Patient should be instructed to carry card and warning bracelet/necklace with info about current therapy and emergency treatment recommendations

• Patient should be taught of the nature of hormone deficiency and the rationale of steroid replacement therapy
• Patient should be educated about glucocorticoid adjustments in stressful events and adrenal crisis prevention strategies

Steroid Replacement Therapy

• Glucocorticoid therapy
  • Patient must be taught to double or triple their dose of glucocorticoid replacement temporarily if they have febrile illness or injury
  • If vomiting occurs soon after oral dose, patient should be instructed to take 2^nd dose
  • Glucocorticoid injection should be provided for self-injection in cases of major injury, severe vomiting, acute adrenal insufficiency (AI), if the patient becomes unresponsive

• Mineralocorticoid therapy
  • No need for patient to increase mineralocorticoid therapy during illness unless critically ill
  • Patients should be instructed to maintain adequate salt intake (3-4 g/day)
  • May need to increase dose of Fludrocortisone and to add extra salt to diet during hot weather, times of strenuous exercise, sweating, etc

History of Excessive Steroid Use

• Educate patient about risks of excessive steroid use