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'''Hydrocortisone''' ([[International Nonproprietary Name|INN]], [[United States Adopted Name|USAN]], [[British Approved Name|BAN]]) is a name for cortisol when it is used as a medication. Hydrocortisone is used to treat people who lack adequate naturally generated cortisol. It is on the [[World Health Organization's List of Essential Medicines]], the most important medications needed in a basic [[health system]].<ref>{{cite web|title=WHO Model List of EssentialMedicines|url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1|work=World Health Organization|accessdate=22 April 2014|date=October 2013}}</ref> |
'''Hydrocortisone''' ([[International Nonproprietary Name|INN]], [[United States Adopted Name|USAN]], [[British Approved Name|BAN]]) is a name for cortisol when it is used as a medication. Hydrocortisone is used to treat people who lack adequate naturally generated cortisol. It is on the [[World Health Organization's List of Essential Medicines]], the most important medications needed in a basic [[health system]].<ref>{{cite web|title=WHO Model List of EssentialMedicines|url=http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1|work=World Health Organization|accessdate=22 April 2014|date=October 2013}}</ref> |
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== Pharmacology == |
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Hydrocortisone is the pharmaceutical term for cortisol used in oral administration, intravenous injection, or topical application. It is used as an [[immunosuppressive drug]], given by injection in the treatment of severe allergic reactions such as [[anaphylaxis]] and [[angioedema]], in place of [[prednisolone]] in patients needing steroid treatment but unable take oral medication, and perioperatively in patients on long-term steroid treatment to prevent [[Addison's disease|Addisonian crisis]]. It may also be injected into inflamed joints resulting from diseases such as [[gout]]. |
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Compared to hydrocortisone, [[prednisolone]] is about four times as strong and [[dexamethasone]] about forty times as strong, in their [[anti-inflammatory]] effect.<ref name=Dexamethasone>{{cite web|title=Dexamethasone|url=http://www.drugs.com/pro/dexamethasone.html|publisher=drugs.com|accessdate=14 June 2013}}</ref> Prednisolone can also be used as cortisol replacement, and at replacement dose levels (rather than anti-inflammatory levels), prednisolone is about eight times more potent than cortisol.<ref>{{Cite journal|last=Caldato|first=Milena C. F.|last2=Fernandes|first2=Vânia T.|last3=Kater|first3=Claudio E.|date=2004-10-01|title=One-year clinical evaluation of single morning dose prednisolone therapy for 21-hydroxylase deficiency|url=http://www.ncbi.nlm.nih.gov/pubmed/15761542|journal=Arquivos Brasileiros de Endocrinologia e Metabologia|volume=48|issue=5|pages=705–712|doi=10.1590/S0004-27302004000500017|issn=0004-2730|pmid=15761542}}</ref> For side effects, see [[corticosteroid]] and [[prednisolone]]. |
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It may be used topically for allergic rashes, [[eczema]], [[psoriasis]], [[pruritis]] (itchyness) and other inflammatory skin conditions. Topical hydrocortisone creams and ointments are available in most countries without prescription in strengths ranging from 0.05% to 2.5% (depending on local regulations) with stronger forms available by prescription only. Covering the skin after application increases the absorption and effect. Such enhancement is sometimes prescribed, but otherwise should be avoided to prevent overdose and systemic impact. |
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=== Protein binding === |
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Most serum cortisol (all but about 4%) is bound to proteins, including [[Transcortin|corticosteroid binding globulin]] (CBG) and [[serum albumin]]. Free cortisol passes easily through cellular membranes, where they bind intracellular [[cortisol receptor]]s.<ref name="isbn1-4377-1753-5">{{cite book |vauthors=Boron WF, Boulpaep EL | title = Medical Physiology | edition = 2nd | publisher = Saunders | location = Philadelphia | year = 2011 | pages = | isbn = 1-4377-1753-5 }}</ref> |
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==References== |
==References== |
Revision as of 14:36, 30 August 2016
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AHFS/Drugs.com | Monograph |
MedlinePlus | a682206 |
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Routes of administration | Oral tablets, intravenous, topical, rectal |
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Formula | C21H30O5 |
Molar mass | 362.460 g/mol g·mol−1 |
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Hydrocortisone (INN, USAN, BAN) is a name for cortisol when it is used as a medication. Hydrocortisone is used to treat people who lack adequate naturally generated cortisol. It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.[1]
Pharmacology
Hydrocortisone is the pharmaceutical term for cortisol used in oral administration, intravenous injection, or topical application. It is used as an immunosuppressive drug, given by injection in the treatment of severe allergic reactions such as anaphylaxis and angioedema, in place of prednisolone in patients needing steroid treatment but unable take oral medication, and perioperatively in patients on long-term steroid treatment to prevent Addisonian crisis. It may also be injected into inflamed joints resulting from diseases such as gout.
Compared to hydrocortisone, prednisolone is about four times as strong and dexamethasone about forty times as strong, in their anti-inflammatory effect.[2] Prednisolone can also be used as cortisol replacement, and at replacement dose levels (rather than anti-inflammatory levels), prednisolone is about eight times more potent than cortisol.[3] For side effects, see corticosteroid and prednisolone.
It may be used topically for allergic rashes, eczema, psoriasis, pruritis (itchyness) and other inflammatory skin conditions. Topical hydrocortisone creams and ointments are available in most countries without prescription in strengths ranging from 0.05% to 2.5% (depending on local regulations) with stronger forms available by prescription only. Covering the skin after application increases the absorption and effect. Such enhancement is sometimes prescribed, but otherwise should be avoided to prevent overdose and systemic impact.
Protein binding
Most serum cortisol (all but about 4%) is bound to proteins, including corticosteroid binding globulin (CBG) and serum albumin. Free cortisol passes easily through cellular membranes, where they bind intracellular cortisol receptors.[4]
References
- ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014.
- ^ "Dexamethasone". drugs.com. Retrieved 14 June 2013.
- ^ Caldato, Milena C. F.; Fernandes, Vânia T.; Kater, Claudio E. (2004-10-01). "One-year clinical evaluation of single morning dose prednisolone therapy for 21-hydroxylase deficiency". Arquivos Brasileiros de Endocrinologia e Metabologia. 48 (5): 705–712. doi:10.1590/S0004-27302004000500017. ISSN 0004-2730. PMID 15761542.
- ^ Boron WF, Boulpaep EL (2011). Medical Physiology (2nd ed.). Philadelphia: Saunders. ISBN 1-4377-1753-5.