Adrenal Insufficiency, adrenal crisis, replacement hydrocortisone
Hydrocortisone is a steroid hormone produced by the adrenal glands. It plays a complex role in regulating body functions and is essential for survival.
Replacement hydrocortisone is prescribed if you do not produce the natural hormone yourself - this is known as adrenal insufficency.
Hydrocortisone is a steroid hormone produced by the adrenal glands. It plays a complex role in regulating body functions and is essential for survival.
Replacement hydrocortisone is prescribed if you do not produce the natural hormone yourself - this is known as adrenal insufficency.
- Primary adrenal insufficiency (Addison's Disease) is when your adrenals do not produce hydrocortisone.
- Secondary adrenal insufficiency is caused by a deficiency of ACTH (produced by the pituitary gland) and most pituitary patients needing hydrocortisone replacement have secondary adrenal insufficiency.
- A third cause is congenital adrenal hydroplasia (CAH) which is a birth defect.
An adrenal crisis is a medical emergency. If left untreated, it can be fatal. If you are not sure that you are having an adrenal crisis it is better to be safe and use your emergency injection (it will not harm you if you didn't need it). If you are unable to have an injection, DO NOT hesitate to dial 999 and say that you are having an Addisonian crisis and need an emergency hydrocortisone injection.
All the information you need to know about hydrocortisone replacement and adrenal crisis can be found on The Pituitary Foundation's website, along with useful downloadable information sheets:
All the information you need to know about hydrocortisone replacement and adrenal crisis can be found on The Pituitary Foundation's website, along with useful downloadable information sheets:
- Hydrocortisone advice for patients & how to inject step-by-step
- Hydrocortisone advice for parents & how to inject step-by-step
- Webinar - sick day rules
- Information for Ambulance - adrenal crisis - Factsheet
- Information for A&E - adrenal crisis
- Information for hospital staff - adrenal insufficiency
- Hydrocortisone refusal letter
- Template letter for GP for extra hydrocortisone prescription
- Bedside form for patients
- Hydrocortisone awareness card
- Patient Care Card
- Medical alert jewellery and emblems
- Society for Endocrinology/NHS emergency steroid/adrenal crisis card:
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The endocrine team at Liverpool University Hospital have released a short video to educate patients with adrenal insufficiency about management of their steroid replacement therapy. It includes a section about sick-day rules, as well as sections about how to administer different types of emergency hydrocortisone injections.
To watch the video on YouTube please click here
The endocrine team at Liverpool University Hospital have released a short video to educate patients with adrenal insufficiency about management of their steroid replacement therapy. It includes a section about sick-day rules, as well as sections about how to administer different types of emergency hydrocortisone injections.
To watch the video on YouTube please click here
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Two forms are also available from the QEHB endocrine nurses:
A free pdf copy of the guidelines can be downloaded from the Addison's website.
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All steroid-dependent patients should have an emergency hydrocortisone injection kit. Your endocrinologist should prescribe the hydrocortisone injection (and might prescribe the syringe and needles).
Emergency injections come in two types:
Hydrocortisone sodium phosphate 100mg - this is a pre-mixed version and is easier to administer.
You can make up your own kit in a suitable container and your family and friends should be instructed on how to administer an injection. The group often has a refresher session on how to give an injection. We also have a downloadable instruction sheet which you can add to your kit:
Two forms are also available from the QEHB endocrine nurses:
- Management of adrenal crisis – important information for ambulance and medical staff
- Management of glucocorticoid requirement during surgery – important information for surgical, medical and nursing staff
A free pdf copy of the guidelines can be downloaded from the Addison's website.
___________________________________________________________________________________________
All steroid-dependent patients should have an emergency hydrocortisone injection kit. Your endocrinologist should prescribe the hydrocortisone injection (and might prescribe the syringe and needles).
Emergency injections come in two types:
- Hydrocortisone 100mg Powder for Solution for Injection or Infusion 1x2ml (vial with diluent) (previously called Solu-Cortef).
- This is in powder form and it has to be mixed with sterile water prior to injecting. It is not as easy to use as the pre-mixed injection but it does have a long shelf life.
-
Hydrocortisone sodium phosphate 100mg - this is a pre-mixed version and is easier to administer.
You can make up your own kit in a suitable container and your family and friends should be instructed on how to administer an injection. The group often has a refresher session on how to give an injection. We also have a downloadable instruction sheet which you can add to your kit:
2024_kit_leaflet.docx | |
File Size: | 2999 kb |
File Type: | docx |
You might find that using a device to snap the top off the glass ampoules is easier and safer.
This simple plastic device will snap off the top and avoid the risk of the ampoule shattering. It is available to buy online for around £3.70 - just search for Safe Snap Ampoule Snapper.
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