What are the guidelines for adjusting corticosteroid doses during acute illness, including considerations for stress dosing in patients with adrenal suppression?
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What are the guidelines for adjusting corticosteroid doses during acute illness, including considerations for stress dosing in patients with adrenal suppression?
1. During acute illness, increase corticosteroid doses 2-3 times for patients with adrenal suppression to prevent crisis.
2. For severe illness or surgery, consider IV hydrocortisone equivalent to 100mg every 8 hours for 24-72 hours.
3. Adjust oral corticosteroids to 20-30mg/day of hydrocortisone during minor infections in adrenal insufficient patients.
4. Monitor vital signs and electrolytes closely; taper back to regular doses as condition improves and stabilizes.
5. Consult endocrinologist for personalized stress dosing during acute events if patient history is complex.