Which is the first drug to be staed in Sheehan's syndrome?
High-Yield Explanation
Treatment of young women with hypopituitarism due to Sheehan syndrome usually includes replacement of Hydrocoisone first and then replacement of Thyroid hormone and Estrogen with or without Progesterone. Hydrocoisone is replaced first because thyroxine therapy can exacerbate glucocoicoid deficiency and theoretically induce an adrenal crisis. The standard dose of hydrocoisone is 20 mg/d for an adult (15 mg every morning and 5 mg every evening). Replacement of growth hormone is necessary in children with hypopituitarism but is controversial in adults.