Adrenal Insufficiency
1) AM Screening Studies:
- Cortisol (<140 nmol or < 5 ug/ dL ~= AI)
-ACTH >2xULN
-Renin/Aldosterone
2) Corticotrophin stimulation test (250 ug; 30 or 60 min) *Best test*
-<500 nmol/L , <18 ug/dL =~ AI
Monitor:
Body weight
Postural BP
Energy Levels
Cushingoid features
Monitor: Target: Plasma renin level w/in ULN
Salt cravings
Postural BP
Edema
Lytes
Management of Adrenal Crisis