hydrocortisone(redirected from Hycort)
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hydrocortisone sodium succinate
Pharmacologic class: Short-acting corticosteroid
Therapeutic class: Anti-inflammatory (steroidal)
Pregnancy risk category C
Suppresses inflammatory and immune responses, mainly by inhibiting migration of leukocytes and phagocytes and decreasing inflammatory mediators
Cream, gel, lotion, ointment, solution: various strengths
Injection: 25 mg/ml, 50 mg/ml; 100 mg/vial, 250 mg/vial, 500 mg/vial, 1,000 mg/vial
Intrarectal aerosol foam: 90 mg
Oral suspension: 10 mg/5 ml
Retention enema: 100 mg/60 ml
Spray (topical): 1%
Tablets: 5 mg, 10 mg, 20 mg
Indications and dosages
➣ Replacement therapy in adrenocortical insufficiency; hypercalcemia due to cancer; arthritis; collagen diseases; dermatologic diseases; autoimmune and hematologic disorders; trichinosis; ulcerative colitis; multiple sclerosis; proctitis; nephrotic syndrome; aspiration pneumonia
hydrocortisone, hydrocortisone cypionate-
Adults and children: 20 to 240 mg/day P.O.
hydrocortisone acetate (suspension)-
Adults and children: 5 to 75 mg by intra-articular injection (depending on joint size) q 2 to 3 weeks
hydrocortisone acetate (intrarectal foam)-
Adults and children: One applicatorful of intrarectal foam daily or b.i.d. for 2 to 3 weeks; then one applicatorful every other day
hydrocortisone sodium phosphate-
Adults and children: 15 to 240 mg/day subcutaneously, I.M., or I.V., adjusted according to response
hydrocortisone sodium succinate-
Adults and children: 100 to 500 mg I.M. or I.V.; may repeat at 2-, 4-, or 6-hour intervals, depending on response and condition
hydrocortisone retention enema-
Adults and children: 100 mg P.R. at bedtime for 21 nights or until desired response; patient should retain enema for at least 1 hour.
➣ Itching and inflammation caused by skin conditions
Adults and children: Thin film of topical preparation applied to affected area one to four times daily, depending on drug form and severity of condition
• Hypersensitivity to drug, alcohol, bisulfites, or tartrazine (with some products)
• Systemic fungal infections
• Concurrent use of other immunosuppressant corticosteroids
• Concurrent administration of live-virus vaccines
Use cautiously in:
• hypertension, osteoporosis, glaucoma, renal or GI disease, hypothyroidism, cirrhosis, thromboembolic disorders, myasthenia gravis, heart failure
• pregnant or breastfeeding patients
• children ages 6 and younger (safety not established).
• Give oral form with food or milk to avoid GI upset.
• Give I.V. injection of sodium succinate form over 30 seconds to a few minutes.
• Know that drug may be given as intermittent or continuous I.V. infusion. Dilute in normal saline solution, dextrose 5% in water, or dextrose 5% in normal saline solution.
• Inject I.M. deep into gluteal muscle. Rotate injection sites to prevent muscle atrophy.
• Be aware that subcutaneous administration may cause muscle atrophy or sterile abscess.
☞ Never abruptly discontinue high-dose or long-term systemic therapy.
• Know that systemic forms typically are used for adrenal replacement rather than inflammation.
• Be aware that occlusive dressings, heat, hydration, inflammation, denuding, and thinning of skin increase topical drug absorption.
CNS: headache, nervousness, depression, euphoria, personality changes, psychoses, vertigo, paresthesia, insomnia, restlessness, conus medullaris syndrome, meningitis, increased intracranial pressure, seizures
CV: hypotension, hypertension, thrombophlebitis, heart failure, shock, fat embolism, thromboembolism, arrhythmias
EENT: cataracts, glaucoma, increased intraocular pressure, epistaxis, nasal congestion, perforated nasal septum, dysphonia, hoarseness, nasopharyngeal or oropharyngeal fungal infections
GI: nausea, vomiting, esophageal candidiasis or ulcer, abdominal distention, dry mouth, rectal bleeding, peptic ulceration, pancreatitis
Metabolic: sodium and fluid retention, hypokalemia, hypocalcemia, hyperglycemia, hypercholesterolemia, amenorrhea, growth retardation, diabetes mellitus, cushingoid appearance, hypothalamic-pituitary-adrenal suppression with secondary adrenal insufficiency (with abrupt withdrawal or high-dose, prolonged use)
Musculoskeletal: osteoporosis, aseptic joint necrosis, muscle pain or weakness, steroid myopathy, loss of muscle mass, tendon rupture, spontaneous fractures
Respiratory: cough, wheezing, rebound congestion, bronchospasm
Skin: rash, pruritus, urticaria, contact dermatitis, acne, bruising, hirsutism, petechiae, striae, acneiform lesions, skin fragility and thinness, angioedema
Other: altered taste; anosmia; appetite changes; weight gain; facial edema; increased susceptibility to infection; masking or aggravation of infection; adhesive arachnoiditis; injection site pain, burning, or atrophy; immunosuppression; hypersensitivity reactions including anaphylaxis
Drug-drug. Amphotericin B, loop and thiazide diuretics, mezlocillin, piperacillin, ticarcillin: additive hypokalemia
Fluoroquinolones: increased risk of tendon rupture
Hormonal contraceptives: prolonged half-life and increased effects of hydrocortisone
Insulin, oral hypoglycemics: increased requirements for these drugs
Live-virus vaccines: decreased antibody response to vaccine, increased risk of adverse reactions
Nonsteroidal anti-inflammatory drugs: increased risk of adverse GI reactions
Phenobarbital, phenytoin, rifampin: decreased hydrocortisone efficacy
Somatrem: inhibition of growth-promoting effect
Drug-diagnostic tests. Calcium, potassium, thyroxine, triiodothyronine: decreased levels
Cholesterol, glucose: increased levels
Digoxin assays: false elevation (with some test methods)
Nitroblue tetrazolium test: false-negative result
Drug-herbs. Echinacea: increased immunostimulation
Ginseng: potentiation of immunomodulation
Drug-behaviors. Alcohol use: increased risk of gastric irritation and GI ulcers
☞ In high-dose therapy (which should not exceed 48 hours), watch closely for signs and symptoms of depression or psychotic episodes.
• Monitor blood pressure, weight, and electrolyte levels regularly.
• Assess blood glucose levels in diabetic patients. Expect to increase insulin or oral hypoglycemic dosage.
☞ Monitor patient's response during weaning from drug. Watch for adrenal crisis, which may occur if drug is discontinued too quickly.
• Instruct patient to take daily P.O. dose with food by 8 A.M.
☞ Urge patient to immediately report unusual weight gain, face or leg swelling, epigastric burning, vomiting of blood, black tarry stools, irregular menstrual cycles, fever, prolonged sore throat, cold or other infection, or worsening of symptoms.
• Tell patient using topical form not to apply occlusive dressing unless instructed by prescriber.
• Advise patient to discontinue topical drug and notify prescriber if local irritation occurs.
• Instruct patient to eat small, frequent meals and to take antacids as needed to minimize GI upset.
• Tell patient that response to drug will be monitored regularly.
☞ Caution patient not to stop taking drug abruptly.
• In long-term use, instruct patient to have regular eye exams.
• Instruct patient to wear medical identification stating that he's taking this drug.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.
hydrocortisone/hy·dro·cor·ti·sone/ (-kor´tĭ-sōn) the name given to natural or synthetic cortisol when it is used as a pharmaceutical. The base and its salts, including h. acetate, h. butyrate, h. cypionate, h. probutate, h. sodium phosphate, h. sodium succinate, and h. valerate are used as replacement therapy in adrenocortical insufficiency and as antiinflammatory and immunosuppressant agents in the treatment of a wide variety of disorders.
hydrocortisone, hydrocortisone acetate, hydrocortisone cyclopentylpropionate
hydrocortisoneCortisol The principal corticosteroid secreted by the adrenal cortex, which has mineralocorticoid activity, and relieves Sx of certain hormone deficiencies, and is immunosuppressive
hydrocortisoneA natural steroid hormone derived from the outer layer (cortex) of the adrenal gland. The drug CORTISONE is converted into hydrocortisone in the liver. Hydrocortisone has anti-inflammatory and sodium-retaining properties. It is widely used as a mild CORTICOSTEROID drug mainly for skin disorders. The drug is on the WHO official list. Brand names are Colifoam, Corlan, Dioderm, Efcortelan, Efcortesol, Hydrocortistab, Hydrocortone, Midison Lipocream. The drug is also formulated, for external use, with a variety of other drugs such as allantoin, antibiotics, azole antifungal drugs, coal tar extracts, crotamiton (anti-itch drug), hydrating agents, local anaesthetics, zinc oxide, etc. At least 40 preparations containing hydrocortisone are available on the UK drug market.
hydrocortisonean adrenocortical steroid with effects similar to CORTISONE.
glucocorticoidsthe group of corticosteroid hormones (mainly cortisol syn hydrocortisone, of which cortisone is the precursor) produced by the adrenal cortex, under the control of adrenocorticotrophic hormone (ACTH) from the anterior pituitary. Their major actions on nutrient metabolism have the net effect of promoting glucose and free fatty acid availability as fuels. Also vital for normal cellular processes as diverse, for example, as excitation-contraction coupling and the health of connective tissues. Synthetic steroids such as prednisolone and dexamethasone have similar actions and are used in the treatment of, for example, asthma and rheumatic conditions. Banned in sport due to their powerful anti-inflammatory action and effect of producing euphoria and masking pain. (Not to be confused with anabolic steroids). See also adrenal glands, hormones; Table 1.
|Site of production||Name of hormone||Main targets||Involved in regulating:||Secretion controlled by:|
|Hypothalamus||Releasing and inhibiting hormones||Anterior pituitary (via local blood vessels)||Secretion of anterior pituitary hormones||Other brain regions; feedback re regulated hormones and their actions|
|Neurohormones released from posterior pituitary:|
|Oxytocin||Uterus, breasts||Labour and lactation||Afferent information from target organs|
|Antidiuretic hormone (ADH, vasopressin)||Kidneys||Water loss: ECF volume and osmolality||Hypothalamic osmoreceptors|
|Anterior pituitary||(Human) growth hormone (H)GH||Most cells||Growth and metabolism||Hypothalamic releasing and inhibiting hormones via local blood vessels|
|Thyroid-stimulating (TSH)||Thyroid gland||Thyroid secretions|
|Gonadotrophins||Ovary or testis||Germ cell maturation and hormone secretions|
|Adrenocorticotrophic (ACTH)||Adrenal cortex||Cortisol secretion|
|Pineal body||Melatonin||Widespread, including brain, thymus, etc.||Hypothalamus; varying light input from retina|
|Parathyroids||Parathormone||Bone, kidneys, gut||ECF [Ca2+]|
|Medulla||Heart, smooth muscle, glands||Cardiovascular and metabolic adjustments to activity and stress||Sympathetic nervous system|
|Atrial wall||Atrial natriuretic hormone||Kidneys||Blood volume; increases sodium (therefore also water) loss in urine||Stretch of atrial wall by venous pressure|
|Gonads: Testis||Androgens (mainly testosterone)||Genitalia and other tissues||Reproductive function and sex characteristics||Anterior pituitary gonadotrophins|
|Ovary||Uterus, breasts and other tissues||Menstrual cycle, pregnancy, lactation|
|Pancreas||Blood levels, storage and cellular uptake of nutrients, notably glucose, but also proteins and fats||Blood levels of nutrients; autonomic nervous system; other gastrointesinal hormones|
|Stomach||Gastrin||Gastric acid-secreting cells||Gastrointestinal functions: motility, digestive juices and other secretions||Local chemical and mechanical factors in the alimentary tract|
|Small intestine||Several GI functions including bile flow, pancreatic enzyme and exocrine secretions||Ingestion of food, distension of GI tract|
hydrocortisone; cortisol potent, naturally occurring glucocorticoids that suppress inflammation (e.g. topical ointment; intra-articular or enthesis injection)
drug class: corticosteroid;
action: decreases inflammation by suppression of macrophage and leukocyte migration; reduces capillary permeability and inhibits lysosomal enzymes;
uses: severe inflammation, shock, adrenal insufficiency, ulcerative colitis, collagen disorders.
drug class: topical corticosteroid;
action: interacts with steroid cytoplasmic receptors to induce antiinflammatory effects; possesses antipruritic, antiinflammatory actions;
uses: psoriasis, eczema, contact dermatitis, pruritus.