A 45-year-old man with primary adrenal insufficiency (Addison disease) managed with hydrocortisone and fludrocortisone develops a febrile illness with...

Question

A 45-year-old man with primary adrenal insufficiency (Addison disease) managed with hydrocortisone and fludrocortisone develops a febrile illness with vomiting. He is unable to keep tablets down. What is the most appropriate advice regarding his steroid therapy?

Accepted Answer

Administer intramuscular hydrocortisone and seek urgent medical review

Answer

Omit hydrocortisone until the illness has resolved

Answer

Double the usual oral dose of hydrocortisone and continue as normal

Answer

Stop fludrocortisone and continue only hydrocortisone

Answer

No change is necessary as stress dosing is not required

au-racp MCQ (SBA): Primary adrenal insufficiency sick-day management

A 45-year-old man with primary adrenal insufficiency (Addison disease) managed with hydrocortisone and fludrocortisone develops a febrile illness with vomiting. He is unable to keep tablets down. What is the most appropriate advice regarding his steroid therapy?