Hydrocortisone

Question 1

What is the trade name for hydrocortisone?

Answer 1

Cortef, Anusol HC, Caldecort, Colocort

Question 2

What is the drug classification for hydrocortisone?

Answer 2

Adrenal corticosteroid; Glucocorticoid

Question 3

How is hydrocortisone supplied?

Answer 3

Injection powder for reconstitution 100mg, 250mg, 500mg, and 1g.

Question 4

Describe the MOA (pharmacodynamics) of hydrocortisone.

Answer 4

❑ Inhibits accumulation of inflammatory cells at inflammation sites, phagocytosis, lysosomal enzyme release, synthesis and or release of mediators of inflammation.
❑ Reverses increased capillary permeability
❑ Prevents/suppresses cell-mediated immune reactions. Decreases/prevents tissue response to inflammatory process

Question 5

List the indications for hydrocortisone use.

Answer 5

• Management of adrenocortical insufficiency, anti-inflammatory, immunosuppressive
• Management of septic shock unresponsive to fluid and vasopressor therapy

Question 6

What is the dose for hydrocortisone?

Answer 6

• Adult: 100 mg SIVP/IO; reconstitution – as per manufactures instructions; may further dilute with NS; for IVP dilute to 50mg/ml
• Pediatric: 1 – 2 mg/kg slow IV. (Don’t use a low dose or less than 25 mg daily)

Question 7

List the contraindications to hydrocortisone.

Answer 7

• Hypersensitivity to hydrocortisone
• Systemic Fungal infections
• Tuberculosis

Question 8

List some precautions for hydrocortisone use.

Answer 8

• Thyroid dysfunction
• Cirrhosis
• Hypertension
• Seizure disorder
• Diabetes
• Acute MI

Question 9

Is hydrocortisone practical for septic patients?

Answer 9

Impractical for the majority of septic patients as most will not have received adequate fluid / vasopressor
resuscitation