A 34-year-old woman with adrenal insufficiency collects hydrocortisone 10 mg on waking, 5 mg at lunchtime and 5 mg early evening. She has vomiting

Question

A 34-year-old woman with adrenal insufficiency collects hydrocortisone 10 mg on waking, 5 mg at lunchtime and 5 mg early evening. She has vomiting and fever and asks whether to skip tablets until she can keep food down. What would you advise the patient?

Accepted Answer

Seek urgent medical help because vomiting may require parenteral steroid

Answer

Replace hydrocortisone with ibuprofen during fever

Answer

Take the evening dose as the whole daily dose

Answer

Use an antacid to improve steroid absorption

Answer

Skip hydrocortisone until vomiting has stopped

Adrenal insufficiency sick-day rules — GPhC CRA MCQ

A 34-year-old woman with adrenal insufficiency collects hydrocortisone 10 mg on waking, 5 mg at lunchtime and 5 mg early evening. She has vomiting and fever and asks whether to skip tablets until she can keep food down. What would you advise the patient?