). In combination with the indicated treatment with low blood pressure, a 0.5% doxa oil solution is administered at a dose of 1–2 ml (5–10 mg per day) intramuscularly. The indication for increasing the dose of glucocorticoids is a pronounced tachycardia in combination with low systolic (below 100 mm Hg.) And diastolic pressure (below 60 mm Hg.).

To combat dehydration and collapse, intramuscular or intramuscular drip administration of 2–3 l of 5% glucose solution in an isotonic solution of sodium chloride with the addition of 50 ml of a 5% solution of ascorbic acid and 4-6 ml of a cordiamine is prescribed. With a sharp decrease in blood pressure, along with hydrocortisone and DOXA, add 1-3 ml of 0.1% epinephrine solution, or 0.2% norepinephrine solution, or 1-2 ml of 1% mezaton solution to the dropper. With indomitable vomiting, 5–10 ml of 10% sodium chloride solution is intravenously injected to fill the electrolyte deficiency. When indicated, anti-bacterial therapy is performed.

local_offerevent_note January 30, 2019

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