Adrenal Insufficency Treatment :

Treatment of adrenal insufficiency : Cortisol is replaced with a synthetic glucocorticoid such as

hydrocortisone, prednisone, or dexamethasone, oral 1-3x each day. Jika aldosterone menurun, it
is replaced with oral doses of a mineralocorticoid, called fludrocortisone acetate (Florinef), taken
1-2 a day. Doctors usually advise patients receiving aldosterone replacement therapy to increase
their salt intake. Because people with secondary adrenal insufficiency normally maintain
aldosterone production, they do not require aldosterone replacement therapy.

During an Addisonian crisis, low blood pressure, low blood glucose, and high levels of
potassium can be life threatening. Standard therapy involves IV injections of glucocorticoids and
large volumes of intravenous saline solution with dextrose, a type of sugar. This treatment
usually brings rapid improvement.

Why ?

Another cause of secondary adrenal insufficiency is surgical removal of the noncancerous,

ACTH-producing tumors of the pituitary gland that cause Cushing's disease. Cushing's disease is
another disorder that leads to excess cortisol in the body. In this case, the source of ACTH is
suddenly removed and replacement hormone must be taken until normal ACTH and cortisol
production resumes. Less commonly, adrenal insufficiency occurs when the pituitary gland either
decreases in size or stops producing ACTH. These events can result from

tumors or infections of the area

loss of blood flow to the pituitary

radiation for the treatment of pituitary tumors

surgical removal of parts of the hypothalamus

surgical removal of the pituitary gland

Cushing removal by surgery :

Removing the tumor may lead to full recovery, but there is a chance that the condition will
return. Survival for people with ectopic tumors depends on the tumor type. Untreated, Cushing
syndrome can be life-threatening.

Prednisone is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally

occurring and synthetic, which are readily absorbed from the gastrointestinal tract. The
molecular formula for prednisone is C21H26O5. Chemically, it is 17,21-dihydroxypregna-1,4-
diene-3,11,20-trione
Indication :1. Endocrine Disorders:

Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice;

synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in
infancy mineralocorticoid supplementation is of particular importance).

Congenital adrenal hyperplasia

Nonsuppurative thyroiditis

Hypercalcemia associated with cancer

Adverse Effect :

Fluid and Electrolyte Disturbances: Potassium loss.

Sodium retention. Hypokalemic alkalosis.

Fluid retention. Hypertension.

Congestive heart failure in susceptible Musculoskeletal:

patients.
Muscle weakness.
The adrenal glands are located in the retroperitoneum superior to the kidneys, they are
quadrilaterial in shape and are situated bilateraly. The combined weight of the adrenal glands in
an adult human ranges from 7 to 10 grams.[1] They are surrounded by an adipose capsule and
renal fascia.

The two adrenal glands (also called the suprarenal glands) are situated in the abdomen, above the
kidneys and below the diaphragm. They have a high cholesterol content giving them a yellowish
colour. They are contained within the same membrane as the kidney but separated from them by
a fibrous layer of tissue. The right gland is tetrahedral in shape and lies lower than the left, which
is semilunar in shape and usually the larger of the two. Each gland weighs approximately 5
grams and measures approximately 50mm vertically, 30mm across and 10mm thick.