Hydrocortisone

Question 1

Drug class

Answer 1

Corticosteroid

Question 2

Pharmacology

Answer 2

Adrenocortical steroid that produces an anti-inflammatory process. Inhibits the accumulation of inflammatory cells at inflammation sites, phagocytosis, lysomal enzyme release & synthesis and/or release of mediators of inflammation. Additionally, it prevents & suppresses cell mediated immune reactions.

Question 3

Metabolism

Answer 3

Hepatic, renal excretion

Question 4

Indications

Answer 4

• Asthma (mod-severe)
• Acute exacerbation of COPD (with resp distress)
• Refractory anaphylaxis with persistent wheeze (unresponsive to 3x IM adrenaline)
• Symptomatic adrenal insufficiency (known Hx Addison’s, congenital adrenal hyperplasia, pan-hypopituitarism or long term steroid admin)

Question 5

Contraindications

Answer 5

Allergy and/or adverse drug reaction

Question 6

Precautions

Answer 6

Hypertension

Question 7

Side effects

Answer 7

Nil

Question 8

Presentation

Answer 8

100mg vial

Question 9

Onset

Duration

Answer 9

IV
O - 1-2hrs
D - 6-12hrs

Question 10

Routes of administration

Answer 10

IM

IV

Question 11

Special notes

Answer 11

Each 100mg vial needs to be reconstituted with 2ml sodium chloride

Question 12

Adult dosages

Answer 12

• Asthma
• Acute exacerbation of COPD
• Symptomatic adrenal insufficiency

▪︎IM & IV 100mg, single dose only
* IV slow push over 1 min

• Refractory anaphylaxis with persistent wheeze (& unresponsive to 3x IM adrenaline)

▪︎IM & IV 200mg, single dose only
*IV slow push over 1min

Question 13

Paediatric dosages

Answer 13

• Asthma
• Refractory anaphylaxis with persistent wheeze

IM & IV 4mg/kg, single dose only, not to exceed 100mg
* IV slow push over 1 min

• Symptomatic adrenal insufficiency

IM & IV 
0-4yrs - 25mg
5-10yrs - 50mg
>10yrs - 100mg
*Single dose only
*IV slow push over 1min