Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Hydrocortisone also is used as a
replacement for the naturally occurring hormone in patients whose adrenal glands
are unable to produce sufficient amounts of corticosteroids.
DOSING: Hydrocortisone should be taken with food. The recommended
dosage range is 10 mg to 300 mg per day depending on the disease administered in
3 to 4 divided doses.
DRUG INTERACTIONS: By interfering with the patient's immune response,
hydrocortisone can impede the effectiveness of vaccinations. Hydrocortisone also
can interfere with the tuberculin skin test and cause false negative results in
patients with
tuberculosis infection.
Rifampin and phenytoin
(Dilantin, Dilantin-125) may increase the
elimination of hydrocortisone from the body, reducing its effectiveness. Troleandomycin and ketoconazole may reduce the elimination of hydrocortisone,
possibly leading to increased side effects.
PREGNANCY: Hydrocortisone has not been adequately evaluated
during
pregnancy.
NURSING MOTHERS: HHydrocortisone can appear in
breast milk, and can
have adverse effects on the baby. Therefore, mothers taking hydrocortisone
should discontinue nursing.
SIDE EFFECTS: Hydrocortisone side effects depend on the dose, the
duration and the frequency of administration. Short courses of hydrocortisone
usually are well tolerated with few and mild side effects. Long term, high doses
of hydrocortisone usually will produce predictable, and potentially serious side
effects. Whenever possible, the lowest effective doses of hydrocortisone should
be used for the shortest possible length of time to minimize side effects.
Alternate day dosing also can help reduce side effects.
Side effects of
hydrocortisone and other corticosteroids range from mild to serious. Side
effects include:
Psychic disturbances can include
depression, euphoria, insomnia, mood swings, personality changes, and even
psychotic behavior.
Hydrocortisone and other corticosteroids can mask signs of
infection and impair the body's natural immune response to infection. Patients
on corticosteroids are more susceptible to infections, and can develop more
serious infections than healthy individuals. For instance,
chickenpox and
measles viruses can produce serious and even fatal illnesses in patients on high
doses of hydrocortisone. Live virus vaccines, such as the small pox vaccine,
should be avoided in patients taking high doses of hydrocortisone, since even
vaccine viruses may cause disease in these patients.
Some infectious organisms,
such as tuberculosis (TB) and malaria, can remain dormant in a patient for
years. Hydrocortisone and other corticosteroids can reactivate dormant
infections in these patients and cause serious illness. Patients with dormant TB
may require anti-TB medications while undergoing prolonged corticosteroid
treatment. Prolonged use of hydrocortisone can depress the ability of body's
adrenal glands to produce corticosteroids.
Abruptly stopping hydrocortisone in
these individuals can cause symptoms of corticosteroid insufficiency, with
accompanying nausea, vomiting, and even shock. Therefore, withdrawal of
hydrocortisone is usually accomplished by gradual tapering. Gradually tapering
hydrocortisone not only minimizes the symptoms of corticosteroid insufficiency,
it also reduces the risk of an abrupt flare of the disease under treatment. The
insufficient adrenal gland function may not recover fully for many months after
stopping hydrocortisone. These patients need additional hydrocortisone treatment
during periods of stress, such as surgery, to avoid symptoms of corticosteroid
insufficiency and shock, while the adrenal gland is not responding by producing
its own corticosteroid.
Addison disease is a hormonal (endocrine) disorder involving destruction of the adrenal glands (small glands adjacent to the kidneys). Diseased glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary for normal daily body functions. Symptoms include weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin. Treatment of Addison disease involves replacing, or substituting, the hormones that the adrenal glands are not making.
Asthma RSS
Healthy Living Tips
