What should patients in shock with known adrenal insufficiency receive?

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Patients in shock with known adrenal insufficiency are at risk for significant complications due to their reduced ability to respond to stress and maintain hemodynamic stability. In adrenal insufficiency, the body lacks adequate levels of corticosteroids, which are necessary for managing stress responses, including the regulation of blood pressure and fluid balance.

Receiving the patient's own Solu-Cortef (hydrocortisone) as prescribed is critical because it helps to restore the deficient corticosteroid levels. This intervention can dramatically improve the patient's condition by helping to stabilize blood pressure and support other physiological functions affected by the adrenal crisis triggered during shock. The timely administration of hydrocortisone is essential in these situations to mitigate the risks associated with adrenal insufficiency.

Other options may address certain aspects of shock management, such as fluid resuscitation with normal saline or providing glucose for hypoglycemia, but these would not directly address the hormonal deficiency that the patient is experiencing. Additionally, while adrenaline (epinephrine) can help in cases of anaphylactic shock or severe asthma exacerbations, it does not replace the glucocorticoid deficiency that is critical in a patient with adrenal insufficiency. Therefore, the administration of hydrocortisone is the most appropriate and necessary treatment for these patients

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