In the management of adrenal disorders, which parameter should be monitored to assess the effectiveness of fludrocortisone therapy?

• A. Blood pressure
• B. Blood sugar
• C. Serum calcium
• D. Renal function

Answer: (A)

Fludrocortisone is a mineralocorticoid that promotes sodium reabsorption and water retention in the kidneys, which increases circulating volume and raises blood pressure. Because its primary therapeutic goal is to restore adequate blood volume and perfusion in adrenal insufficiency, the best way to gauge effectiveness is to monitor blood pressure (including for orthostatic changes). If blood pressure is too low, the dose may need to be increased; if it becomes too high or there are signs of fluid overload, the dose should be reduced.

Electrolytes like potassium and sodium are affected by mineralocorticoid action, so they’re important to monitor, but they don’t directly reflect how well the replacement is working as promptly or clearly as blood pressure does. Blood sugar, serum calcium, and renal function aren’t direct indicators of mineralocorticoid adequacy in this context.