Ace the INBDE Pharmacology Test 2026 – Unlock Your Dental Destiny!

In an acute hypoaldosteronism crisis, the priority is rapid replacement of glucocorticoids and, importantly, support of mineralocorticoid activity to correct hypotension and electrolyte imbalance. Hydrocortisone is the only glucocorticoid with meaningful mineralocorticoid effects, making it the drug of choice for adrenal crises. The hemisuccinate form is water-soluble, allowing quick intravenous administration and fast onset of action, which is crucial in an emergency. This provides the necessary cortisol replacement and some mineralocorticoid activity to stabilize hemodynamics and electrolytes. Prednisone and dexamethasone have little mineralocorticoid activity, so they’re less suitable in this acute setting. Hydrocortisone sodium succinate is also IV hydrocortisone, but the hemisuccinate form is the established rapid IV option for acute crisis.