Hover over products below to view reaction partnersĭata regarding acute overdoses of glucocorticoids are rare. 13 Cortisone is further metabolized to tetrahydrocortisone and dihydrocortisol. Hydrocortisone is metabolised to 6-beta hydrocortisol via CYP3A, 5-beta tetrahydrocortisol via 3-oxo-5-beta-steroid 4-dehydrogenase, 5-alpha tetrahydrocortisol via 3-oxo-5-alpha-steroid 4-dehydrogenase 2, cortisone via Corticosteroid 11-beta-dehydrogenase isozyme 1 and Corticosteroid 11-beta-dehydrogenase isozyme 2, and glucuronide products. Hydrocortisone is 90.1% bound to proteins in plasma, with 56.2% bound to albumin. 1 Protein bindingĬorticosteroids are generally bound to corticosteroid binding globulin 11 and serum albumin 12 in plasma.
#Hydrocortisone cream free
Total hydrocortisone has a volume of distribution of 39.82L, while the free fraction has a volume of distribution of 474.38L. 4Ī 20mg IV dose of hydrocortisone has an AUC of 1163☒77ng*h/mL. 4 Slow absorbers take up hydrocortisone at a rate of 0.361☐.255/h while fast absorbers take up hydrocortisone at a rate of 1.05☐.255/h. Hydrocortisone retention enemas are have a bioavailability of 0.810 for slow absorbers and 0.502 in rapid absorbers. Topical hydrocortisone cream is 4-19% bioavailable with a T max of 24h.
1 However, the pharmacokinetics of hydrocortisone can vary by 10 times from patient to patient. Oral hydrocortisone at a dose of 0.2-0.3mg/kg/day reached a mean C max of 32.69nmol/L with a mean AUC of 90.63h*nmol/L 1 A 0.4-0.6mg/kg/day dose reached a mean C max of 70.81nmol/L with a mean AUC of 199.11h*nmol/L. 10 High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.
Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive. Glucocorticoids inhibit neutrophil apoptosis and demargination they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives they inhibit NF-Kappa B and other inflammatory transcription factors they promote anti-inflammatory genes like interleukin-10. 10 Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days. The short term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation. 1, 6 Patients should stop taking the medication if irritation or sensitization occurs. 10 Hydrocortisone has a wide therapeutic index 8 and a moderate duration of action. Hydrocortisone binds to the glucocorticoid receptor leading to downstream effects such as inhibition of phospholipase A2, NF-kappa B, other inflammatory transcription factors, and the promotion of anti-inflammatory genes. Varicella-zoster virus acute retinal necrosis.Superficial infection of the external auditory canal with inflammation.Disseminated Pulmonary Tuberculosis (TB).
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