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Steroid Supplementation Addison Disease — NDEB AFK MCQ

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HardMedical Emergencies in DentistrySteroid Supplementation Addison DiseaseNDEB AFK

In the management of a patient with Addison disease requiring a stressful dental procedure, what supplemental corticosteroid protocol may be considered?

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Correct answer: D — Double the patient's usual daily corticosteroid dose on the day of the procedure

Current evidence suggests that most dental procedures (including surgical extractions) in patients with adrenal insufficiency can be managed by doubling the patient's usual daily corticosteroid dose on the day of the procedure (or the traditional 'stress dose' supplementation). The previous practice of routine high-dose supplementation for all procedures is considered excessive. For major oral surgery under general anaesthesia, hydrocortisone 100 mg IV at induction may be appropriate. The key principle is to prevent adrenal crisis by ensuring adequate cortisol availability during physiological stress.

Reference: Malamed – Medical Emergencies in the Dental Office, 8th ed., 2022