Hydrocortisone

Adrenal cortex hormone drugs. Superphysiological doses of glucocorticoids have multiple pharmacological effects such as anti-inflammatory, anti-allergic and immunosuppressive. 1 Anti-inflammatory effect: glucocorticoids reduce and prevent tissue response to inflammation, thereby reducing the manifestation of inflammation. 2 Immunosuppressive effect: prevent or inhibit cell-mediated immune response, delayed allergic reaction, and reduce the expansion of primary immune response. 3 Anti-toxic and anti-shock effects: glucocorticoids can counteract the stimulation of bacterial endotoxins on the body, reduce cell damage, and play a role in protecting the body.

Hydrocortisone

1. Used for diseases caused by adrenal insufficiency, rheumatoid arthritis, rheumatic fever, gout, bronchial asthma, etc. 2. Used for allergic dermatitis, seborrheic dermatitis, pruritus, etc. 3. Long-term and large-scale use causes Cushing's syndrome, water and sodium retention, mental symptoms, digestive system ulcers, osteoporosis, and growth and development inhibition. 4. Used for iridocyclitis, keratitis, scleritis, conjunctivitis, etc. 5. Used for neurodermatitis, tuberculous meningitis, pleurisy, arthritis, tenosynovitis, acute and chronic sprains, tendon sheath strain, etc.

1. Hydrocortisone acetate tablets: Oral administration: 1 tablet each time (containing 20 mg), 1-2 times a day. Hydrocortisone acetate ointment, 1% ointment, for external use. Hydrocortisone acetate eye drops: 5 mg (3 ml) per bottle, eye drops, 1-2 drops each time. 2. Dermatitis film (neurodermatitis aerosol film): Aerosol sprayed on the surface of the skin lesions, a thin film is formed, which can isolate various external stimuli to the skin lesions, so that the skin lesions remain stable for a long time, coupled with the anti-inflammatory effect of hydrocortisone, so it has a certain effect on neurodermatitis. Generally, the itching sensation is reduced or completely disappeared after use, and the skin lesions gradually improve. The effect is faster for those with a short course of disease, and the cure rate is also higher, but there is recurrence after recovery. 3. Shake well for joint injection and intrathecal injection. Intraarticular injection, 1-2 ml each time (each ml contains 25 mg of drug); intrathecal injection, 1 ml each time. Alternative treatment: Adults take 20-25 mg daily, 2/3 in the morning and 1/3 after lunch.

There are no obvious adverse reactions when glucocorticoids are used for replacement therapy with physiological doses. Adverse reactions mostly occur when pharmacological doses are used, and are closely related to the course of treatment, dose, type of medication, usage and route of administration. Common adverse reactions are as follows. 1. Rapid intravenous administration of large doses may cause systemic allergic reactions, including swelling of the face, nasal mucosa, eyelids, urticaria, shortness of breath, chest tightness, and wheezing. Long-term medication may cause the following side effects: iatrogenic Cushing's syndrome face and posture, weight gain, lower limb edema, purple lines, bleeding tendency, poor wound healing, acne, menstrual disorders, avascular necrosis of the humeral or femoral head, osteoporosis or fractures (including vertebral compression fractures, pathological fractures of long bones), muscle weakness, muscle atrophy, hypokalemia syndrome, gastrointestinal irritation (nausea, vomiting), pancreatitis, peptic ulcer or intestinal perforation, growth inhibition in children, glaucoma, cataracts, benign intracranial hypertension syndrome, impaired glucose tolerance and aggravation of diabetes. 2. Patients may experience psychiatric symptoms: euphoria, agitation, restlessness, delirium, disorientation, and may also manifest as inhibition. Psychiatric symptoms are particularly prone to occur in people with chronic wasting diseases and those who have had mental disorders in the past. When the dosage reaches 40 mg or more of prednisone per day, it can appear after a few days to two weeks of medication. Concurrent infection is the main adverse reaction of glucocorticoids. It is mainly caused by fungi, tuberculosis, Staphylococcus, Proteus, Pseudomonas aeruginosa and various herpes viruses. It often occurs during medium-term or long-term therapy, but it can also occur after short-term use of high doses. 3. The suppression of the hypothalamus-pituitary-adrenal axis is an important complication of hormone therapy, and its occurrence is related to factors such as preparation, dosage, and course of treatment. When more than 20 mg of prednisone is used daily for more than 3 weeks, and when iatrogenic Cushing's syndrome occurs, it should be considered that adrenal function has been suppressed. 4. The syndrome after glucocorticoid withdrawal may have the following different situations. ① Hypothalamic-pituitary-adrenal dysfunction, which can be manifested as fatigue, weakness, loss of appetite, nausea, vomiting, low blood pressure, and the recovery of this axis function after long-term treatment generally takes 9 to 12 months. The order of functional recovery is as follows: i. Hypothalamic corticotropin-releasing hormone (CRF) secretion is restored and increased; ii. ACTH secretion is restored and higher than normal, and the secretion of adrenal cortical hormones is still low at this time; iii. The basal secretion of hydrocortin returns to normal, and the pituitary ACTH secretion returns to normal from the original excess; iv. The response of the hypothalamic-pituitary-adrenal cortex axis to stress returns to normal. ② After stopping the drug, the symptoms of the original disease that have been controlled reappear. In order to avoid the occurrence of adrenal cortical dysfunction and the recurrence of the original disease symptoms, the dosage should be gradually reduced after long-term hormone treatment, and the original dose should be changed from several times a day to once a day in the morning, or once every other morning. ③ Glucocorticoid withdrawal syndrome. Sometimes patients experience dizziness, tendency to faint, abdominal pain or back pain, low fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue, and weakness after stopping the drug. If adrenal cortex insufficiency and recurrence of the original disease can be ruled out after careful examination, it can be considered as glucocorticoid dependence syndrome. 5. Long-term use of large doses may cause obesity, hirsutism, acne, increased blood sugar, blood pressure and intraocular pressure, water and sodium retention, and edema. It can cause hypokalemia, muscle paralysis, excitement, gastrointestinal ulcers, and even gastrointestinal bleeding, perforation, osteoporosis, pathological fractures, difficult wound healing, cataracts, and blindness. Sudden drug withdrawal can cause withdrawal syndrome.

1. Medication during pregnancy; glucocorticoids can pass through the placenta. Animal experimental studies have confirmed that administration during pregnancy can increase the incidence of fetal palate fissure, placental insufficiency, spontaneous abortion and intrauterine growth retardation. Human use of pharmacological doses of glucocorticoids can increase the incidence of placental insufficiency, neonatal weight loss or stillbirth. It has not been proven to be teratogenic to humans. Those who have received a certain dose of glucocorticoids during pregnancy should pay attention to whether their babies have symptoms of adrenal cortex hypofunction. 2. For premature infants, in order to avoid respiratory distress syndrome, dexamethasone is used for mothers before delivery to induce the formation of lung surface activation protein in premature infants. Since it is only used for a short period of time, no adverse effects on the growth and development of young children have been observed. 3. Medication during lactation: Physiological doses or low pharmacological doses (25 mg of cortisone or 5 mg of prednisone per day, or less) generally have no adverse effects on infants. However, if the mother receives a large pharmacological dose of glucocorticoids, she should not breastfeed, because glucocorticoids can be excreted in breast milk and cause adverse effects on the baby, such as growth inhibition and adrenal cortex function inhibition. 4. Pediatric medication: Children should be very cautious when using adrenocortical hormones for a long time, because hormones can inhibit the growth and development of children. If long-term use is necessary, short-acting (such as cortisone) or medium-acting preparations (such as prednisone) should be used, and long-acting preparations (such as dexamethasone) should be avoided.

Precautions for children: 1. Oral medium-acting preparations every other day can reduce the inhibitory effect on growth. Children or adolescents who use glucocorticoids for a long time must be closely observed, as the risk of osteoporosis, avascular necrosis of the femoral head, glaucoma, and cataracts in children is increased. 2. In addition to the general age or weight, the dosage of hormones for children should be determined according to the severity of the disease and the child's response to treatment. For the treatment of children with adrenal insufficiency, the dosage of hormones should be based on body surface area. If it is based on weight, it is easy to overdose, especially in infants and short or obese children. Precautions for the elderly: Elderly patients are prone to hypertension when using glucocorticoids. Elderly patients, especially women after menopause, are prone to osteoporosis when using glucocorticoids. Glucocorticoids and infection: Patients with adrenal insufficiency are prone to infection, which is often serious and an important cause of death. Giving physiological doses of adrenocortical hormones can improve patients' resistance to infection.

1. Nonsteroidal anti-inflammatory analgesics can enhance its ulcerogenic effect. 2. It can enhance the hepatotoxicity of acetaminophen. 3. When used in combination with amphotericin B or carbonic anhydrase inhibitors, it can aggravate hypokalemia. Long-term use with carbonic anhydrase inhibitors can easily lead to hypocalcemia and osteoporosis. 4. When used in combination with protein anabolic hormones, it can increase the incidence of edema and aggravate acne. 5. When used in combination with anticholinergics (such as atropine) for a long time, it can cause increased intraocular pressure. 6. Tricyclic antidepressants can aggravate the mental symptoms caused by it. 7. When used in combination with hypoglycemic drugs such as insulin, the dose of hypoglycemic drugs should be appropriately adjusted because it can increase blood sugar in diabetic patients. 8. Thyroid hormones can increase its metabolic clearance rate, so when thyroid hormones or antithyroid drugs are used in combination with it, the dose of the latter should be appropriately adjusted. 9. When used in combination with contraceptives or estrogen preparations, it can enhance its therapeutic effects and adverse reactions. 10. When used in combination with cardiac glycosides, it can increase the toxicity of digitalis and the occurrence of arrhythmias. 11. When used in combination with potassium-excreting diuretics, it can cause severe hypokalemia and weaken the sodium-excreting and diuretic effects of diuretics due to water and sodium retention. 12. When used in combination with ephedrine, its metabolic clearance can be enhanced. 13. When used in combination with immunosuppressants, it can increase the risk of infection and may induce lymphoma or other lymphoproliferative diseases. 14. It can increase the metabolism and excretion of isoniazid in the liver, and reduce the blood concentration and efficacy of isoniazid. 15. It can promote the metabolism of mexiletine in the body and reduce its blood concentration. 16. When used in combination with salicylates, it can reduce the concentration of plasma salicylate. 17. When used in combination with growth hormone, it can inhibit the latter's growth-promoting effect.

Keep away from light and store in a sealed container.

Tianjin Jinjin Pharmaceutical Co., Ltd.

• Founded in:

  1998-10-13

• Address:

  Zhangjiawo Industrial Zone, Xiqing Economic Development Zone (multiple address information exists)

• Tax NO.:

  91120111103851027X

• Registered Funds:

  24.4898 million yuan

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