Hydrocortisone Name of the medication: Generic Name (Brand name) Hydrocortisone Solu-cortef, Cortisan Classification: Corticosteroid Dosage, Frequency

and Route: Adverse reactions: Tachycardia, tremor, petechiae

Action:

Indication:

Contraindication:

Nursing interventions:

Adults: IM, IV (hydrocortisone sodium succinate): 100500 mg initially and q 210 hr Acute adrenal insufficiency: 100 mg IV followed by 100 mg q 8 hr in IV fluids. Pediatrics: Oral: 20240 mg/day in single or divided doses.

Hydrocortisone is a corticosteroid used for its antiinflammatory and immunosuppres sive effects. Its antiinflammatory action is due to the suppression of migration of polymorphonucl ear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.

Replacement therapy in adrenal cortical insufficiency Allergic statessevere or incapacitating allergic conditions Short-term inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (SLE), dermatologic diseases (pemphigus), status asthmaticus, and autoimmune disorders Hematologic disorders thrombocytopenic purpura, erythroblastopenia Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas Intra-articular or softtissue administration: Arthritis, psoriatic

Viral/fungal infections, tubercular or syphilitic lesions, bacterial infections unless used in conjunction with appropriate chemotherapy.

WARNING: Give daily before 9 AM to mimic normal peak diurnal corticosteroid levels and minimize HPA suppression. Space multiple doses evenly throughout the day. Do not give IM injections if patient has thrombocytopenic purpura. Rotate sites of IM repository injections to avoid local atrophy. Use minimal doses for minimal duration to minimize adverse effects. Taper doses when discontinuing high-dose or long-term therapy. Arrange for increased dosage when patient is subject to unusual stress. Ensure that adequate

plaques Retention enema: For ulcerative colitis, proctitis Dermatologic preparations: To relieve inflammatory and pruritic manifestations of dermatoses that are steroid responsive

amount of Ca2+ is taken if prolonged administration of steroids. Use alternate-day maintenance therapy with short-acting corticosteroids whenever possible. WARNING: Do not give live virus vaccines with immunosuppressive doses of hydrocortisone. Provide antacids between meals to help avoid peptic ulcer. Advise patient to take it with meals or snacks if GI upset occurs.