Practice Question
Which glucocorticoid is preferred for routine replacement therapy in adults with primary adrenal insufficiency?
Answer Choices:
Correct Answer:
Hydrocortisone
Rationale:
🔹 Hydrocortisone is preferred for routine replacement in primary adrenal insufficiency because it most closely mimics endogenous cortisol in both potency and duration.
🔹 It has a short half-life, allowing dosing to replicate the normal diurnal rhythm of cortisol (higher dose in the morning, lower in the afternoon).
🔹 Hydrocortisone provides adequate glucocorticoid effects without excessive suppression or prolonged exposure.
🔹 It is well tolerated and easily adjusted during stress, illness, or surgery, which is essential in adrenal insufficiency management.
🔹 For these reasons, it is the standard first-line agent for cortisol replacement in adults.
❌ Why the other options are not preferred
❌ Dexamethasone
🔹 Extremely long-acting and potent, making it difficult to mimic physiologic cortisol patterns and increasing risk of overtreatment.
❌ Fludrocortisone
🔹 Primarily a mineralocorticoid, used to replace aldosterone, not cortisol.
❌ Methylprednisolone
🔹 More potent and longer-acting than hydrocortisone, making it less physiologic for routine replacement.
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This question is from ☑️ EXAM 3 2025 which contains 42 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: General Exams
- Domain: 🚑Pharmacology
- Answer Choices: 4