Supplement in adrenal insufficiency during minor surgery under general anaesthesia
Hydrocortisone is indicated for use in the following conditions:
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- Primary or secondary adrenocortical insufficiency
- Acute adrenocortical insufficiency
- Shock unresponsive to conventional therapy
- Congenital adrenal hyperplasia
- Hypercalcemia associated with cancer
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Hydrocortisone is indicated for use in the following conditions:
- Primary or secondary adrenocortical insufficiency
- Acute adrenocortical insufficiency
- Shock unresponsive to conventional therapy
- Congenital adrenal hyperplasia
- Hypercalcemia associated with cancer
- Nonsuppurative thyroiditis
- Rheumatic Disorders
- Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
- Control of severe or incapacitating allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Seasonal or perennial allergic rhinitis, Drug hypersensitivity reactions, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
- Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, iridocyclitis, Chorioretinitis, Diffuse posterior uveitis and choroiditis, Optic neuritis)
- Gastrointestinal Diseases
- Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
- Loeffler’s syndrome
- Aspiration pneumonitis
- Hematologic Disorders (Acquired, autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura in adults, Secondary thrombocytopenia, Erythroblastopenia)
- Neoplastic Diseases (Leukemias and lymphomas in adults, Acute leukemia of childhood)
- Edematous States
- Acute exacerbations of multiple sclerosis
Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Hydrocortisone reduces various vasoactive agents released during inflammation. It also controls the rate of protein synthesis.
Drugs that induce hepatic enzymes such as Phenobarbital, Phenytoin and Rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as Troleandomycin and Ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.
Hydrocortisone is generally well tolerated except in prolonged high doses. It may cause cardiac arrhythmia, esophageal candidiasis, menstrual irregularity, decreased carbohydrate & glucose tolerance, fluid retention, increased appetite, weight gain, euphoria, mood swings, depression, insomnia, acne etc.
This should be prescribed in pregnancy and lactation only if absolutely required.
Hydrocortisone should be used with caution in patients with a history of peptic ulceration as it increases the incidence of peptic ulceration. This drug should be used with caution in patients with congestive heart failure, hypertension, glaucoma, diabetic mellitus and epilepsy.
Glucocorticoids
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
