Hydrocortisone

Question 1

What is hydrocortisone?

Answer 1

Hydrocortisone (100mg powder) is an adrenocorticoid steroid with multiple mechanisms of action including anti-inflammatory activity, immunosuppressive properties and anti-proliferative actions.

Onset - 1 to 2 hours
Duration - 6 to 12 hours
Half-life - 1 to 2 hours

Hepatic metabolism with renal excretion.

Question 2

Indications for hydrocortisone?

Answer 2

1. Asthma (excluding mild)
2. Acute exacerbation of COPD (with evidence of respiratory distress)
3. Refractory anaphylaxis with persistent wheeze (unresponsive to 3 x IM adrenaline)
4. Suspected or at risk of an acute adrenal insufficiency (adrenal crisis)

Question 3

Contraindications for hydrocortisone?

Answer 3

1. Allergy/ADR

Question 4

Precautions for hydrocortisone?

Answer 4

1. Hypertension

Question 5

What are the doses of hydrocortisone for an adult?

Answer 5

Asthma, acute exacerbation of COPD & suspected or at risk of an acute adrenal insufficiency (adrenal crisis):
100mg IM/IV
Single dose only
Slow push over 1 min for IV

Refractory anaphylaxis with persistent wheeze:
200mg IM/IV
Single dose only
Slow push over 1 min for IV

Question 6

What are the doses of hydrocortisone for a paediatric?

Answer 6

Asthma & refractory anaphylaxis with persistent wheeze:
4mg/kg IM/IV
Single dose only, not to exceed 100mg
Slow push over 1 min for IV

Suspected or at risk of an acute adrenal insufficiency (adrenal crisis):
IM/IV 
0-4 years - 25mg 
5-10 years - 50mg 
>10 years - 100mg 
Single dose 
Slow push over 1 min for IV