The adrenal cortex normally secrets hydrocortisone (cortisol) which has glucocorticoid activity and weak mineralcocorticoid activity. It also secretes the mineralocorticoid aldosteone.
In deficiency states, physiological replacement achieved with a combination of Hydrocortsone and mierallocorticoid fludrocortisone;
hydrocortisone alone does not usually provide sufficient mineralocorticoid activity for complete replacement.
In addison's disease o following adrenalectomy, hydrocotisone 20 to 30 mg daily by mouth is usually reqiured. This is given in two doses, the larger in the morning and the smaller in the evening, mimicking the normal diurnal rhythm of cortisol secretion.
The optimum daily dose is determind on the basis of clinical response. Glucocorticoid therapy is supplemented by fludrocortisone 50 to 300 micro-grams daily.
Notes;The adrenal cortex—the outer part of the gland—produces hormones that are vital to life, such as cortisol (which helps regulate metabolism and helps your body respond to stress) and aldosterone (which helps control blood pressure).
In deficiency states, physiological replacement achieved with a combination of Hydrocortsone and mierallocorticoid fludrocortisone;
hydrocortisone alone does not usually provide sufficient mineralocorticoid activity for complete replacement.
In addison's disease o following adrenalectomy, hydrocotisone 20 to 30 mg daily by mouth is usually reqiured. This is given in two doses, the larger in the morning and the smaller in the evening, mimicking the normal diurnal rhythm of cortisol secretion.
The optimum daily dose is determind on the basis of clinical response. Glucocorticoid therapy is supplemented by fludrocortisone 50 to 300 micro-grams daily.
Notes; Addison's disease is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well.In acute adrenocortical in sufficiency, hydrocortisone is given intravenously (preferably as sodium succinate) in doses of 100 mg every 6 to 8 hours in sodium chloride intravemous infusion 0.9%.
Notes; Typically, “infusion therapy” means that a drug is administered intravenously, but the term also may refer to situations where drugs are provided through other non-oral routes, such as intramuscular injections and epidural routes (into the membranes surrounding the spinal cord).In hypopituitarism glucocorticoids should be given as in adrenocortical insufficiency, but since production of aldosterone is also regulated by the renin-angiotensin system a mineralocorticoid is not usually required. Additional replacement therapy with levothyroxine be given as indicated by the pattern of hormone of hormone deficiency.
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