Adrenal and thyroid gland disorders are common among people in the United States, but in their decompensated form, or crisis, they produce exaggerated and/or unique presentations, particularly in patients whose disorder has not yet been diagnosed.1  Inpatient treatment is challenging because symptoms are often nonspecific and may parallel those of multiple other disease states. Delays in care affect morbidity and mortality, which have remained high for these disease states. Severe Cushing syndrome, adrenal crisis, pheochromocytoma, myxedema coma, and thyroid storm are defined by physiologic derangements that may require multimodal drug therapy. This article highlights the pharmacotherapeutic management of various endocrine disease states with respect to common critical presentations and emergency management.

Critical adrenal disorders have 2 forms: Cushing syndrome, which involves cortisol excess, and adrenal insufficiency, which involves a lack of cortisol. Cortisol, a glucocorticoid created by the adrenal cortex, is involved in a wide range of physiological processes,...

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