Hydropac

Hydrocortisone Na succinate

Substitution therapy in adrenal insufficiency states where high levels of hydrocortisone are required rapidly, & in patients w/ adrenal insufficiency prior to surgery, shock, severe trauma or other stress conditions. Symptomatic relief of inflammatory conditions & as an immunosuppressant.

IM/IV 100-500 mg tds-qds, IM, IV or IV infusion in 24 hr depending on the severity & response. Childn 6-12 yr 100 mg, 1-5 yr 50 mg, up to 1 yr 25 mg.

Hypersensitivity to corticosteroids. TB; ocular herpes simplex; primary glaucoma; acute psychosis & psychoneurosis; systemic infection; peptic ulcer; osteoporosis.

May mask infections. Do not give live vaccines in patients on high dosed treatment. Regularly check patients on long course therapy for HTN, glycosuria, hypokalemia, gastric discomfort & mental changes. Na intake may be reduced & K supplements may be administered. Daily mass records may indicate fluid retention & back pain may signify osteoporosis. Increased risk of raised ICP in childn. Treat infections as emergency. Give large doses by infusion to prevent CV collapse. Enhanced metabolism & reduced effects w/ barbiturates, phenytoin or rifampicin. Reduced response to anticoagulants. May cause excessive K loss w/ K-depleting diuretics.

May cause electrolyte disturbances characterized by HTN, & oedema due to Na & water retention, & increased K excretion, which may cause hypokalaemic alkalosis. Increased susceptibility to infection (eg, sepsis fungal & viral) & delayed wound healing. Cardiac failure. Peptic ulcerations w/ haemorrhage & perforation. Glycosuria; osteoporosis & spontaneous fractures. Increased appetite. Posterior subcapsular cataract. Adrenal cortex atrophy, acute adrenal insufficiency in prolonged treatment. Cushing syndrome. Growth inhibition or arrest in childn. Amenorrhoea. Behavioural disturbances including mental & neurological disturbances. Intracranial HTN. Thrombo-embolic complications; lymphocytopaenia. Myopathy. Hyperglycaemia w/ accentuation or precipitation of diabetic state; increased insulin requirements of diabetics. Hyperhidrosis & aseptic necrosis of bone.

May increase clearance & require increased doses w/ hepatic enzyme inducers eg, phenobarbital, phenytoin & rifampin. May inhibit metabolism & decrease clearance w/ troleandomycin & ketoconazole. May increase clearance of chronic high dose aspirin which may lead to decreased salicylate serum levels or increased risk of salicylate toxicity when corticosteroid is w/drawn. Use w/ aspirin cautiously in patients suffering from hypoprothrombinemia. May enhance & diminish effects of anticoagulants; monitor coagulation indices to maintain desired anticoagulant effect.

Corticosteroid Hormones

H02AB09 - hydrocortisone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.