Which medication is the patient with Cushing's syndrome least likely to require for management?

In the management of Cushing's syndrome, the primary concern is addressing the excess cortisol levels and its associated metabolic effects. A patient with Cushing's syndrome often experiences complications like hypertension, hyperglycemia, and electrolyte imbalances.

An ACE inhibitor is used primarily to manage hypertension and may not be directly related to the specific complications or treatments associated with Cushing's syndrome. While hypertension is often present, the need for an ACE inhibitor is not a universal requirement, especially when other medications might be more directly indicated. Instead, therapies would generally focus on controlling hyperglycemia or managing potassium levels due to the effects of cortisol on fluid balance and electrolyte metabolism.

In contrast, potassium replacement could be necessary if there is significant hypokalemia, which is often seen in Cushing’s syndrome due to the effects of corticosteroids. Metformin may be needed for managing insulin resistance or hyperglycemia that can occur as a consequence of excess cortisol. A thiazide diuretic might also be indicated, especially if hypertension accompanies fluid retention, which can be observed in these patients.

Thus, while an ACE inhibitor can be beneficial for hypertension, it is not a medication that Cushing’s syndrome patients are specifically required to take, making it the least likely choice among the