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Adrinaline

The document discusses disorders of the adrenal gland, focusing on adrenal insufficiency (Addison's disease) and Cushing's syndrome. Addison's disease results from inadequate adrenal cortex function, leading to symptoms like muscle weakness and low blood pressure, while Cushing's syndrome is characterized by excess adrenal hormone secretion. Management strategies for both conditions include medication, surgical interventions, and lifestyle adjustments to restore hormonal balance and address symptoms.

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deepak
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9 views29 pages

Adrinaline

The document discusses disorders of the adrenal gland, focusing on adrenal insufficiency (Addison's disease) and Cushing's syndrome. Addison's disease results from inadequate adrenal cortex function, leading to symptoms like muscle weakness and low blood pressure, while Cushing's syndrome is characterized by excess adrenal hormone secretion. Management strategies for both conditions include medication, surgical interventions, and lifestyle adjustments to restore hormonal balance and address symptoms.

Uploaded by

deepak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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DISORDERS OF ADRENAL GLAND

• There are two adrenal glands inn the human, each attached to
the upper portions of a kidney. It comprises of two parts-
Adrenal medulla and Adrenal cortex. The main functions of
adrenal medulla is to promote catabolism of stored food to
meet the caloric needs from endogenous sources. A functioning
adrenal cortex is necessary for life; adrenocortical secretions
make it possible for body to adapt to stress of all kind. There are
three types of steroid hormones produced by adrenal cortex-
glucocorticoid, mineralocorticoid and androgens. Without
adrenal cortex, severe stress would cause peripheral circulatory
failure, circulatory shock .
• Adrenal gland disorders includes:
• Adrenal insufficiency (Addison’s disease)
Adrenal insufficiency
• Adrenocortical insufficiency includes all
conditions in which production of one or more
adrenal cortical hormones are impaired. It
may be due to a congenital defect or
destruction of adrenal gland.
Addison’s disease
PATHOPHYSIOLOGY
Inadequate functioning of adrenal cortex, surgical removal of both
adrenal glands, infection of adrenal gland( TB and histoplasmosis),
therapeutic use of corticosteroids

Destruction of adrenal gland tissues

Adrenal insufficiency

Suppression of body’s normal response to stress

Addison’s disease characterized by muscle weakness, anorexia,


GIT symptoms, fatigue, dark pigmentation of skin, knuckles,
knees, elbows and mucous membrane, low blood glucose levels,
low serum sodium levels and high serum potassium levels
Mental status changes such as depression, apathy, confusion

Disturbance of sodium and potassium metabolism marked by depletion


of sodium and water

Chronic dehydration

Acute hypotension, develops addisonian crisis characterized by cyanosis


and classic signs of circulatory shock: pallor, apprehension, rapid and
weak pulse, rapid respirations and low BP
Management
• Restoring blood circulating, administering fluids and corticosteroids,
monitoring vital signs and placing the patient in a recumbent
position with the legs elevated.
• Hydrocortisone is administered intravenously, followed with 5%
dextrose in normal saline. Vasopressor amines may be required if
hypotension persists.
• Antibiotics may be administered if infection has precipitated .
• Oral intake be initiated as soon as tolerated. Intravenous fluids are
decreased when oral fluids are decreased when oral intake is
adequate.
• Additional supplementary therapy with glucocorticoids during
stressful procedures or significant illness to prevent addisonian
crisis.Additionally ,the patient may need to supplements dietary
intake with added salt during times of gastrointestinal losses of fluids
through vomiting and diarrhea.
Cushing’s syndrome

Cushing’s syndrome is characterized by


excess secretion of adrenal cortex hormones.
ETIOLOY
The causes are divided in to three categories:
Iatrogenic causes: excessive cortisol level from chronic
therapy with glucocoticoids.
excessive cortisol production from adrenal neoplasms
such as or adenomas or carcinomas.
Secondary cause: excessive production of
adrenocorticotropic hormone from the anterior
pituitary gland due to pituitary carcinomas or due to
ectopic acth secretion by neoplasms of lungs, kidneys,
pancreas, thyroid etc.
RISK FACTOR
• Women are five times more likely than men
• Women of age 20 -40 years
• Long term corticosteroid therapy
• Family history
(DUE TO
dehydroepiandrostero
ne sulfate/DHEAS)
pathophysiology
Use of corticosteriods medications and is infrequently due to
excessive corticosteriod production by the adrenal cortex,
tumors of pituitary glands
ACTH production and stimulation of adrenal cortex to
increase its hormone secretion
Inaffective normal feedback mechanism that control the
function of adrenal cortex
Loss of usual diurnal pattern of cortisol
Over production of glucocorticoids and androgens(sex
hormone)
Cushing syndrome
Management

• Surgical removal of the tumor by transsphenoidal


hypophysectomy is the treatment of choice.
• Radiation of the pituitary gland
• Adrenalectomy in case of primary adrenal hypertrophy
• Adrenal enzyme inhibitors( eg. Metyrapone, Amino
glutathimide, Mitotane, Ketoconazole) may be used to
reduce hyperadrenalism.
• If Cushing syndrome is a result of administration of
corticosteroids then adjust the medication to the
minimum doses needed to treat the underlying disease
process ( Autoimmune and allergic diseases).
Nursing management:
Nursing diagnosis:
® Risk for infection related toexposure to environmental pathogens and
suppression of immune system secondary to hypercortisolism.
® Risk for injury : fracture related to decreased muscle strength, fatigue,
osteoporosis, and increased protein catabolism.
® Altered nutrition: more than body requirements related to increasing
appetite and intake of high-calorie foods and inactivity as manifested
by statement of increased appetite; preference for fatty, sweet foods;
weight 10% or more than optimum for height; inappropriate menu
choices.
® Activity intolerance related to weaknes,fatigue, muscle
wasting, and altered sleep pattern.
® Impaired skin integrity
® Disturbed body image
Conclusion:

• Metabolic disorders include a number of


disorders, which can cause a number of
problems in an individual. Allthough , it is not
possible to avoid such diseases, yet the early
detection and in time management results in
almost complete recovery of the person.

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