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Generic/Bran

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

Tablets: 5, 10, 20 mg;


Oral suspension: 10 mg/5 mL;

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

- Advise patient to take


oral medication with
food to minimize GI
upset.
- Warn patient not to
stop taking drug
abruptly.
- Caution diabetic
patients that insulin or
oral hypoglycemic
agent needs may
increase.
- Instruct elderly
patient to have BP,
blood glucose, and
electrolytes monitored
at least every 6 mo.
- Advise patient that
sunglasses may reduce
sensitivity to sunlight
that occurs with optic
administration.
- Caution against eye
contact with topical
agents.
- Instruct patient to
wash or soak areas for

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)