Hydrocortisone IV

Question 1

Dose of hydrocortisone in anaphylaxis

Answer 1

200mg IV

Question 2

Dose of hydrocortisone in acute severe asthma

Answer 2

100-500mg iv every 6 hours or step down to 40mg oral prednisolone

Question 3

Contraindications of hydrocortisone

Answer 3

None in life threatening anaphylaxis/asthma

Long term use - cushing’s syndrome, adrenal insufficiency if stopped suddenly

Question 4

Side effects of hydrocortisone

Answer 4

Vertigo, headache, psychiatric disturbance, increased ICP with papilloedema

Long term use can cause cushings

Question 5

What interacts with hydrocortisone?

Answer 5

Anticholinergics
CNS depressants - don’t give sedatives in asthma attack
Lithium, alcohol.

Question 6

How is hydrocortisone eliminated

Answer 6

Metabolised by liver, excreted in urine

Question 7

How does hydrocortisone work?

Answer 7

Corticosteroid - decreases formation, storage and release of histamines from mast cells
Potentiates response to circulating catecholamines