A patient with adrenal insufficiency takes hydrocortisone replacement and develops a high fever. Which instruction is most appropriate?
Correct answer: A. Follow the prescribed sick-day plan and contact the provider
- A. Follow the prescribed sick-day plan and contact the provider
- B. Stop hydrocortisone until the fever has completely settled
- C. Take the usual dose only and avoid reporting the illness
- D. Replace hydrocortisone with levothyroxine during the fever
Explanation
Fever increases the body's need for cortisol, so a patient with adrenal insufficiency may require prescribed stress dosing and prompt medical advice. Abruptly stopping replacement can precipitate adrenal crisis.
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About Endocrine and Diabetes Drugs
Endocrine pharmacology includes insulin preparations, oral antidiabetic drugs, thyroid and antithyroid medicines, corticosteroids, sex hormones and drugs affecting calcium balance. Questions address onset and duration, administration, monitoring, hypoglycaemia, steroid adverse effects and the difference between replacing a deficient hormone and suppressing excessive hormone activity.
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