Generic/Brand

Name &
Classification
Generic:

Dose,
Strength &
Formulation
Ordered:

Hydrocortisone

100mg, q6
IVTT

Brand:
Hydrocortone

Classification:
Pharmacologic
Class
Adrenal cortical
steroid
Corticosteroid
Glucocorticoid
Therapeutic
Class
Hormone
Pregnancy
category
C

Timing:
12am
6am
12pm
6pm

Duration:
Other
forms:
Tablets: 5,
10, 20 mg;
Oral
suspension:
10 mg/5 mL;

Injection:
25, 50
mg/mL,
100, 200,
500, 1,000

Indication/Mechanism
s of Drug Action

Adverse/Side
Effects Drug
Interaction

Nursing
Responsibilities

Indication:

CNS: Vertigo,
headache,
paresthesias,
insomnia,
seizures,
psychosis

- To
Before:
- You should not prevent

-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,
immunosuppressive
(glucocorticoid), and
salt-retaining
(mineralocorticoid)
actions. Some
actions may be
undesirable,
depending on drug
use.

CV:
Hypotension,
shock, HPN and
heart failure
secondary to
fluid retention,
thromboembolis
m,
thrombophlebitis
, fat embolism,
cardiac
arrhythmias
Dermatologic:
Thin, fragile
skin, petechiae,
ecchymoses,
purpura, striae,
subcutaneous
fat atrophy

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
immunosuppres
sive doses of
hydrocortisone.

Rationale

further
complicatio
ns

- 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
well while

Client
Teaching
- 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
hypoglycem
ic agent
needs may
increase.
- Instruct
elderly
patient to
have BP,

mg/vial
(Lippincott Williams
& Wilkins. 2013)

EENT: Cataracts,
glaucoma,
increased IOP
Endocrine:
Amenorrhea,
irregular mens,
growth
retardation,
decreased
carbohydrate
tolerance and
DM, cushingoid
state, HPA
suppression
systemic ,
hyperglycemia
GI: Peptic or
esophageal
ulcer,
pancreatitis,
abdominal
distention,
nausea,
vomiting,
increased
appetite and
weight gain
Hematologic: Na

During:
- 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.

you are
taking a
steroid.

- To avoid
withdrawal
symptoms
when
stopping
the
medication.

- To
monitor
any
adverse
effects and
reactions
to the
patient

blood
glucose,
and
electrolytes
monitored
at least
every 6 mo.
- Advise
patient that
sunglasses
may reduce
sensitivity
to sunlight
that occurs
with optic
administrati
on.
- Caution
against eye
contact with
topical
agents.
- Instruct
patient to
wash or
soak areas
for topical
administrati
on prior to
administrati

and fluid
retention,
hypocalcemia,
increased blood
sugar, increased
serum
cholesterol,
decreased T3
and T4 levels
Hypersensitivity:
Anaphylactoid or
hypersensitivity
reactions
Musculoskeletal:
Muscle
weakness,
steroid
myopathy and
loss of muscle
mass,
osteoporosis,
spontaneous
fractures
Other:
Immunosuppres
sion,
aggravation or
masking of
infections,

- Instruct client
to take drug
exactly as
prescribed.
-Carry an ID
card or wear a
medical alert
bracelet stating
that you are
taking a steroid

(Lippincott
Williams &
Wilkins. 2013)

on to
increase
absorption.

- In case of
emergency

- Advise
patient to
apply
topical
agents
sparingly,
rubbing in
lightly.
- Caution
against
covering
topically
treated
areas
unless
specifically
prescribed
by health
care
provider.
- Advise
against
mixing
topical
agents with

impaired wound
healing
(Lippincott
Williams &
Wilkins. 2013)

other
products
unless
advised by
health care
provider.
- Instruct
patient if
topical dose
is missed to
apply as
soon as
remembere
d, but not to
double
doses.