Solu-Cortef

Situations requiring rapid & intense hormonal effect eg, acute adrenocortical insufficiency, bilateral adrenalectomy, severe shock, acute hypersensitivity reactions, overwhelming infections w/ severe toxicity, SLE in relapse, aspiration pneumonitis.

Adult Initially 100-500 mg IV over 30 sec-10 min, may be repeated at 2-, 4- or 6-hr intervals. Ped patient Initially 0.56-8 mg/kg daily in 3 or 4 divided doses (20-240 mg/m² daily).

Hypersensitivity. Systemic fungal infections, idiopathic thrombocytopenic purpura. Intrathecal administration.

Not to be used IA, intrabursally or for intratendinous & epidural administration. Avoid deltoid muscle inj, intrathecal route. Discontinue use in Kaposi's sarcoma patients. Not for traumatic brain injury. Not to be used in active ocular herpes simplex. Avoid use in cerebral malaria. Not recommended in optic neuritis & inj into previously infected site. Left ventricular free wall rupture after recent MI; unusual stress, hypothalamic-pituitary adrenal axis suppression, Cushing's syndrome, hyperglycemia; susceptibility to infections; exacerbated systemic fungal infections; latent or active amebiasis; known or suspected Strongyloides (threadworm) infestation; active or latent TB; posterior subcapsular cataracts, glaucoma; cardiac enlargement, CHF, HTN; active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, non-specific ulcerative colitis; osteoporosis; neuromuscular transmission disorders eg, myasthenia gravis; psychic derangements, aggravated existing emotional instability or psychotic tendencies; pheochromocytoma; tumor lysis syndrome. Screen for hepatitis B infection prior to initiation. Monitor IOP in therapy >6 wk; thyroid status during therapy. Dietary salt restriction & K supplementation. Avoid abrupt w/drawal. Avoid exposure to varicella or measles. High-dose & prolonged use. Not to be used w/ live or live-attenuated vaccine. Concomitant use w/ neuromuscular-blocking drugs eg, pancuronium. May affect ability to drive & use machines. Renal insufficiency; cirrhosis. Pregnancy & lactation. Premature infants; growth & development suppression in childn. Elderly ≥65 yr.

Allergic reactions; leukocytosis; CV, dermatologic, endocrinal, GI, ophth reactions; fluid & electrolyte disturbances; -ve nitrogen balance; musculoskeletal, neurologic/psychiatric disorders.

Increased risk of corticosteroid effects w/ CYP3A-metabolized corticosteroids. Loss of corticosteroid-induced adrenal suppression w/ aminoglutethimide. Development of hypokalemia w/ K-depleting agents. Decreased clearance w/ macrolides. Severe weakness in myasthenia gravis patients w/ anticholinesterases. Inhibition of response to warfarin. Increased blood glucose conc by antidiabetics. Decreased INH serum conc. Increased clearance by cholestyramine. Increased activity of both cyclosporine & corticosteroids. Increased risk of arrhythmias due to hypokalemia w/ digitalis glycosides. Decreased hepatic metabolism w/ estrogens. Enhanced metabolism by hepatic enzyme inducers. Increased plasma conc w/ hepatic enzyme inhibitors. Decreased metabolism w/ ketoconazole. Increased risk of GI effects w/ aspirin or other NSAIDs. Increased salicylate clearance. May suppress reactions to skin tests. Diminished response to toxoids & live or inactivated vaccines due to Ab response inhibition. Potentiated replication of some organisms in live-attenuated vaccines.

Corticosteroid Hormones

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

B