Professional Documents
Culture Documents
d Name &
Classification
Generic:
Dose,
Strength &
Formulatio
n
Ordered:
Hydrocortisone
100mg, q6 IVTT
Brand:
Timing:
Hydrocortone
12am
6am
12pm
6pm
Classification:
Pharmacologic
Class
Adrenal cortical
steroid
Corticosteroid
Glucocorticoid
Duration:
Other forms:
Therapeutic
Class
Hormone
Pregnancy
category
C
Indication/Mechanis
ms of Drug Action
Adverse/Side
Effects Drug
Interaction
Nursing
Responsibilities
Rationale
Client
Teaching
Injection:
25, 50
mg/mL,
100, 200,
500,
1,000
mg/vial
Indication:
-Replacement
therapy in
adrenal cortical
insufficiency
- Allergic states
severe or
incapacitating
allergic
conditions
- Hematologic
disorders
- Ulcerative
colitis
Mechanism of
action:
Enters target
cells and binds
to cytoplasmic
receptor;
initiates many
complex
reactions that
are responsible
for its antiinflammatory,
immunosuppres
sive
(glucocorticoid),
and saltretaining
(mineralocortico
CNS: Vertigo,
headache,
paresthesias,
insomnia,
seizures,
psychosis
CV:
Hypotension,
shock, HPN
and heart
failure
secondary to
fluid
retention,
thromboembo
lism,
thrombophleb
itis, fat
embolism,
cardiac
arrhythmias
Dermatologic:
Thin, fragile
skin,
petechiae,
ecchymoses,
purpura,
striae,
subcutaneous
Before:
- You should
not use this
medication if
you are allergic
to
hydrocortisone,
or if you have a
fungal infection
anywhere in
your body.
- tell your
doctor about
all of your
medical
conditions, and
about all other
medicines you
are using.
- Do not give
live vaccines
with
immunosuppre
ssive doses of
hydrocortisone.
During:
- To
prevent
further
complicati
ons
- There are
many
other
diseases
that can
be
affected by
steroid
use, and
many
other
medicines
that can
interact
with
steroids.
- Vaccines
may not
work as
id) actions.
Some actions
may be
undesirable,
depending on
drug use.
fat atrophy
(Lippincott
Williams &
Wilkins. 2013)
Endocrine:
Amenorrhea,
irregular
mens, growth
retardation,
decreased
carbohydrate
tolerance and
DM,
cushingoid
state, HPA
suppression
systemic ,
hyperglycemi
a
EENT:
Cataracts,
glaucoma,
increased IOP
GI: Peptic or
esophageal
ulcer,
pancreatitis,
abdominal
distention,
nausea,
vomiting,
- Do not give
IM injections if
patient has
thrombocytop
enic purpura.
- Taper doses
when
discontinuing
high-dose or
long-term
therapy.
After:
- Monitor client
for at least 30
minutes.
- Educate client
on the side
effects of the
medication and
what to expect.
- Instruct client
to report pain
at injection
site.
- Instruct client
well while
you are
taking a
steroid.
topical administration
prior to administration
to increase absorption.
- Advise patient to
apply topical agents
sparingly, rubbing in
lightly.
- To avoid
withdrawal
symptoms
when
stopping
the
medication
.
- To
monitor
any
adverse
effects and
reactions
to the
patient
- Caution against
covering topically
treated areas unless
specifically prescribed
by health care provider.
- Advise against mixing
topical agents with
other products unless
advised by health care
provider.
- Instruct patient if
topical dose is missed
to apply as soon as
remembered, but not to
double doses.
increased
appetite and
weight gain
to take drug
exactly as
prescribed.
Hematologic:
Na and fluid
retention,
hypocalcemia
, increased
blood sugar,
increased
serum
cholesterol,
decreased T3
and T4 levels
-Carry an ID
card or wear a
medical alert
bracelet
stating that
you are taking
a steroid
Hypersensitivi
ty:
Anaphylactoid
or
hypersensitivi
ty reactions
Musculoskelet
al: Muscle
weakness,
steroid
myopathy
and loss of
muscle mass,
osteoporosis,
spontaneous
(Lippincott
Williams &
Wilkins. 2013)
- In case of
emergency
fractures
Other:
Immunosuppr
ession,
aggravation
or masking of
infections,
impaired
wound
healing
(Lippincott
Williams &
Wilkins. 2013)