A 39-year-old man suffers from chronic adrenal insufficiency and receives replacement glucocorticoid therapy (hydrocortisone – 15 mg/day). He is to undergo elective surgery for calculous cholecystitis. What medication adjustment should be made on the day of the surgery to prevent the development of acute adrenal insufficiency?

Answer options

1. Prescribe a large volume intravenous fluid infusion
2. Add a mineralocorticoid
3. Increase the dosage by 2-3 times
4. Add an antibiotic
5. Cancel the drug for the day of the surgery

Explanation

A 39-year-old man suffers from chronic adrenal insufficiency and receives replacement glucocorticoid therapy (hydrocortisone – 15 mg/day). He is to undergo elective surgery for calculous cholecystitis. What medication adjustment should be made on the day of the surgery to prevent the development of acute adrenal insufficiency?Adrenal insufficiency has been reported after major surgery because of stress or blood loss affecting the pituitary gland.