Which is appropriate in response to hypoaldosteronism?

Which is appropriate in response to hypoaldosteronism?

• A. Hydrocortisone Hemisuccinate 100 mg
• B. Hydrocortisone Hemisuccinate 50 mg
• C. Hydrocortisone Hemisuccinate 25 mg
• D. 2ml (100 mg) Hydrocortisone Hemisuccinate

Answer: (D)

In acute hypoaldosteronism or suspected adrenal crisis, the priority is rapid glucocorticoid replacement with hydrocortisone, which also provides some mineralocorticoid effect. The best initial approach is an intravenous bolus of hydrocortisone hemisuccinate, 100 mg (commonly given as a 2 ml vial). This delivers fast cortisol replacement and supports vascular tone and electrolyte balance while stabilization continues. The IV route and the 100 mg dose are standard for emergent management, with follow-up dosing (for example, 50 mg IV every 6 hours or 100 mg every 8 hours) to maintain replacement. Lower single doses, such as 50 mg or 25 mg, would not be adequate for immediate, life-supporting therapy in this setting.

In acute hypoaldosteronism or suspected adrenal crisis, the priority is rapid glucocorticoid replacement with hydrocortisone, which also provides some mineralocorticoid effect. The best initial approach is an intravenous bolus of hydrocortisone hemisuccinate, 100 mg (commonly given as a 2 ml vial). This delivers fast cortisol replacement and supports vascular tone and electrolyte balance while stabilization continues. The IV route and the 100 mg dose are standard for emergent management, with follow-up dosing (for example, 50 mg IV every 6 hours or 100 mg every 8 hours) to maintain replacement. Lower single doses, such as 50 mg or 25 mg, would not be adequate for immediate, life-supporting therapy in this setting.