Final answer:
In response to increased periods of stress, patients with adrenal insufficiency due to hypopituitarism require an adjusted higher dose of cortisol replacement therapy to compensate for their body's inability to produce adequate cortisol.
Step-by-step explanation:
A patient with known adrenal insufficiency secondary to hypopituitarism who is undergoing a period of stress, such as illness or surgery, should be given increased doses of cortisol replacement therapy. This is essential because their body is unable to produce enough cortisol to cope with the increased demands that stress places on the body. The usual stress dosing involves a higher dose of glucocorticoids, which is adjusted according to the severity of the stress.
Cortisol is crucial for the body's long-term stress response, and during stress, the hypothalamus releases corticotropin-releasing hormone (CRH), which triggers the pituitary gland to release adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal glands to produce cortisol. However, in patients with hypofunction of the adrenal cortex, such as those with Addison's disease or secondary adrenal insufficiency due to hypopituitarism, this pathway is compromised, and synthetic cortisol must be provided.