Patients should be told to double their dose of hydrocortisone in the event of intercurrent stress or febrile illness. If they cannot take their steroid by mouth (e.g. in the event of surgery or gastroenteritis), it should be given parenterally. All patients should carry a steroid card, or preferably a bracelet or necklace, giving details of their condition.
For minor operations (e.g. dental extraction), 100mg hydrocortisone hemisuccinate should be administered with the premedication. For major surgery, the steroid regime for acute adrenal crisis should be adopted.
