Which of the following is the drug of choice for Addison's disease?
High-Yield Explanation
Hydrocoisone is the drug of choice for the acute treatment of an Addisonian crisis. Hydrocoisone has 1% of mineralocoicoid activity of aldosterone so concomitant mineralocoicoid replacement therapy is not needed when large doses of hydrocoisone are needed. As the precipitating illness resolves, hydrocoisone is tapered to maintenance doses over 1 to 3 days. Mineralocoicoid deficiency is treated with saline and fluid loading. Mineralocoicoid replacement therapy with fludrocoisone is staed when the patient is stable and is able to take oral medications. Ref: Textbook of Therapeutics: Drug and Disease Management edited by Richard A. Helms, page 975.