Hydrocortisone injection

Topical glucocorticoids are well-known contact sensitizers. Immediate allergic or allergic-like reactions to systemic glucocorticoids also occur, but less often. Two atopic patients developed urticaria, possibly IgE-mediated, from a hydrocortisone injection or infusion (176) and other reactions have been reported. 

Papachristou G, Anagnostou S, Katsorhis T 1997 The effect of intraarticular hydrocortisone injection on the articular cartilage of rabbits. Acta Orthopaedica Scandinavica 68(suppl) 132-134... 

In mice fed a tryptophan-deficient diet ad libitum for 1 week, Jones et al.31 reported on tissue serotonin synthesis rates, systemic tryptophan metabolism, and its response to steroid or cycloheximide treatment. In the experimental mice, brain serotonin synthesis was decreased while duodenal serotonin synthesis was increased following a tryptophan load. Liver total protein was depressed in experimental mice but increased following a tryptophan load. Blood tryptophan (total and free) and albumin were decreased in experimental mice, but ratios of albumin-bound tryptophan were increased. Enzyme kinetic studies indicated that, in experimental mice, brain tryptophan-5-hydroxylase had a reduced Vmax but the enzyme response to tryptophan or hydrocortisone injection was increased. However, hepatic tryptophan-2,3-dioxygenase response to tryptophan or hydrocortisone injection was blunted in experimental mice. 

Sample preparation Dilute solution 10-fold with mobile phase. Mix 100 p-L with 100 xL 300 pg/mL hydrocortisone, inject 10 pL. 

Dose As sodium succinate salt of hydrocortisone injection as 100 mg IM as hydrocortisone acetate intraarticular injection and as topical cream 1-2.5% for skin, ear, and eye (Wycort ). 

O Garra JA (1962) Anaphylactic reactions to hydrocortisone injections. Br Med J 1 615 Panzani R (1966) Une nouvelle A.C.T.H. purifiee dans le traitement de la maladie asthma-tique. Etude clinique. Rev Fr Allergol 6 93... 

Fig. 5 summarizes the relationship between cysteine dioxygenase activity in rat liver with or without hydrocortisone injection and the hepatic cysteine contents during development. No significant activity was detected in fetal and postnatal rat liver younger than 4-day-old, and first appeared in detectable levels at the 8th postnatal day. The enzyme activity gradually increased to 13% of the adult level by 12-day-old and then markedly increased to reach the adult level at the 28th postnatal day. 

Fig. 5. The appearance of enzyme activity and response to hydrocortisone mediated induction of cysteine dioxygenase, and the change of cysteine contents in rat liver during development. Rats were injected with hydrocortisone acetate(0.1 mg/g body weight) 25h, 20h, 15h, lOh prior to sacrifice at 2 or 4-, 8-, 12-, and over 16-postnatal-day respectively, since the time reaching the maximum induction is differ from each other depending on the age. Enzyme activity with (0) Of without(O) hydrocortisone injection. Cysteine contents in rat liver (A) Results are expressed as the mean S.D.(represent by vertical line) of five animals.

Lefebvre, Y., Marier, R., Amyot, G., Bilodeau, R., Hotte, R., Raynault, P., Durocher, J. G. and Lanthier, A. (1976) Maternal, fetal, and intra-amniotic hormonal and biologic changes resulting from a single dose of hydrocortisone injected in the intra-amniotic compartment. Amer. J. Obstet. Gynec., 125, 609. 

Figure 4. Effect of pretreatment with hydrocortisone (50 mg/kg) on response of animal to a lethal injection of palytoxin (0.01 /ig/kg).

In patients presenting with acute adrenal crisis who have not been diagnosed previously with adrenal insufficiency, immediate treatment with injectable hydrocortisone and intravenous saline and dextrose solutions should be initiated prior to confirmation of the diagnosis because of the life-threatening nature of this condition. Determine and correct the underlying cause of the acute adrenal crisis (e.g., infection). 

Patients with adrenal insufficiency should carry a card or wear a bracelet or necklace that contains information about their condition. They should also have easy access to injectable hydrocortisone or glucocorticoid suppositories in case of an emergency or during times of physical stress, such as febrile illness or injury. 

Triamcinolone is a corticosteroid that is more potent than hydrocortisone and has a longer duration of action. Triamcinolone has only slight mineralocorticoid activity, whereas hydrocortisone has high mineralocorticoid activity and therefore triamcinolone is unsuitable for disease suppression on a long-term basis. Triamcinolone is available as injection, dental paste, nasal spray and as cream or ointment preparations. Hydrocortisone is available as cream, tablets and injections. 

The first extensively tested RES-specific contrast agent on the basis of iodinated lipids was EOE-13 with its precursors, AG 52-315 and AG 60-99. EOE-13 is an aqueous emulsion of the iodinated ester of poppy seed oil and is able to selectively enhance the normal liver and spleen parenchyma [10-12]. However, severe adverse events such as headache, fever and chills prevented further use of these contrast agents [13-15], although their extent could be decreased by hydrocortisone given prior to contrast injection. 

Figure 6.40 Multiple peak trapping on a SPE cartridge (a) single trap and (b) four times trapping. 1 pg of hydrocortisone per injection, 2 mm Cis HD SPE cartridge, 600 MHz, 3-mm z-gradient LC-SEl probe with an active volume of 60 pi, 1024 transients.

Hydrocortisone sodium phosphate - Administer by IV, IM, or subcutaneous injection. Initial dose is 15 to 240 mg/day. Usually, 33% to 50% of the oral dose every 12 hours. For acute diseases, doses greater than 240 mg may be required. 

Hydrocortisone acetate - For intralesional, intra-articular, or soft tissue injection only. Not for IV use. Dosage range is 5 to 37.5 mg. If desired, a local anesthetic may be injected before hydrocortisone acetate or mixed in a syringe and given simultaneously. 

Pharmacokinetics Hydrocortisone and most of its congeners are readily absorbed from the Gl tract altered onsets and durations are usually achieved with injections of suspensions and esters. Hydrocortisone is metabolized by the liver, which is the rate-limiting step in its clearance. The metabolism and excretion of the synthetic glucocorticoids generally parallel hydrocortisone. Induction of hepatic enzymes will increase the metabolic clearance of hydrocortisone and the synthetic... 

It is usual to give a sedating antihistamine, for example chlorphenamine 10 mg by intramuscular or slow intravenous injection, because of the relatively short half-life of epinephrine (adrenaline), and because of the active role of histamine in anaphylaxis. In addition, the inflammatory reaction can be moderated by the administration of a corticosteroid, such as hydrocortisone 200 mg by intramuscular or slow intravenous injection. Corticosteroids may take several hours to act, but can be of some help in so-called biphasic anaphylactic reactions. 

Therapy, to be effective, depends upon administration of an adequate number of platelets, generally 5 X 10 in a 70 kg man or a 60 kg woman given over 15 minutes - with suitable adjustment for body surface area in children. It is mandatory that the increment is calculated and the duration of response be documented at 24 hours. The optimum practice is to relate the number infused to changes achieved in the patient by means of the corrected count index. This step anticipates the emergence of resistance that limits the value of repeated transfusions. Occasional allergic reactions have to be blocked by premedication with an intravenous injection 100 mg of hydrocortisone, 12.5 mg of phenergan and 1 g of paracetamol... 

Hydrocortisone (Cortisol HYCOSON) 100 mg IM used as hydrocortisone sodium succinate injection. Also used as intraarticular inj. as hydrocortisone acetate 1-2.5% topical (skin, ear eye WYCORT)... 

The peak response to steroids is delayed by 6-12 hours after intravenous administration. Steroid therapy may be administered by inhalation or intravenous injection. The inhaied route is unreiiabie in acute attacfe and is most suitabie for prophyiaxis as a means of reducing the frequency of acute attacks. Hydrocortisone 0.5 mg-kg-l h-l or 4 mg-kg-1 intravenousiy 4-houriy is wideiy... 

Local therapy, such as topical preparations for skin disease, ophthalmic forms for eye disease, intra-articular injections for joint disease, inhaled steroids for asthma, and hydrocortisone enemas for ulcerative colitis, provides a means of delivering large amounts of steroid to the diseased tissue with reduced systemic effects. 

Parenteral 4, 10, 20 mg/mL for IV, IM, intralesional, or intra-articular injection 24 mg/mL for IV use only Hydrocortisone [cortisol] (generic, Cortef)... 

Tolerance to glucocorticoids in this, as in some other respects, varies from individual to individual some patients tolerate 30 mg of prednisone for a long time without developing Cushing s syndrome, while others develop symptoms at 7.5 mg the doses recommended today to avoid Cushing s syndrome in most patients are usually equivalent to hydrocortisone 20 mg. Cushing s syndrome and other systemic adverse effects can occur not only from oral and injected glucocorticoids, but also from topical and intranasal treatment (115) and intrapul-monary or epidural administration (SEDA-19, 376 SEDA-20, 370 116,117). 

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