Hycortil

Anti-inflammatory. Primary or secondary adrenocortical insufficiency; SLE; severe erythema multiforme (Steven's syndrome); bronchial asthma, anaphylactic reactions; ulcerative colitis, Crohn's disease; aspiration of gastric contents; shock secondary to adrenocortical insufficiency or shock unresponsive to conventional therapy when adrenocortical insufficiency may be present.

Adult 100-500 mg IV inj over a period of 1-10 min. Dose may be repeated at intervals of 2, 4 or 6 hr depending on patient's response & condition. Max duration: 48-72 hr. Childn & infant >25 mg daily.

Hypersensitivity. Systemic fungal infection unless specific anti-infective therapy is employed.

History of drug allergy. Avoid prolonged use & abrupt w/drawal. Suppression of inflammatory response & immune function. Increased risk of chicken pox. Passive immunization for non-immune patients. History of TB, osteoporosis, HTN or CHF, history of severe affective disorders (steroid psychosis), DM, glaucoma, previous corticosteroid-induced myopathy, liver failure or cirrhosis, renal insufficiency, epilepsy, peptic ulceration or fresh intestinal anastomoses, predisposition to thrombophlebitis, abscess or other pyogenic infections, ulcerative colitis, diverticulitis; myasthenia gravis, ocular herpes simplex for fear of corneal perforation, hypothyroidism. Risk of steroid-induced electrolyte disturbance/K loss in patients receiving cardioactive drugs eg, digoxin. Growth retardation in childn. Pregnancy & lactation. Elderly.

Anaphylactoid reaction eg, bronchospasm, hypo or hyperpigmentation, SC & cutaneous atrophy, sterile abscess, laryngeal edema & urticaria; dyspepsia, peptic ulceration w/ perforation & hemorrhage, abdominal distention, esophageal ulceration, esophageal candidiasis, acute pancreatitis, perforation of bowel. Increase in alanine ALT/SGPT, AST/SGOT & ALP. Increased susceptibility & severity of infections. Proximal myopathy, osteoporosis, vertebral & long bone fractures, avascular osteonecrosis, tendon rupture, aseptic necrosis, muscle weakness. Na & water retention, K loss, HTN, hypokalemic alkalosis, CHF in susceptible patients. Impaired healing, petechiae & ecchymosis, skin atrophy, bruising, striae, increased sweating, telangiectasia, acne. Suppression of the hypothalamo-pituitary-adrenal axis; menstrual irregularity & amenorrhea, Cushingoid facies, hirsutism, wt gain, impaired carbohydrate tolerance w/ increased requirement for antidiabetic therapy, -ve nitrogen & Ca balance, increased appetite. Euphoria, psychological dependence, mood swings, depression, personality changes, insomnia, convulsions, increased intracranial pressure w/ papilloedema in childn (pseudotumour cerebri), w/drawal psychosis, aggravation of schizophrenia seizures. Increased IOP, glaucoma, papilloedema, cataracts w/ possible damage to the optic nerve, corneal of scleral thinning, exacerbation of ophthalmic viral or fungal disease, exophthalmos. Leukocytosis, hypersensitivity reactions eg, anaphylaxis, thromboembolism, nausea, malaise. W/drawal syndrome eg, fever, myalgia, arthralgia, rhinitis, conjunctivitis, painful itchy skin nodules & wt loss.

Mutual inhibition of metabolism leading to convulsion w/ ciclosporin. Enhanced metabolism & may reduce therapeutic effects w/ rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone & aminoglutethimide. May decrease the rate of metabolism of corticosteroids & increase the serum conc w/ CYP3A4 enzyme eg, cimetidine, erythromycin, ketoconazole, itraconazole, diltiazem & mibefradil. May reduce the effects of anticholinesterases in myasthenia gravis. Antagonized effects of hypoglycaemic agents (eg, insulin), antihypertensives & diuretics. Enhanced hypokalaemic effects of acetazolamide, loop, thiazide diuretics & carbenoxolone. May enhance efficacy of coumarin anticoagulants. Increased renal clearance of salicylates. Neuromuscular blockers eg, pancuronium.

Corticosteroid Hormones

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

Rx