Hydrocortisone

 


Other Names

    Solu-Cortef


Classification

•Steroid


Action

•Hydrocortisone is a short-acting synthetic steroid with both glucocorticoid and mineralocorticoid properties that affect nearly all systems of the body. By inhibiting the formation, storage and release of histamine from mast cells, it reduces the effects of an allergic response. It also increases the body’s response to circulating catecholamines.


Indications

  1. To reduce inflammation during an allergic reaction, severe anaphylaxis, asthma, or COPD.

  2. To treat urticaria.


Contraindications

  1. Hydrocortisone is contraindicated in patients with hypersensitivity to glucocorticoids.

  2. In treatment of anaphylaxis, there are no absolute contraindications.

  3. In the prehospital phase of care, give only a single bolus.

  4. Long-term steroid therapy can cause gastrointestinal bleeding, prolonged wound healing , and suppression of the adrenocortical steroids.  Patients on long term steroidal care may require additional steroids during crisis (because their bodies can’t manufacture enough on their own)


Precautions

•No information identified.


Adverse Reactions

  1. Multiple adverse reactions, but few that are relevant or critical in the prehospital setting.

  2. Vertigo , headache, nystagmus, ataxia, increased intracranial pressure with papilledema , mentally disturbances, aggravation of preexisting psychiatric conditions, insomnia, syncopal episodes, thrombophlebitis, thromboembolism, palpitation, tachycardia, necrotizing angiitis, decreased glucose tolerance, hypocorticism , amenorrhea and menstrual difficulties.

  3. The elderly and the patient with low serum albumin are specially susceptible to adverse or side effects.


Interactions/Compatibility/Stability

•Anticholinergics, CNS depressants

•Lithium and alcohol use


Special Considerations

•Inject IM preparation deep into gluteal muscle

•IV Administration: IV hydrocortisone may be given by direct IV indiluted in NS or D5W. Administer at a rate of 25 mg or a fraction thereof over 1 min.

•IV administration in infants, children: verify correct IV concentration and rate of infusion/injection with medical control

  1. Solutions that have been diluted for IV infusion should be administered within 24 hrs of dilution.


Dosages

Adult: 40-250 mg IV/IM.

Pediatric :4-8 mg/kg/IM/IV


Kinetics

No information discovered.




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