Hydrocortisone

Гидрокортизон Drug photo

The description is actual on 18.07.2016

  • Latin name: Hydrocortisone
  • ATH code: D07AA02
  • Active ingredient: Hydrocortisone (Hydrocortisone)
  • Producer: Hemofarm (Serbia), Ursafarm Artsnaymittel Gmbh (Germany), Jelfa S.A. (Poland), Synthesis Joint-stock Kurgan company of medical supplies and products of joint stock company (Russia), Tatkhimfarmpreparata (Russia), Murom instrument-making plant (Russia), Quinacrine (Russia), Nizhpharm (Russia), Farmak of PAO (Ukraine)

Structure

In 1 bottle — powder of a hydrocortisone of sodium of a gemisuktsinat of 100 or 500 mg.

In 1 ml of suspension — Hydrocortisoni acetas of 25 mg.

In 1 g of an oculentum — Hydrocortisoni acetas of 10 mg or 25 mg.

Hydrocortisone Richter contains in 1 ml Hydrocortisoni acetas 25 mg and lidocaine of a hydrochloride of 5 mg.

Release form

The lyophilized powder in bottles for preparation of solution for in/in and injections of 100 mg in oil and 500 mg, is applied solvent (alcohol) in ampoules.

Suspension in ampoules for in oil and intra joint injections of 2,5% 1 ml, 2 ml.

Ointment of 1% for external use on 5, 15, 20 and 30 g in a tuba.

Oculentum of 0,5% 3,5,10 g in a tuba.

Oculentum the Hydrocortisone of POS of 1%, and 2,5% in a tuba.

Cream of 1% in a tuba on 10 ml.

The tablets containing a hydrocortisone of 5, 10 or 20 mg are issued under the name Cortefum. The emulsion of 0,1% containing a hydrocortisone 17 butyrate has a trade name Lokoid Krelo.

Pharmacological action

Antiallergic, antiinflammatory.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Wikipedia defines a hydrocortisone as a highly active adrenal hormone. It is similar to a cortisone, but is more active. Possesses the expressed action on an exchange of carbohydrates, proteins and fats. In a liver strengthens deposition of a glycogen and synthesis of glucose that activates release of insulin. Increases glucose level in blood, detains sodium and water, strengthens removal of calcium from an organism.

Has antiinflammatory, antiallergic, antishock effect. Possesses immunodepressive activity. Slows down development of adenoid and connecting tissue, reduces permeability of capillaries. In medical practice apply a natural hydrocortisone or its synthetic ethers (acetate and sodium gemisuktsinat). Succinates and gemisuktsinata are dissolved in water and render fast, but short-term action at injection introduction. Acetates represent suspensions not soluble in water.

Hydrocortisoni acetas shows mainly antiinflammatory activity. Inhibits A2 phospholipases that attracts suppression of synthesis of prostaglandins. Slows down migration of leukocytes of macrophages and mast cells in the inflammation center, suppresses proteolytic activity, growth of fibroblasts detains. Slows down release of a histamine. Reduces hypersensitivity reactions, exudative processes in the center of an inflammation and a hyperemia, renders slowly developing, but long effect. It is applied to introduction to soft tissues and in a joint. The effect at intra joint introduction is observed in 6-20 h and several days and last weeks. Topical administration of ointment suppresses inflammatory and allergic reactions of a front piece of an eye. On antiinflammatory activity in more weakly Prednisolonum.

Hydrocortisone gemisuktsinat has metabolic and antiinflammatory effect. Is choice drug at acute adrenal insufficiency and other medical emergencies, at an adrenogenital syndrome.

Pharmacokinetics

At in introduction action is noted in 15 min. Contacts proteins for 40-90%. It is metabolized in a liver. It is removed by kidneys, T1/2 — 80-120 min. For maintenance of high concentration into blood it is entered each 4–6 h. At introduction in oil it is absorbed slowly (to 48 h). Well gets through mucous. In a placenta 70% are metabolized.

Ointment with a hydrocortisone gets into epidermis and collects in it. It is slightly absorbed in a system blood stream, having systemic action. Absorption of active agent increases at use on extensive sites, frequent use, when drawing on face skin and to the area of folds, under occlusive bandages. At children absorption is more expressed in this connection apply on a limited site, is not long. At frequent use cumulation of active agent in skin increases. It Biotransformirutsya in epidermis, soaked up in a system blood stream for 90% contacts proteins, it is metabolized in a liver, removed by kidneys and with bile.

Ointment the Hydrocortisone for eyes badly gets through a cornea, but gets into epidermis and an epithelium of mucous. Penetration depends on a condition of a cornea and increases at an inflammation or damage mucous eyes.

Indications to use

System use for replacement therapy and treatment of inflammatory processes:

  • insufficiency of adrenal glands;
  • arterial hypotension;
  • cardiogenic and traumatic shock;
  • thyrocardiac crisis;
  • hepatic coma;
  • collapse at Addison's illness;
  • asthmatic status;
  • serum disease;
  • hay fever;
  • throat hypostasis;
  • nephrotic syndrome;
  • acute liver failure;
  • exacerbations of ulcer colitis and illness Krone;
  • psoriasis and pseudorheumatism;
  • acute gouty arthritis;
  • juvenile arthritis;
  • system lupus erythematosus;
  • dermatomyositis;
  • spondylitis;
  • humeroscapular periarthritis;
  • rheumatic carditis.

Intra articulary and periartikulyarny introduction:

  • reactive synovitis;
  • acute bursitis;
  • pseudorheumatism;
  • epicondylitis;
  • acute tendosinovit;
  • posttraumatic osteoarthritis;
  • syndrome of a carpal tunnel.

Topical administration of ointment:

  • eczema;
  • allergic dermatitis;
  • exfoliative dermatitis;
  • seborrheal dermatitis;
  • pruritic dermatosis;
  • anogenitalny itch;
  • photodermatoses;
  • neurodermatitis;
  • psoriasis;
  • stings of insects;
  • prurigo;
  • erythrosis.

Use of an oculentum

  • allergic conjunctivitis, blepharitis;
  • blefarokonjyunktivit;
  • dermatitis century;
  • keratitis and state after the postponed keratitis;
  • iridocyclitis (acute and subacute);
  • iritis;
  • back uveitis and choroiditis;
  • thermal and corrosive burns;
  • state after operative measures.

Contraindications

In/in and in oil it is contraindicated to enter a hydrocortisone at:

  • hypersensitivity;
  • heavy current of an idiopathic hypertensia;
  • diseases of Itsenko-Kushinga;
  • nephrite;
  • epilepsies;
  • peptic ulcer;
  • acute psychoses;
  • osteoporosis;
  • to round ulcer;
  • active forms of tuberculosis;
  • diabetes mellitus;
  • renal failure;
  • AIDS;
  • system mycoses;
  • postvaccinal period;
  • age till 1st year.

It is contraindicated to apply this form of release at pregnancy.

Topical administration of ointment is contraindicated at:

  • bacterial skin diseases;
  • virus and fungal infections of skin;
  • displays of syphilis;
  • tuberculosis cutis;
  • ulcers and wounds of skin;
  • skin tumors;
  • rozatsea;
  • perioral dermatitis;
  • vulgar eels;
  • postvaccinal period;
  • age till 2 flyings.

With care it is appointed at a diabetes mellitus, a general disease tuberculosis. With care to apply on face skin in connection with a possibility of emergence of by-effects (teleangiectasias, an atrophy, perioral dermatitis), even after short-term use. For the prevention of infectious damages of skin Hydrocortisone ointment is recommended to appoint in combination with antibacterial and antifungal agents.

The oculentum is not appointed at:

  • viral diseases of eyes;
  • disturbance of integrity of a cornea;
  • tuberculosis, purulent and fungal infection of eyes;
  • during vaccination;
  • to trachoma.

At pregnancy perhaps topical administration on doctor's orders if the expected effect exceeds risk of possible complications for a fruit. Duration of use for pregnant women should not exceed 7–10 days.

Side effects

The hydrocortisone in ampoules at in oil and intra joint introduction can cause:

  • delay of sodium and liquid;
  • potassium loss;
  • congestive heart failure;
  • disturbance of a heart rhythm;
  • gipokaliyemichesky alkalosis;
  • steroid myopathy;
  • necrosis of heads humeral and femurs;
  • osteoporosis and pathological fractures;
  • gastrointestinal tract canker;
  • pancreatitis;
  • petechias and ecchymomas;
  • increase of intracranial pressure;
  • mental disorders;
  • spasms;
  • immunity oppression;
  • disturbance of a menstrual cycle;
  • suppression of growth at children;
  • Icenco-Cushing syndrome.

For reduction of side reactions appoint a diet rich with potassium and restriction of sodium. Control the arterial pressure, sugar of blood and coagulability.

External use of ointment can cause the Hydrocortisone:

  • irritation in a drug site of application;
  • hyperemia;
  • burning;
  • itch and dryness;
  • striya;
  • skin depigmentation;
  • puffiness;
  • atrophic changes;
  • hypertrichosis;
  • aknepodobny rash;
  • secondary infectious defeats;
  • teleangiectasias.

At prolonged use on big sites there can be system undesirable effects as manifestation of resorptive effect of drug (oppression of bark of adrenal glands, a hyperglycemia, a syndrome of Kushinga, a glucosuria). Prevention of infectious damages of skin requires a combination to antibacterial agents.

The oculentum POS Hydrocortisone having the bigger content of active agent causes:

  • burning;
  • reddening of scleras;
  • dermatokonjyunktivit;
  • eczema century;
  • secondary steroid glaucoma (at prolonged use);
  • exophthalmos;
  • cataract;
  • perforation of a cornea (at disturbance of its integrity);
  • accession of consecutive infection.

In this regard use of ointment till 2 weeks is allowed.

Application instruction of the Hydrocortisone (Way and dosage)

Ointment Hydrocortisone, application instruction

2–3 times a day are applied with a thin layer on affected areas of skin. Treatment duration — 6-14 days, and at a persistent current lasts till 20 days. At hypertrophic manifestations apply under occlusive bandages which change in 24-48 h. If after week treatment improvement is not noted, use of drug is stopped and further treatment is coordinated with the doctor. To avoid hit in eyes. With extra care apply on face skin as emergence of teleangiectasias and an atrophy is possible. At prolonged treatment appoint a diet with restriction of sodium and enter enough protein.

At children suppression of bark of adrenal glands develops quicker, besides development of a growth hormone decreases. Therefore to children it is appointed only under medical control. At use for children of 1 year limit duration of treatment and do not apply occlusive bandages. In cases of need of use of ointment on area of the person under a bandage duration of treatment is limited two weeks.

Unlike ointment cream 1% (Nikomed) can be applied at sunblisters, photodermatites and an intertrigo at children. It can be applied on a face.

Oculentum Hydrocortisone, application instruction

Eye ointment is put in a conjunctival sac for a lower eyelid, apply an ointment strip in 1-2 cm 3 times a day. After procedure carefully close eyes. Treatment duration about two weeks also lasts only on doctor's orders.

Not to allow contact of a tube with an eye conjunctiva surface. During treatment not to use contact lenses. At simultaneous use of drops ointment is put in 15 min. after an instillation. When using ointment more than 2 weeks it is necessary to control intraocular pressure.

Suspension Hydrocortisone, application instruction

Before use contents are stirred up for receiving homogeneous suspension. The hydrocortisone in ampoules is entered deeply into a gluteus by 50-300 mg, at most 1000-1500 mg a day. At states, life-threatening, each 4 h the first two days, then in 8 h enter 150 mg. To children each 4 h, a daily dose appoint 1-2 mg to weight kg up to 6-9 mg on weight kg.

To adults and children since 14 enter 5-50 mg into a cavity of joints, to children of younger age of 5-25 mg once a week. The course of treatment makes 3-5 injections. Action begins in 6-20 h and several days or proceed weeks.

The suspension the Hydrocortisone Richter containing a hydrocortisone and lidocaine is entered only periartikulyarno or into a joint cavity. Adult 5-50 mg. A single dose to children aged from 3 months till 1 year at periartikulyarny introduction — 25 mg, till 6 flyings — 25-50 mg, 6-14 years — 50 mg.

Repeated introduction is carried out in 3 weeks. No more than 3 times a year as adverse influence on a hyaline cartilage affects are entered into the same joint. At a tendinitis the injection is done in a sinew vagina (it is impossible to enter into a sinew).

The instruction on drug in ampoules (bottles)

Liofilizovanny powder of a hydrocortisone gemisuktsinat is dissolved in the enclosed solvent and entered intravenously or intramusculary. At acute states the Hydrocortisone in / is appointed century. At the beginning during 30 sec. the dose of 100 mg is entered, then within 10 min. increases to 500 mg (on weight of a state). Each 2-6 h repeat introductions. Before stabilization of a state (usually 48-72 h) high doses are appointed. A daily dose — 1000-1500 mg. Usually 2/3 doses enter in the morning, and 1/2 during the lunchtime. If long therapy by corticosteroids is necessary, pass to other drug which does not cause a sodium delay. A dose for children — not less than 25 mg a day.

Sodium hydrocortisone powder gemisuktsinat which is well dissolved in water can be applied to inhalations with use of the nebulizer. Technically it is feasible, but action will be not local, but system. It needs to be considered, especially when inhalations with a hydrocortisone to children are carried out, the daily dose in that case should not exceed 25 mg of drug. To do inhalation in the morning and in the evening, no more than 5 days.

Physiotherapeutic topical treatment using a hydrocortisone yields good results, increases efficiency and is often applied in complex treatment of many diseases.

Ultrasound with the Hydrocortisone

The ultrasound renders the expressed anesthetic, spasmolytic and antiinflammatory action, stimulates blood circulation, improves a trophicity. As a result quicker effects of hemorrhages, infiltrates, traumatic hypostases and exudates resolve. At ultrasonic therapy in addition apply medicines on an ointment or gel basis. Their use allows to achieve medical concentration in a problem zone. Use a mobile technique: the site is greased by 1% with ointment and, densely pressing a head vibrator, move it in around or in the longitudinal direction. Before beginning procedures, it is necessary to consider contraindications on ultrasound with the Hydrocortisone:

  • general diseases of skin;
  • pustulous defeats on site procedure uses;
  • oncological diseases of skin;
  • psychoneuroses;
  • pregnancy (second half);
  • arterial hypertension of the III Art.;
  • the expressed atherosclerosis;
  • disturbance of a cordial rhythm;
  • arterial hypotonia;
  • frequent attacks of stenocardia;
  • thyrotoxicosis;
  • osteoporosis;
  • the complicated peptic ulcer;
  • the complicated myopia;
  • diabetes mellitus of a heavy current.

Fonoforez with the Hydrocortisone

From the technical point of view procedure differs from influence in ultrasound a little. At a fonoforeza by means of high-frequency ultrasonic fluctuations by intensity from 800 to 3000 kHz medicinal substance is also entered into the damaged site. In this case suspension of a hydrocortisone of 5 ml, vaseline and lanolin on 25 g is applied

It is applied at artrozoartrita, prostatitis, neuritis of a facial nerve, neurodermatitis, an adnexitis, a vulva itch, antritis. The noticeable effect is observed after 5-6 procedures, and steady — after the termination of a full course.

Contraindications on fonoforez with a hydrocortisone include:

  • idiopathic hypertensia of a heavy current;
  • heart failure;
  • disturbance of a cordial rhythm;
  • thyrotoxicosis;
  • peptic ulcer;
  • diabetes mellitus of a heavy current;
  • vibration illness;
  • osteoporosis;
  • bronchoectatic disease;
  • the complicated myopia;
  • myelosyringosis.

It should be taken into account also the general contraindications for fiziprotsedur: oncological diseases, bleedings, pregnancy.

Electrophoresis

It is a method of impact on an organism of a direct current and the medicinal substances entered with its help. An active electrode of the device influence a problem zone, and the indifferent electrode is in the patient's hand. At procedure drug in ampoules is used.

Indications on an electrophoresis with a hydrocortisone include:

  • rheumatic diseases;
  • injuries;
  • arthroses;
  • bursitis and tendovaginitis;
  • dermatological diseases and their effects in the form of hems (the external condition of skin improves, hems almost completely are eliminated).

Overdose

Overdose at prolonged use of drug in oil or in/in can is shown by oppression of bark of adrenal glands, nausea and vomiting, a hyperglycemia, bleeding, a delay of sodium and water, increase of arterial pressure, development of an Icenco-Cushing syndrome, a sharpening of persistent infections.

At topical administration of ointment acute overdose is improbable, but at prolonged use emergence of symptoms of chronic overdose with system manifestations is possible.
Treatment: symptomatic therapy, gradual drug withdrawal.

Interaction

Effect of drug at intramuscular or its intravenous administration is weakened by barbiturates, antihistaminic and antiepileptic means, diuretics — strengthen a hypopotassemia. Action of hypoglycemic means at such way of introduction decreases.

Use with NPVS increases risk of a yazvoobrazovaniye, paracetamol — a hepatotoxic.

The hydrocortisone reduces concentration in blood of salicylates and activity of sakharosnizhayushchy means. Cardiac glycosides and diuretics strengthen a hypopotassemia. At appointment with Amphotericinum In heart failure is shown.

Simultaneous use of an oculentum and drugs which cause increase of intraocular pressure promotes bigger increase of intraocular pressure.

Terms of sale

Ointment and oculentum are released without recipe of the doctor.

Suspension for injections — according to the recipe.

Storage conditions

Temperature of storage of ampoules of 25 °C, ointments 5-15 °C.

Period of validity

Drug in bottles and ampoules — 5 years.

Ointment — 3 years.

Analogs

Coincidence on the ATH code of the 4th level:

The tablets Cortefum, powder in bottles for injections to Saul Cortefum, solution for injections Sopolkort N.

Analogs of ointment which contain a hydrocortisone: Askortin, Hyoxysonum, Korteyd, Latikort, Lokoid Lipokrem.

About the Hydrocortisone

The ointments and creams containing corticosteroids have antiallergic antiinflammatory and antipruritic action. From what ointment the Hydrocortisone and at what diseases of skin it is used? It first of all, eczema, neurodermatitis, psoriasis, pruritic and allergic dermatosis, skin manifestations of a lupus erythematosus. Most often resort to hormonal therapy only in case of inefficiency of other means of topical treatment. Really, use of this ointment gives fast antiinflammatory effect, in several days the itch and hypostasis disappears.

About ointment the Hydrocortisone most often positive and it concerns persons who the first time tried to use hormonal ointment. Those who have a wide experience of use of ointments on the basis of hormones, say that Prednisolonum on antiinflammatory activity considerably exceeds a hydrocortisone, besides, to a lesser extent detains in an organism water. And the ointments containing dexamethasone and betamethasone are even more active. The hydrocortisone and Prednisolonum belong to the first generation of corticosteroids which are rather poorly active ingredients. Ointments and creams with these substances apply in pediatric practice, besides, they can be applied on face skin. Judging by responses, at any form of eczema treatment was begun with use of this ointment, in case of not expressed effect used more strong means — Ftorokortum or Polcortolonum. Skin atrophy, eels, hypopigmentation, striya — the widespread local undesirable reactions of corticosteroids arising on a face and inguinal area therefore on these sites corticosteroids of low activity have to be used.

For what ointment can be used? It is applied at physiotherapeutic procedures, for example, at treatment by ultrasound of diseases of joints and a backbone, cicatricial contractures, calcaneal spurs. Under the influence of ultrasound exudates resolve, analgeziruyushchy, antiinflammatory and vasodilating action is shown. Has similar effect fonoforez using suspension. Practically all who passed treatment left positive About a fonoforeza with a hydrocortisone. High performance, fast disappearance of pains and recovery was noted. This procedure was appointed after gynecologic diseases, and also at antritises. Some patients noted an aggravation after the first sessions.

There were data on the Internet on use of this ointment from wrinkles. What it is based on and whether harmfully to apply ointment for this purpose? Topical administration of a hydrocortisone causes a delay of liquid and some hypostasis which hides wrinkles and visually they become invisible. But it is temporary effect, after the termination of "procedures" liquid is lost, and wrinkles are shown again. Doctors categorically against use of a hydrocortisone in the cosmetic purposes. First of all is a hormonal drug which makes system impact on an organism (in the form of change of exchange processes) and local — a skin atrophy, it becomes thinner and process of aging accelerates. Besides, hormonal ointment causes accustoming of skin and decrease in effect at topical administration. Considering contraindications and possible complications, whether not too the high price of such imaginary rejuvenation? Ointment and oculentum the Hydrocortisone have to be appointed only by the doctor according to strict indications, it is impossible to conduct treatment by them independently. The oculentum was appointed by the patient at a keratitis, corrosive burns and after operative measures. At some patients the first days of use it burning, reddening of scleras and an itch was noted a century, but after survey of the doctor treatment was continued. Eye drops with active ingredient a hydrocortisone are absent. If you are interested in hormonal eye drops, then it: Oftan Deksametazon, Deksapos, Maksitrol, Maksideks, Deksametazon which include dexamethasone.

The hydrocortisone can be used for inhalations at laryngitis with the antiedematous purpose. If suspension for inhalations is used — it needs to be parted. How to part for inhalations? Take 1 ml of suspension and 2-3 ml of normal saline solution, fill an inhaler, 5 min. breathe. Inhalation is carried out in the morning and in the evening. About inhalations positive as hypostasis and a spasm is quickly stopped, cough decreases, breath is facilitated.

Suspension in a nose is sometimes appointed in the form of instillations at hypertrophic rhinitis, but, as a rule, it is not effective and it is not possible to avoid surgical treatment. Otolaryngologists often write out pharmaceutical drops which part solution of a dioxidin, adrenaline and suspension of a hydrocortisone or miramistin, nazivin and suspension is. Good results at treatment of allergic rhinitis and antritis are noted.

Zdravzona

  • Hydrocortisone of 1% ointment 10 of/JSC Nizhpharm/Nizhpharm
  • Hydrocortisone Richter of 25 mg +5mg/ml suspension for injections of 5 ml No. 1 flakongedeon Richter
  • Hydrocortisone of 0,5% oculentum 3gjelfa SA
  • Gidrokortizon-POS oculentum of 2,5% 2,5gursapharm Arzneimittel GmBH
  • Hydrocortisone of 2,5% suspension for injections of 2 ml No. 10 ampulyfarmak joint stock company

Drugstore of IFC

  • Gidrokortizon-POS hl ointment. 2,5% 2,5g, Ursapharm Arzneimittel Gmbhgermaniya
  • Hydrocortisone ointment of 1% 10 g *, Nizhpharm (N. Novgorod) Russia
  • Hydrocortisone hl ointment. 0.5% of a tube of 5 g *, Synthesis of AKO of joint stock company (Kurgan) Russia
  • Hydrocortisone hl ointment. 0.5% of a tube of 3 g, Murom priborostroit.z-d (Murom) Russia
  • Gidrokortizon-POS hl ointment. 1% 2,5g, Ursapharm Arzneimittel Gmbhgermaniya
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Apteka24

  • Gidrokortizonnizhfarm (Russia, Nizhny Novgorod)
  • Gidrokortizonfarmak (Ukraine, Kiev)
  • Gidrokortizonjelfa (Poland)

Paniapteka

  • Ointment hydrocortisone of 0.5% 3gnizhfarm
  • Hydrocortisoni acetas for infection. 2.5% of 2 ml No. 10
  • Ointment hydrocortisone of 0.5% 3gnizhfarm

BIOSPHERE

  • Hydrocortisone of 1% 10 g ointment in tubebiosintez (Russia)
  • Gidrokortizon-AKOS 1% 10 g ointment in tubesintez joint stock company (Russia)
  • Hydrocortisone of 0,5% 3 g ointment glazn.
  • Hydrocortisone of 5 ml susp.d/in.
  • Hydrocortisone of 1% 10 g ointment in tubenizhfarm (Russia)
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Section: Hormonal Dermatological For eyes
in more detail

Education: Graduated from Sverdlovsk medical school (1968 - 1971) as "Paramedic". Graduated from the Donetsk medical institute (1975 - 1981) as "An epidemiologist, a hygienist". Passed postgraduate study in the Central scientific research institute of epidemiology Moscow (1986 - 1989). An academic degree – the candidate of medical sciences (degree is awarded in 1989, protection – the Central scientific research institute of epidemiology Moscow). Numerous advanced training courses are studied in epidemiology and infectious diseases.

Experience: Work as the manager of department of disinfection and sterilization of 1981 - 1992. Work as the manager of department of especially dangerous infections of 1992 - 2010. Teaching activity at Medical institute 2010 - 2013.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use the Hydrocortisone surely consult with the attending physician.