What is an appropriate intervention in a patient taking exogenous steroids who develops severe hypotension?

In a patient taking exogenous steroids who develops severe hypotension, administering hydrocortisone is a critical intervention. Exogenous steroids, such as hydrocortisone, are often prescribed for conditions like adrenal insufficiency or inflammatory diseases. These steroids can affect the body's response to stress and fluid balance, and in some cases, can lead to adrenal crisis, especially if the patient's body is unable to produce sufficient cortisol in response to stress or illness.

When such a patient experiences severe hypotension, this may indicate a deficiency in cortisol, which is essential for maintaining vascular tone and responsiveness, particularly in challenging situations like hypotension. Hydrocortisone administration can help restore the patient’s cortisol levels, improving hemodynamic stability and supporting the body's ability to respond appropriately to stress.

Other interventions, such as vasopressin, atropine, or calcium chloride, do not address the underlying issue of inadequate steroid hormone levels in this specific context related to exogenous steroid use. Therefore, hydrocortisone is the most appropriate choice for managing this patient’s severe hypotension linked to steroid use.