McKenna's Pharmacology for Nursing, 2e

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P A R T 6  Drugs acting on the endocrine system

TABLE 36.3

DRUGS IN FOCUS Adrenocortical agents (continued)

Drug name

Dosage/route

Usual indications

Glucocorticoids (continued) cortisone (Cortate)

Oral, IM Adult: 25–300 mg/day PO; 20–330 mg IM Paediatric: base dose on response, monitor closely Oral, IV, IM, inhalation, intranasal, ophthalmic, topical Adult and paediatric: individualise dose based on response and severity: 0.75–9 mg/day PO; 8–16 mg/day IM; 0.5–9 mg/day IV; two to three inhalations per day for inhalation; one to two sprays in each nostril b.d. for nasal spray; 1 drop (gtt) t.d.s. to q.i.d. for ophthalmic solutions; apply topical preparation sparingly Oral, IV, IM, topical, ophthalmic, rectal, intra-articular Adult: 100–500 mg IM or IV q 2–6 hours; 100 mg half-strength by retention enema for 21 days; one applicator-full daily to b.d. intrarectal; apply topical sparingly; 5–20 mg/day PO based on response Paediatric: 20–240 mg/day PO, IM or SC; 100 mg half-strength by retention enema for 21 days; one applicator-full daily to b.d. intrarectal; apply topical sparingly; 5–20 mg/day PO based on response Oral, IV, IM, intra-articular Adult: 40–120 mg/day PO or IM; 10–40 mg IV slowly Paediatric: base dose on severity and response Oral, IV, IM, ophthalmic, intra-articular Adult: 5–60 mg/day PO; 4–60 mg IM or IV; 1–2 gtt in affected eye t.d.s. to q.i.d. Paediatric: base dose on severity and response Adult: 5–80 mg in divided dose (initial dose); 5–20 mg daily (maintenance dose). Dose individualised according to severity of the disease and individual’s response rather than age or body weight Paediatric: base dose on severity and response Oral, IM, inhalant, intra-articular, topical Adult: 4–60 mg/day PO; 2.5–60 mg/day IM; two inhalations t.d.s. to q.i.d. Paediatric: individualise dose based on severity and response; 6–12 years, one to two inhalations t.d.s. to q.i.d. Oral, IM Adult: 25–300 mg/day PO or 20–330 mg/day IM Paediatric: base dose on severity and response

Replacement therapy in adrenal insufficiency; allergic and inflammatory disorders treatment

dexamethasone (Dexmethsone)

Management of allergic and inflammatory disorders, adrenal hypofunction

hydrocortisone (Sigmacort, Solu-Cortef)

Replacement therapy, treatment of allergic and inflammatory disorders

methylprednisolone (Advantan, Depo- Medrol, Depo-Nisolone) prednisolone (Panafcortelone, Predsol, Redipred)

Treatment of allergic and inflammatory disorders

Treatment of allergic and inflammatory disorders

Replacement therapy for adrenal insufficiency; treatment of allergic and inflammatory disorders; severe bronchial asthma, status asthmaticus, acquired haemolytic anaemia, nephrotic syndrome Treatment of allergic and inflammatory disorders, management of asthma; treatment of adrenal insufficiency when combined with a mineralocorticoid Used for replacement therapy in adrenal insufficiency, treatment of allergic and inflammatory disorders Used for replacement therapy and treatment of salt-losing adrenogenital syndrome with a glucocorticoid; not recommended for children; being tried for treatment of severe orthostatic hypotension because sodium and water retention effects can lead to increased blood pressure

prednisone (Lodotra, Panafcort, Sone)

triamcinolone (Aristocort, Kenacomb, Tricortone)

Mineralocorticoids cortisone (Cortate)

Adult: 0.1–0.2 mg/day PO

fludrocortisone (Florinef)