Pharmacological action – glucocorticoid.
Dosage and administration
In / in, in the form of / in infusions, in / m. As an emergency treatment of acute conditions, it is recommended to prescribe intravenously. At the end of the acute period, either parenterally prescribed dosage forms of the drug with a longer duration of action, or oral forms of the drug. Treatment begins with intravenous administration over 30 seconds (eg, 100 mg) and up to 10 minutes (eg, 500 mg or more), depending on the severity of the patient’s condition.
High doses of corticosteroids should be prescribed only until the patient’s condition has stabilized, but usually not more than within 48-72 hours. Adverse events with high doses of corticosteroids for a short period of time develop rarely, but peptic ulcers may develop.
Perhaps the appointment of prophylactic antacid therapy.
When prescribing high doses of hydrocortisone for longer than 48 to 72 hours, hypernatremia may develop. In this case, it is recommended to replace Sola Cortef with another corticosteroid drug, such as methylprednisolone sodium succinate, which causes little or no sodium retention in the body.
The dose of the drug is prescribed again every 2-4-6 hours, depending on the response of the patient’s body and the clinical picture of the disease. When prescribing to children, the doses of the drug are correspondingly reduced, while the prescribed dose should primarily depend on the severity of the disease and the body’s response to the treatment, in addition, it is necessary to take into account the age and weight of the child. The prescribed dose should not be less than 25 mg/day and not more than 15 mg/kg.
If after corticosteroid therapy in patients there is a stressful situation, such patients should be under strict supervision due to the possible development of insufficiency of the adrenal cortex.
Corticosteroid therapy does not replace standard therapy, but is prescribed as an additional one.
Preparation of solutions.
Preparations for parenteral administration should be inspected visually for discoloration or the appearance of particles whenever the solution and utensils permit.
100 mg bottle
For intravenous or intramuscular injection, a solution is prepared by adding to the vial (observing the rules of antisepsis) no more than 2 ml of bacteriostatic water for injection or sodium chloride solution for injection with a bacteriostatic additive and shaking the vial until the powder is completely dissolved. For intravenous infusion, first prepare a solution by adding no more than 2 ml of bacteriostatic water for injection to the vial, then this solution can be added to 100 or 1000 ml of a 5% dextrose solution in water (or saline, or 5% dextrose in saline). solution if the patient does not need to limit the amount of sodium).
ACT-O-VIAL 2-capacity bottle
- Press down on the plastic activator to force the solvent into the bottom container.
- Gently shake the vial until the powder dissolves.
- Remove the plastic disc covering the center of the cork.
- Treat the surface of the cork with an appropriate antiseptic.
- Pierce the center of the cork with a needle so that the tip of the needle is visible. Turn the vial over and take the required amount of solution with a syringe.
For intravenous or intramuscular injections, further dilution is not required. For intravenous infusion, the solution is first prepared as described above. This solution is then added to 100 or 1000 ml of 5% dextrose in water (or saline, or 5% dextrose in saline if the patient does not require sodium restriction). In cases where a small volume of fluid is desired, hydrocortisone 100 to 3000 mg (equivalent to sodium hydrocortisone succinate) may be added to 50 ml of the above diluted solutions. The resulting solutions are stable for 4 hours and can be administered intravenously directly or through a second dropper.
If the drug solutions are prepared as above, then the pH will be from 7 to 8, and the osmolarity will be 0.36 osmol (saline = 0.28 osmol).
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