Hydrocortisone: It's Uses And Nurses' Responsibility

 Hydrocortisone is a corticosteroid with glucocorticoid and to a lesser extent mineralocorticoid activity. It is used as an immunosuppressive drug, and for conditions adrenogenital syndrome, adrenocortical insufficiency and high blood calcium.
Topics hydrocortisone is used to treat itching,  redness.

Dosage and administration
Hydrocortisone is available in oral, topical and injections. It may be intravenously given,  slowly, in emergencies like acute severe asthma; shock, anaphylaxis. The usual dose is 100mg – 500mg, repeated 3 or 4 times in 24 hours,  according to severity of the condition. 
It can also be given intramuscularly.
For local administration,  topical hydrocortisone can be applied on affected site.

Dosage
Tablet: 5mg, 10mg, 20mg
Powder: 100mg, 250mg, 500mg, 1g

Adverse effects
• Cardiac failure may be induced
• Impaired tissue repair may be seen,  and can lead to delayed wound healing
• Menstrual irregularities
• Amenorrhea
• Mood changes
• Increased role of infection
• Swelling
• Indigestion
• Fast heart rate
• Nose bleeding
• Peptic ulcer

Precautions
You should take caution is administering hydrocortisone to patient with the following:
• Cirrhosis
• Hypertension
• Peptic ulcer
• Pregnancy
• Congestive heart failure

Nurse’s Responsibility 
• Explain the process to the patient. In case of topic hydrocortisone,  explain the rationale for the prescription of the ointment to the patient.
• Detect and minimize the adverse effects associated with the use of drugs
• Ask patient for signs of adverse effects if patient is on a long term administration of hydrocortisone

Index:
• Adrenocortical insufficiency: a disorder in which the adrenal glands don’t produce enough hormones
• Adrenogenital syndrome: a group of genetic conditions limiting hormone productions in the adrenal glands

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