Hydrocortisone

Question 1

What type of medication is hydrocortisone?

Answer 1

It is a synthetic corticosteroid.

Question 2

What is the mechanism of action of hydrocortisone?

Answer 2

Hydrocortisone is a glucocorticoid drug that reduces the inflammation and suppresses immune response

It does this by acting as a corticosteroid hormone receptor agonist.

The production of the two main results of inflammation (prostaglandins and leukotrienes) are inhibited by the action of glucocorticoids binding to cytosolic glucocorticoid receptors. The cascading effect of this binding results in inhibition of production of cyclooxygenase (both COX-1 and COX-2) as well as other effects, all suppressing an inflammatory response.

https://pubchem.ncbi.nlm.nih.gov/compound/hydrocortisone

Question 3

What is the route, onset, peak and duration of hydrocortisone?

Answer 3

• Route: IV/IM
• Onset: 1-2hrs
• Peak: N/A
• Duration: 6-12hrs

Question 4

What are the adverse effects of hydrocortisone?

Answer 4

Nil for NSW Ambulance

Question 5

What are the contraindications of hydrocortisone?

Answer 5

• Known or suspected allergy to corticosteroids, sodium succinct or sodium phosphate
• Uncontrolled infection except for patients with adrenal insufficiency
• Active peptic ulcer disease

Question 6

and the doses for the uses of hydrocortisone?

Answer 6

• Preparation: 100mg vial - reconstitute with 2mL NaCl (50mg:1mL)
• Indication:
  
  • Adrenal Crisis: Symptomatic patients with Adrenal insufficiency. Patients with an existing Doctor/Specialist or hospital care plan should be administered the dose as stated on the plan.
  • Asthma/Anaphylaxis/COPD exacerbation: <6yo severe/life threatening asthma only, 6yo+ moderate to severe/life threatening asthma.
  • Anaphylaxis patients with persistent wheeze post salbutamol administration.
• <16 yo: 4mg/kg bolus (max bolus 100mg)
  
  • Repeat: Nil
  • Max Total Dose: 4mg/kg (up to 100mg)
• 16yo+: 100mg bolus
  
  • Repeat: Nil
  • Max Total Dose: 100mg

Note: Paramedics should administer the dose stated on the patient’s treatment directive if applicable.