What is the recommended dose adjustment of glucocorticoids a patient with Addison's disease requires before surgery?

In the context of Addison's disease, patients have an impaired adrenal response and may not produce enough glucocorticoids, especially in times of stress such as surgery. Therefore, it's crucial to provide adequate glucocorticoid coverage during such procedures to prevent adrenal crisis.

The recommended management strategy typically involves increasing the glucocorticoid dose before surgery to ensure that the patient's physiological and metabolic needs are met, particularly in response to the stress of surgery. The standard guideline suggests a dose adjustment where the usual maintenance dose of glucocorticoids is increased, often by about threefold for moderate to high-stress procedures. This helps to mimic the body’s natural response during times of stress, ensuring that the patient maintains hemodynamic stability and normal metabolic function.

In summary, the appropriate adjustment calls for tripling the patient's usual glucocorticoid dosage prior to surgery, thus effectively managing the additional physiological stress placed on the body during the surgical procedure.