The bio-availablity of hydrocortisone is about 50 % after oral administration. It is metabolised in the hepatic microsomal enzymes. It is 90% plasma protein bound. The plasma half life is 1.5 hours.
ACUTE ADRENO-CORTICAL FAILURE: 100mg 8 hourly.
STATUS ASTHMATICUS: 100-200mg 6hrly
ANAPHYLAXIS: 100-500mg 6 hrly treatment with IM OR SC adrenaline is recommended.
FULMINANT SYSTEMIC LUPUS:
JOINT INFLAMMATIONS: 5-50mg inj.
A natural corticosteroid used for anti-inflammatory and immunosuppressive effects as well as hormone replacement therapy, systemic and topical use. ANti-inflammatory action is independent of the challenge and depends on the redution in the production of various vasoactive inflammatory mdediators. The typical effect of systemic steroids include glucose intolerance, increased catabolism, redistrubutionof dody fat, lipolysis, sodium and water retention, muscular weakness, osteoporosis, etc. these are not seen at doses for replacement therapy. Long term use will lead to suppressionof pituitary-adrenal axis.
Hydrocortisone has reduced efficacy with concurrent use of carbamazepine, phenytoin, primidone and barbiturates. It has enhanced effect in women taking oral contraceptives.
Precaution has to be taken in CCF, hypertension, diabetes, epilepsy, CRF and in elderly. Longterm use of Hydrocotisone can cause cushing’s habitus, hyperglycemia, muscular weakness, increased susceptibility to infection, delayed wound healing, and psychiatric disturbances.