Define the Disorder
The insufficient secretion of hormones from the adrenal cortex.
Acute Adrenocortical Insufficiency
Primary and Secondary Cause
Types of Causes of Acute Adrenocortical Insufficiency
As shown in this photo, former US President John F. Kennedy, diagnosed with Addison’s Disease, physically exhibited this clinical manifestation.
Tanned or Bronzed Appearance
An increase in this waste product, along with elevated potassium and calcium, may be seen in adrenal insufficiency due to decreased renal perfusion.
BUN (Blood Urea Nitrogen)
This type of solution is added to fluids during treatment to correct low blood sugar.
Dextrose
Life-threatening disorder caused by Adrenal Insufficiency
Addisonian Crisis
In this type of adrenal insufficiency, the adrenal gland itself is dysfunctional and fails to produce cortisol even when stimulated.
Primary Cause
Seen in adrenal insufficiency often caused by decreased sodium and water retention.
Hypotension
Low levels of this electrolyte, combined with hypotension and dehydration, are classic findings in adrenal hormone deficiency.
Hyponatremia
This glucocorticoid is commonly administered in adrenal crisis to replace deficient cortisol levels.
Hydrocortisone
Hormones of the adrenal cortex produced insufficiently in Acute Adrenocortical Insufficiency.
Aldosterone, cortisol, and androgen
In this form of adrenal insufficiency, cortisol production can still occur because the adrenal gland remains functional.
Secondary Adrenal Insufficiency
Hypoglycemia, or low blood glucose, occurs in Adrenocortical Insufficiency because there is not enough production of this stress hormone which would usually cause elevated glucose.
Cortisol
This condition is suggested when cortisol levels fail to rise after administration of synthetic ACTH.
Primary Adrenal Insufficiency
This medication, along with insulin, is used to lower dangerously high potassium levels by removing it from the body through the GI tract.
Kayexalate
A deficiency in this hormone from the adrenal cortex can lead to low blood pressure and electrolyte imbalance.
Aldosterone
The hormone produced by the Hypothalamus that stimulated the pituitary gland to produce ACTH, which then further causes the adrenal gland to secrete cortisol
Cortisol-Releasing Hormone (CRH)
This electrolyte imbalance is commonly seen when adrenal hormone production is impaired, especially aldosterone.
Hyperkalemia
If cortisol levels increase after ACTH administration, this type of adrenal insufficiency is more likely.
Secondary Adrenal Insufficiency
This IV medication is administered during hyperkalemia to stabilize cardiac membranes and reduce the risk of arrhythmias.
Calcium Gluconate
These adrenal cortex hormones contribute to secondary sexual characteristics and are also deficient in adrenal insufficiency.
Androgens
In Secondary Adrenal Insufficiency, there may be issues with these two parts of the brain:
Hypothalamus & Pituitary Gland
3 “H” Symptoms of Acute Adrenocortical Insufficiency
Hypotension, Hypoglycemia, Hyperkalemia
This diagnostic test is used to distinguish between primary and secondary causes of adrenal insufficiency.
ACTH Stimulation Test
This hormone is given with glucose to shift potassium into cells and also prevent hypoglycemia.
Insulin