Hydrocortisone Flashcards
Drug code for Hydrocortisone?
HYC
Presentation and dosage of Hydrocortisone?
Solution for injection: Hydrocortisone phosphate 100mg/1ml solution for injection ampoules
Powder for solution for injection: Hydrocortisone (as Hydrocortisone sodium succinate) 100mg powder for reconstitution with up to 2ml of water.
An ampoule containing 100 milligrams hydrocortisone sodium succinate for reconstitution with up to 2 ml of water.
What is an ampoule?
A small sealed vial which is used to contain and preserve a sample, usually a solid or liquid.
Ampoules are made of glass.
Most commonly used to contain pharmaceuticals and chemicals that must be protected from air and contaminants.
Indications of Hydrocortisone?
Sever or life-threatening asthma
Anaphylaxis
Adrenal crisis, a time-critical medical emergency with an associated mortality
In what patients may adrenal crisis occur?
patients on long-term steroid therapy, either:
as replacement therapy for adrenal insufficiency from any cause
in long-term therapy at doses of 5+mg prednisolone, e.g. for immune-suppression
How would you administer hydrocortisone to patients in established adrenal crisis?
IV administration prefrable
Ensure parenteral hydrocortisone is given prior to transportation
How and when would you administer hydrocortisone to patients with suspected adrenal insufficiency?
Adrenal insufficiency or long-time steroid therapy patients who have become unwell
To prevent them having an adrenal crisis
IM administration is usually sufficient
Would you administer hydrocortisone to a patient where you have doubts about potential adrenal insufficiency?
Yes.
Actions of hydrocortisone?
Glucocorticoid drug that restores blood pressure, blood sugar, cardiac synchronicity and volume.
High levels are important to survive shock
Therapeutic actions of hydrocortisone?
suppression of inflammation and immune response
Contra-Indications of hydrocortisone?
Known allergy to the product/excipients
Cautions of hydrocortisone?
None relevant to a single dose
Avoid intramuscular administration if the patient likely to require thrombolysis
What is thrombolysis/thrombolytic therapy
A treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs.
Side effects of hydrocortisone?
Both sodium phosphate and sodium succinate solutions contain significant amounts of phosphate preservative and may cause stinging or burning sensations
Dosage of hydrocortisone for severe or life-threatening asthma and adrenal crisis?
If there is any doubt of previous steroid administration, it is better to administer further hydrocortisone
There is no toxic dose for hydrocortisone, but advanced hypercortisolemia may rapidly prove fatal
What is hypercortisolemia
a condition involving a prolonged excess of serum levels of cortisol that can develop as a result of disregulatory abnormalities in the hypothalamic-pituitary-adrenal axis or from exogenous-source steroids
What can hypercortisolemia also be known as?
Cushing syndrome
Route of administration of hydrocortisone for severe or life-threatening asthma and adrenal crisis?
Preferably intravenous (SLOW injection over a minimum of 2 minutes to avoid side effects) Otherwise: intramuscular (upper arm or thigh) where IV access is not possible Note that in patients with a larger BMI a longer IM needle will be required.
Dosage and administration of hydrocortisone in adults for sever or life-threatening asthma and adrenal crisis where both IV and IM can be used?
Include initial dose, repeat dose, dose interval, volume and maximum dose.
Adult, 100 milligrams in 1ml Initial dose: 100 milligrams Repeat dose: none Dose interval: N/A Volume: 1ml Maximum dose: 100 milligrams
Dosage and administration of hydrocortisone in adults for sever or life-threatening asthma and adrenal crisis where only IV can be used?
Include initial dose, repeat dose, dose interval, volume and maximum dose.
Adult 100 milligrams in 2ml Initial dose: 100 milligrams Repeat dose: none Dose interval: N/A Volume: 2ml Maximum dose: 100 milligrams
Route of administration of hydrocortisone for anaphylaxis?
intravenous (SLOW injection over a minimum of 2 minutes to avoid side effects)/intraosseous
Intramuscular (when IV access is impossible)
What is intraosseous infusion, why is it used?
The process of injecting directly into the marrow of a bone.
This provides a non-collapsible entry point into the systemic venous system.
When would intraosseous infusion be used over intravenous?
When intravenous access is not available or not feasible.
Dosage and administration of hydrocortisone in adults for anaphylaxis where IV, IM and IO can be used?
Include initial dose, repeat dose, dose interval, volume and maximum dose.
Adult, 100 milligrams in 1ml Initial dose: 200 milligrams Repeat dose: none Dose interval: N/A Volume: 2ml Maximum dose: 200 milligrams
Adult 100 milligrams in 2ml Initial dose: 200 milligrams Repeat dose: none Dose interval: N/A Volume: 4ml Maximum dose: 200 milligrams
