Glucocorticoid Excess

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clinical causes
anesthetic management
treatment

Clinical causes:

-exogenous administration of steroid hormone
-hyperfunction of adrenal cortex ex. adrenocortical adenoma
-ectopic ACTH stimulation syndrome ex. nonpituitary secreting tumor
-Cushings Disease: pituitary secreting tumor

Cushings Syndrome:

-muscle wasting
-weakness
-osteoporosis
-central obesity
-abdominal striae
-glucose intolerance
-hypertension
-altered mental status

Treatment:

-spironolactone (aldosterone anatagonist, K+ sparring)
-potassium supplementation

Anesthetic management:

-hypervolemic patient therefore avoid fluid overload
-hypokalemic patient therefore metabolic alkalosis