Hydrocortisone is usually the corticosteroid of choice for replacement therapy in patients with adrenocortical insufficiency, because these drugs have both glucocorticoid and mineralocorticoid properties. Concomitant administration of a more potent mineralocorticoid (fludrocortisone) may be required in some patients. For anti-inflammatory or immunosuppressive uses, synthetic glucocorticoids which have minimal mineralocorticoid activity are preferred.

Hydrocortisone (cortisol) is a glucocorticoid secreted by the adrenal cortex.

Most glucocorticoids are rapidly removed from the blood and distributed to muscles, liver, skin, intestines, and kidneys. Glucocorticoids cross the placenta and may be distributed into milk. Pharmacologically active glucocorticoids are metabolized in most tissues, but primarily in the liver, to biologically inactive compounds. Inactive metabolites are excreted by the kidneys, primarily as glucuronides and sulfates, but also as unconjugated products.

Hypersensitivity, during the immediate and early post-operative period after ileocolostomy; systemic fungal infection.

C

Safe; single dose systemically administered corticosteroids are secreted into breast milk in quantities not likely to have an adverse effect on the infant.

Adverse effects associated with long-term systemic use include fluid retention, hypertension, euphoria, depression, adrenal suppression, hyperglycemia, growth suppression, gastrointestinal upset, cataracts, glaucoma, osteoporosis, and infection. Topical products may cause burning, itching, or irritation.

Initial, 100 to 500 mg IV; may repeat at intervals of 2, 4, or 6 hours IV/IM as indicated by response and clinical condition.Continue high-dose corticosteroid therapy only until patient condition has stabilized and limit high-dose therapy to 48 to 72 hours due to risk for hypernatremia; may switch to methylPREDNISolone sodium succinate in such conditions if required

Hydrocortisone sodium succinate 250 mg/L is physically compatible with D5W.Continue high-dose corticosteroid therapy only until patient condition has stabilized and limit high-dose therapy to 48 to 72 hours due to risk for hypernatremia; may switch to methylPREDNISolone sodium succinate in such conditions if required