hydrocortisone

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Related to Hycort: Hydrocortisone acetate, Lanacort

hydrocortisone

 [hi″dro-kor´tĭ-sōn]
the pharmaceutical term for cortisol, the principal glucocorticoid secreted by the adrenal gland; 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 in replacement therapy for adrenocortical insufficiency and as antiinflammatory and immunosuppressant agents in the treatment of a wide variety of disorders.

hydrocortisone

Ala-Cort, Ala-Scalp, Cetacort, Colocort, Cortef, Cortenema, Hi-Cor, Hycort (CA), Hytone, Stie-Cort, Synacort, Texacort

hydrocortisone acetate

Cortifoam, Hydrocortistab (UK)

hydrocortisone butyrate

Locoid

hydrocortisone sodium succinate

A-hydroCort, Solu-Cortef

hydrocortisone valerate

Westcort

Pharmacologic class: Short-acting corticosteroid

Therapeutic class: Anti-inflammatory (steroidal)

Pregnancy risk category C

Action

Suppresses inflammatory and immune responses, mainly by inhibiting migration of leukocytes and phagocytes and decreasing inflammatory mediators

Availability

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

Off-label uses

• Phlebitis

• Stomatitis

Contraindications

• 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

Precautions

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).

Administration

• 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.

Adverse reactions

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

Hematologic: purpura

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

Interactions

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

Patient monitoring

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.

Patient teaching

• 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.

hy·dro·cor·ti·sone

(hī'drō-kōr'ti-sōn),
The principal glucocorticoid produced by the adrenal cortex. Although synthetic products used medicinally are usually known by this name, the natural hormone is more often called cortisol. See: cortisol.

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

(hī′drə-kôr′tĭ-sōn′, -zōn′)
n.
1. The steroid hormone cortisol.
2. A preparation of this hormone obtained from natural sources or produced synthetically and used to treat inflammatory and allergic conditions and adrenal failure.

hydrocortisone

[-kôr′tisōn]
a topical corticosteroid.
indication It is prescribed for the topical treatment of skin inflammation.
contraindications Viral and fungal diseases of the skin that occur where circulation is impaired or known hypersensitivity to steroids prohibits its use.
adverse effects Among the more serious adverse effects are various systemic side effects that may result from prolonged or excessive use. Local irritation of the skin may occur.

hydrocortisone, hydrocortisone acetate, hydrocortisone cyclopentylpropionate

See cortisol.

hydrocortisone

Cortisol The principal corticosteroid secreted by the adrenal cortex, which has mineralocorticoid activity, and relieves Sx of certain hormone deficiencies, and is immunosuppressive

hy·dro·cor·ti·sone

(hī'drō-kōr'ti-sōn)
A steroid hormone secreted by the cortex of the suprarenal gland and the most potent of the naturally occurring glucocorticoids in humans.
Synonym(s): cortisol.

hydrocortisone

A 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.

cortisol

or

hydrocortisone

an adrenocortical steroid with effects similar to CORTISONE.

Hydrocortisone

A steroid hormone produced by the adrenal glands that provides resistance to stress.

glucocorticoids

the 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.
Table 1: Hormones
Site of productionName of hormoneMain targetsInvolved in regulating:Secretion controlled by:
HypothalamusReleasing and inhibiting hormonesAnterior pituitary (via local blood vessels)Secretion of anterior pituitary hormonesOther brain regions; feedback re regulated hormones and their actions
Neurohormones released from posterior pituitary:
OxytocinUterus, breastsLabour and lactationAfferent information from target organs
Antidiuretic hormone (ADH, vasopressin)KidneysWater loss: ECF volume and osmolalityHypothalamic osmoreceptors
Anterior pituitary(Human) growth hormone (H)GHMost cellsGrowth and metabolismHypothalamic releasing and inhibiting hormones via local blood vessels
ProlactinBreastsMilk production
Trophic hormones:
Thyroid-stimulating (TSH)Thyroid glandThyroid secretions
GonadotrophinsOvary or testisGerm cell maturation and hormone secretions
Adrenocorticotrophic (ACTH)Adrenal cortexCortisol secretion
Pineal bodyMelatoninWidespread, including brain, thymus, etc.
  • Sleep/wake cycle
  • Antioxidant
  • Immune system
Hypothalamus; varying light input from retina
Thyroid
  • Thyroxine
  • Triiodothyronine
  • Calcitonin
  • Most cells
  • Bone, kidneys, gut
  • Cellular oxidative metabolism
  • Decreases ECF [Ca2+]
  • TSH from anterior pituitary. Negative feedback from blood hormone concentration
  • ECF [Ca2+]
ParathyroidsParathormoneBone, kidneys, gut
  • Calcium and phosphorus absorption, secretion and turnover in bone.
  • Increases ECF [Ca2+]
ECF [Ca2+]
Adrenal: Cortex
  • Cortisol
  • Aldosterone
  • Androgens
  • Most cells
  • Kidneys
  • Gonads & other tissues
  • Metabolism
  • Response to stress
  • Na and K balance
  • Sex characteristics and reproductive function
  • ACTH from anterior pituitary
  • ECF [Na+] [K+]
  • Renin-angiotensin
  • ACTH
Medulla
  • Adrenaline
  • Noradrenaline
Heart, smooth muscle, glandsCardiovascular and metabolic adjustments to activity and stressSympathetic nervous system
Atrial wallAtrial natriuretic hormoneKidneysBlood volume; increases sodium (therefore also water) loss in urineStretch of atrial wall by venous pressure
Gonads: TestisAndrogens (mainly testosterone)Genitalia and other tissuesReproductive function and sex characteristicsAnterior pituitary gonadotrophins
Ovary
  • Oestrogens
  • Progesterone
Uterus, breasts and other tissuesMenstrual cycle, pregnancy, lactation
Pancreas
  • Insulin, glucagon
  • Somatostatin
  • Most cells
  • Other secretory cells in the pancreas
Blood levels, storage and cellular uptake of nutrients, notably glucose, but also proteins and fatsBlood levels of nutrients; autonomic nervous system; other gastrointesinal hormones
Alimentary tract
StomachGastrinGastric acid-secreting cellsGastrointestinal functions: motility, digestive juices and other secretionsLocal chemical and mechanical factors in the alimentary tract
Small intestine
  • Secretin
  • Cholecystokinin- pancreozymin (CCK-PZ)
  • Somatostatin, motilin
  • Other peptide hormones including vasoactive intestinal peptide (VIP)
  • Widespread on
  • GI tract
Several GI functions including bile flow, pancreatic enzyme and exocrine secretionsIngestion of food, distension of GI tract

hydrocortisone

; cortisol potent, naturally occurring glucocorticoids that suppress inflammation (e.g. topical ointment; intra-articular or enthesis injection)

hy·dro·cor·ti·sone

(hī'drō-kōr'ti-sōn)
Principal glucocorticoid produced by the cortex of the suprarenal gland. Although synthetic products used medicinally are usually known by this name, the natural hormone is more often called cortisol (q.v.).

hydrocortisone (hī´drōkôr´tisōn),

n (cortisol), a glucocorticosteroid secreted by the adrenal cortex in response to stimulation by ACTH. Hydrocortisone is antianabolic, stim-ulates gluconeogenesis, and probably acts on some cellular system in response to a need for adaptation to change (stress).
hydrocortisone acetate/hydrocortisone sodium phosphate/hydrocortisone sodium succinat,
n brand names: Cortef, Cortifoam, Cortenema;
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.
hydrocortisone acetate/hydrocortisone valerate,
n brand names: Acticort, Cortaid, Cort-Dome, Dermicort;
drug class: topical corticosteroid;
action: interacts with steroid cytoplasmic receptors to induce antiinflammatory effects; possesses antipruritic, antiinflammatory actions;
uses: psoriasis, eczema, contact dermatitis, pruritus.

hydrocortisone

the pharmaceutical term for cortisol, the principal glucocorticoid secreted by the adrenal gland; it is used in the treatment of inflammations, allergies, pruritus, collagen diseases, adrenocortical insufficiency, and certain neoplasms. The soluble salts, sodium succinate and sodium phosphate, are used intravenously in the treatment of shock.