Hydrocortisone

Question 1

Hydrocortisone

Class

Answer 1

Systemic Corticosteroid and anti-inflammatory

Question 2

Hydrocortisone

Presentation

Answer 2

Powder and solvent for solution for injection or infusion.
Vial containing off white powder and vial containing water for injections.
Prepare the solution aseptically by adding not more than 2ml of sterile water for injections to the contents of one 100mg vial, shake and withdraw for use.

Question 3

Hydrocortisone

Administration

Answer 3

Intravenous (IV) Infusion
Intramuscular (IM)
The preferred route for initial emergency use is intravenous

Question 4

Hydrocortisone

Indications

Answer 4

Severe or recurrent anaphylactic reactions
Asthma refractory to Salbutamol and Ipratropium Bromide.
Exacerbation of COPD
Adrenal Insuffiency

Question 5

Hydrocortisone

Contraindications

Answer 5

No major contraindications in acute management of anaphylaxis

Question 6

Hydrocortisone

Dosage

Answer 6

Adult:
Anaphylactic Reaction and COPD
200mg IM or slow IV (over 1 - 10mins) in 100ml NaCl

Asthma: 100mg Slow IV Infusion 100ml NaCl

Adrenal Insufficiency: 100mg IM/IV Infusion Slow 100ml NaCl

Paed:
Anaphylaxis and Asthma (asthma IV only)
< 6 months - 25mg IM or slow IV (over 1 - 10mins)
6 months to < 6 years - 50mg IM or slow IV (over 1 - 10mins)
6 years - <12 years - 100mg IM or slow IV (over 1 - 10mins)
12 years - 200mg IM or Slow IV

Asthma (IV only)
< 1 year - 25mg slow IV Infusion
1 - 5 years - 50mg slow IV Infusion
> 5 years - 100mg Slow IV Infusion
>
Adrenal Insufficiency
6mth - ≤5yrs - 50mg IM or slow IV Infusion
>5yrs - 100mg IM or slow IV Infusion

Question 7

Hydrocortisone

Pharmacology

Answer 7

Potent anti-inflammatory properties and inhibit many substances that cause inflammation.

Question 8

Hydrocortisone

Side Effects

Answer 8

CCF, 
Hypertension, 
Abdominal distension, 
Vertigo, 
Headache, 
Nausea, 
Malaise 
Hiccups

Question 9

Hydrocortisone

Additional Info

Answer 9

Intramuscular injection should avoid the deltoid area because of the possibility of tissue atrophy.
Dosage should not be less than 25mg
IV is the Preferred route for Adrenal Crisis.
If the patient, in an Adrenal Srisis, is still unwell following Hydrocortisone administration prior to arrival of the practitioner, the standard dose of Hydrocortisone should be administered