In a primary adrenal crisis, hydrocortisone helps by?

• A. It directly lowers potassium via kidney
• B. It does not affect mineralocorticoid activity
• C. It only addresses glucose
• D. It provides both glucocorticoid and mineralocorticoid effects to replace cortisol deficiency and support mineralocorticoid activity

Answer: (D)

In a primary adrenal crisis you’re replacing two missing hormones: cortisol and aldosterone. Hydrocortisone fits best because it has both glucocorticoid and mineralocorticoid activity. The glucocorticoid action replaces the missing cortisol, helping with stress response, glucose metabolism, and vascular sensitivity. The mineralocorticoid action supports sodium and water retention and potassium excretion, which helps correct hypotension and electrolyte imbalances characteristic of adrenal insufficiency. This dual replacement addresses the full spectrum of the crisis, whereas a treatment that only affects glucose or lacks mineralocorticoid activity wouldn’t fully correct the underlying deficiency.