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group_3_presentation_2_-_addison_s_disease [2017/03/10 23:30] javedaa |
group_3_presentation_2_-_addison_s_disease [2018/01/25 15:18] (current) |
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| ====== Diagnosis ====== | ====== Diagnosis ====== | ||
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| **Injection Alternatives** | **Injection Alternatives** | ||
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| Since some individuals experience nausea leading to vomiting as a symptom, intravenous or intramuscular cortisol injections can replace the oral tablets (Mayo Clinic, 2015). | Since some individuals experience nausea leading to vomiting as a symptom, intravenous or intramuscular cortisol injections can replace the oral tablets (Mayo Clinic, 2015). | ||
| It is strongly recommended that individuals with the disease carry a cortisol injection kit with them in case of Addisonian/Adrenal Crisis (Canadian Addison Society, 2017). In the appropriate hospital setting, receiving an intravenous dose of hydrocortisone and dextrose sugar in saline solution would be an ideal treatment for the adrenal crisis (Mayo Clinic, 2015). Otherwise, the individual or family member can follow the appropriate instructions to inject the hydrocortisone intramuscularly into a large muscle, typically the thigh (quadricep muscle) (Canadian Addison Society, 2017). | It is strongly recommended that individuals with the disease carry a cortisol injection kit with them in case of Addisonian/Adrenal Crisis (Canadian Addison Society, 2017). In the appropriate hospital setting, receiving an intravenous dose of hydrocortisone and dextrose sugar in saline solution would be an ideal treatment for the adrenal crisis (Mayo Clinic, 2015). Otherwise, the individual or family member can follow the appropriate instructions to inject the hydrocortisone intramuscularly into a large muscle, typically the thigh (quadricep muscle) (Canadian Addison Society, 2017). | ||
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| Oral tablets, intravenous injections and intramuscular injections are current hormone replacement therapies for Addison’s Disease, however, there have been many clinical trials considering continuous subcutaneous hydrocortisone infusions (CSHI) as a better treatment option. A 2014 study investigated the efficacy of CSHI versus conventional oral hydrocortisone (OHC) replacement and the subcutaneous infusions showed improvements in normalization of ACTH and cortisol levels and improvements in quality of life (Oksnes et al., 2014). As shown in figure 12, the infusions got the morning blood cortisol levels back to normal ranges as opposed to the oral tablets (Oksnes et al., 2014). Cortisol levels should be high in the morning and the infusions reestablished this to the normal range (Oksnes et al., 2014). | Oral tablets, intravenous injections and intramuscular injections are current hormone replacement therapies for Addison’s Disease, however, there have been many clinical trials considering continuous subcutaneous hydrocortisone infusions (CSHI) as a better treatment option. A 2014 study investigated the efficacy of CSHI versus conventional oral hydrocortisone (OHC) replacement and the subcutaneous infusions showed improvements in normalization of ACTH and cortisol levels and improvements in quality of life (Oksnes et al., 2014). As shown in figure 12, the infusions got the morning blood cortisol levels back to normal ranges as opposed to the oral tablets (Oksnes et al., 2014). Cortisol levels should be high in the morning and the infusions reestablished this to the normal range (Oksnes et al., 2014). | ||
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