The symptoms of needing injected steroids are:
- profound muscle weakness
- low blood pressure
- extreme sleepiness
- possibly headache, chills or fever
- possibly hypovolaemic shock or coma.
As a general rule, the steroid-dependent person should give themselves an emergency injection of 100mg hydrocortisone as soon as they vomit. This will act to stabilise their condition so that further medical advice or treatment can be sought.
The injection buys time in the event of severe illness or injury. It can be given by a friend or family member if the person is too ill to inject themselves. Giving too much steroid during injury or illness will do no harm. Under-replacement in these circumstances is potentially life-threatening, or may have other severe outcomes due to circulatory/cardiovascular complications from low blood pressure.
Further explanation of when to inject can be found in the video interview given by Prof John Wass, Chair of the Addison's Clinical Advisory Panel:
It is important to check that the correct hydrocortisone injection brand has been supplied: hydrocortisone sodium phosphate or sodium succinate-based drug products. Any acetate-based hydrocortisone injection product should be discarded as it would not be effective.
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