Rifampicin-Induced Adrenal Crisis In Addisonian Patients Receiving Corticosteroid Replacement Therapy

摘要: Rifampicin induced profound alterations in cortisol metabolism when administered to three patients with primary adrenal failure receiving adequate corticosteroid replacement therapy. In one patient, crisis was precipitated after the institution of rifampicin therapy for treatment coexistent tuberculosis and another, asthenia, decrease blood pressure, hyperkalemia, hyponatremia developed during hydrocortisol kinetic study. The clinical symptoms subsided electrolyte abnormalities were corrected approximately 7 days withdrawal. half-life area under curve decreased by 35% 23%, respectively, whereas systemic clearance increased administration. It appears, that effectiveness glucocorticoids mineralocorticoids greatly impaired administration due induction liver steroid-metabolizing enzymes. is strongly recommended compromised function, must be accompanied doubling or tripling dose steroids maintain steroid