PCP Expansion - Respiratory (Hydrocortisone)

Question 1

Define hydrocortisone

Answer 1

Hydrocortisone is a short-acting corticosteroid medication that is widely used in various medical settings due to its potent anti-inflammatory and immunosuppressive properties

Question 2

How does Hydrocortisone treat an adrenal crisis?

Answer 2

In an adrenal crisis, there is an acute deficiency of cortisol in the body. Hydrocortisone rapidly replaces the deficient cortisol in the body, preventing or reversing the life-threatening symptoms associated with the crisis

Question 2

What medication class is Hydrocortisone in?

Answer 2

Systemic corticosteroid

Question 3

What are the two ways Hydrocortisone decreases inflammation?

Answer 3

• Suppressing the migration of polymorphonuclear leukocytes
• Reversing increased capillary membrane permeability

Question 4

What three factors must be present for Hydrocortisone use?

Answer 4

1. Signs and symptoms
2. Medical history
3. Prescribed hydrocortisone

Question 5

What are the signs and symptoms of adrenal crisis?

Answer 5

• Nausea and vomiting
• Hypoglycemia
• Hypotension
• Weakness
• Dizziness
• Confusion or altered levels of consciousness

Question 6

What medical history does the patient need to have to be eligible for Hydrocortisone administration?

Answer 6

• > 3 weeks of systemic corticosteroid use such as:
  • Prednisone
  • Prednisolone
  • Budesonide
  • Dexamethasone
  • Hydrocortisone
  • Fludrocortisone
  • Methylprednisone
    These medications do NOT include topical, inhaled, intranasal, ocular, otic or intraarticular corticosteroids
• Non compliance or cessation of chronic corticosteroid therapy, including difficulties with compliance because of nausea/vomiting or prolonged illness
• Addison’s disease
• Pituitary insufficiency

Question 7

Define Adrenal Crisis

Answer 7

Adrenal crisis, or acute adrenal insufficiency, is a life-threatening endocrine emergency caused by a lack of cortisol. The key features of adrenal crisis are hypotension and shock. Adrenal crisis requires immediate treatment with hydrocortisone and fluid resuscitation

Question 8

True or false, administration of Hydrocortisone requires clinical consult for PCPs and ACPs

Answer 8

True

Question 9

What is the onset of IV Hydrocortisone?

Answer 9

1 hour

Question 10

What is the duration of IV Hydrocortisone?

Answer 10

Varies

Question 11

What is the peak of IV Hydrocortisone?

Answer 11

Varies

Question 12

What are the contraindications of Hydrocortisone?

Answer 12

• Hypersensitivity to hydrocortisone or other corticosteroids
• Systemic fungal infections

Question 13

Why are systemic fungal infections a contraindication of Hydrocortisone?

Answer 13

Corticosteroids suppress the immune system and can worsen infections

Question 14

What are the three precautions of Hydrocortisone?

Answer 14

• People of all age groups
• Acute traumatic head injuries
• Heart failure or hypertension patients

Question 15

Why are heart failure and hypertension precautions for Hydrocortisone?

Answer 15

Corticosteroids have been associated with fluid retention and electrolyte disturbance

Question 16

What adverse effects are associated with administration of Hydrocortisone?

Answer 16

• Thrombophlebitis
• Burning
• Itching at IV site
• Hypertension
• Hypokalemia
• Hyperglycemia
• Sodium/fluid retention

Question 17

Are adverse effects common with Hydrocortisone?

Answer 17

Patients with adrenal insufficiency experience very few adverse effects from a single dose of hydrocortisone, making its administration safe for the patient

Question 18

Is Hydrocortisone a long or short acting corticosteroid?

Answer 18

Short acting