药品信息:
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英文药名: Hydrocortisone Tablets 5mg
中文药名: 氢化可的松片
生产厂家: Douglas Pharmaceuticals Ltd
药品名称
【别名】可的索;皮质醇;氢化皮质酮;氢可的松;氢化可的松
【外文名】Hydrocortisone
【成份】本品主要成份:氢化可的松
【性状】本品为白色片。
药理毒理
本品为糖皮质激素类药物。具有抗炎、抗毒、抗休克和免疫抑制等多种药理作用。
(1)抗炎作用:对除病毒外的各种病因引起的炎症均有作用,糖皮质激素减轻和防止组织对炎症的反应,从而减轻炎症的症状,亦可抑制炎症后期组织的修复,减少后遗症。
(2)免疫抑制作用:防止或抑制细胞中介的免疫反应,延迟性的过敏反应,并减轻原发免疫反应的扩展。
(3)抗毒、抗休克作用:糖皮质激素能提高机体的耐受能力,减轻细胞损伤,发挥保护机体的作用。还有扩张血管,增强心肌收缩力,改善微循环作用。
药代动力学
本品极易自消化道吸收,约1小时血药浓度达峰值,T1/2约为100分钟,生物半效期约8~12小时。在血中90%以上与血浆蛋白结合,其中80%与皮质激素转运蛋白(CBG)结合,本品主要经肝脏代谢,转化为四氢可的松和四氢氢化可的松,大多数代谢产物结合成葡糖醛酸酯,极少数以原形经尿排泄。
适应症
1.用于肾上腺功能不全所引起的疾病、类关节炎">风湿性关节炎、风湿性发热、痛风、支气管哮喘等。
2.用于过敏性皮炎、脂溢性皮炎、瘙痒症等。
3.用于虹膜睫状体炎、角膜炎、巩膜炎、结膜炎等。
4.用于神经性皮炎。
5.用于结核性脑膜炎、胸膜炎、关节炎、腱鞘炎、急慢性捩伤、腱鞘劳损等。
用法用量
1.醋酸氢化可的松片:口服每次1片(含药5mg),1日1~2次。
2.醋酸氢化可的松软膏,1%软膏,外用。
3.醋酸氢化可的松滴眼液:每瓶5mg(3ml),滴眼,每次1~2滴。
4.皮炎膜(神经性皮炎气雾膜):气雾剂喷射于皮损表面,即形成一层薄膜,可隔绝外界对皮损的各种刺激,使皮损处保持较长时间的稳定,再加上氢化可的松的消炎作用,故对神经性皮炎有一定疗效。一般用后痒感减轻或完全消失,皮损逐渐改善,病程短的见效较快,痊愈率也较高,但痊愈后有复发。
5.摇匀后供关节注射与鞘内注射。关节腔内注射,每次1~2ml(每ml内含药25mg);鞘内注射,每次1ml。
6.替代治疗: 成人每日20~25mg,晨服2/3,午餐后服1/3。
任何疑问,请遵医嘱!
不良反应
本品在应用生理剂量替代治疗时一般无明显不良反应。不良反应多发生在应用药理剂量时,而且与疗程、剂量、用药种类、用法及给药途径等有密切关系。常见不良反应有以下几类:
1.长程使用可引起以下副作用:医源性库欣综合征面容和体态、体重增加、下肢浮肿、紫纹、易出血倾向、创口癒合不良、痤疮、月经紊乱、肱或股骨头缺血性坏死、骨质疏松及骨折(包括脊椎压缩性骨折、长骨病理性骨折)、肌无力、肌萎缩、低血钾综合征、胃肠道刺激(恶心、呕吐)、胰腺炎、消化性溃疡或穿孔,儿童生长受到抑制、青光眼、白内障、良性颅内压升高综合征、糖耐量减退和糖尿病加重。
2.患者可出现精神症状:欣快感、激动、谵妄、不安、定向力障碍,也可表现为抑制。精神症状尤易发生于患慢性消耗性疾病的人及以往有过精神不正常者。
3.并发感染为肾上腺皮质激素的主要不良反应。以真菌、结核菌、葡萄球菌、变形杆菌、绿脓杆菌和各种疱疹病毒为主。
4.糖皮质激素停药综合征:有时患者在停药后出现头晕、昏厥倾向、腹痛或背痛、低热、食欲减退、恶心、呕吐、肌肉或关节疼痛、头疼、乏力、软弱,经仔细检查如能排除肾上腺皮质功能减退和原来疾病的复燃,则可考虑为对糖皮质激素的依赖综合征。
禁忌
对本品及其它甾体激素过敏者禁用。下列疾病患者一般不宜使用,特殊情况应权衡利弊使用,但应注意病情恶化可能:严重的精神病(过去或现在)和癫痫,活动性消化性溃疡病,新近胃肠吻合手术,骨折,创伤修复期,角膜溃疡,肾上腺皮质机能亢进症,高血压,糖尿病,孕妇,抗菌药物不能控制的霉菌感染、水痘、麻疹,较重的骨质疏松症等。
注意事项
1.发感染:在激素作用下,原来已被控制的感染可活动起来,最常见者为结核感染复发。在某些感染时应用激素可减轻组织的破坏、减少渗出、减轻感染中毒症状,但必须同时用有效的抗生素治疗、密切观察病情变化,在短期用本药后,即应迅速减量、停药。
2.对诊断的干扰:
(1)糖皮质激素可使血糖、血胆固醇和血脂肪酸、血钠水平升高、使血钙、血钾下降。
(2)对外周血象的影响为淋巴细胞、真核细胞及嗜酸、嗜碱细胞数下降,多核白细胞和血小板增加,后者也可下降。
(3)长期大剂量服用糖皮质激素可使皮肤试验结果呈假阴性,如结核菌素试验、组织胞浆菌素试验和过敏反应皮试等。
(4)还可使甲状腺131I摄取率下降,减弱促甲状腺激素(TSH)对TSH释放素(TRH)刺激的反应,使TRH兴奋实验结果呈假阳性。干扰促黄体生成素释放素(LHRH)兴奋试验的结果。
(5)使同位素脑和骨显象减弱或稀疏。
3.下列情况应慎用:心脏病或急性心力衰竭、糖尿病、憩室炎、情绪不稳定和有精神病倾向、全身性真菌感染、青光眼、肝功能损害、眼单纯性疱疹、高脂蛋白血症、高血压、甲减(此时糖皮质激素反应增强)、重症肌无力、骨质疏松、胃溃疡、胃炎或食管炎、肾功能损害或结石、结核病等。
4.随访检查:长期应用糖皮质激素者,应定期检查以下项目:
(1)血糖、尿糖或糖耐量试验,尤其是糖尿病或糖尿病倾向者。
(2)小儿应定期检测生长和发育情况。
(3)眼科检查,注意白内障、青光眼或眼部感染的发生。
(4)血清电解质和大便隐血。
(5)高血压和骨质疏松的检查,尤其注意老年人。
(6)用药过程中减量宜缓慢,不可突然停药。
孕妇及哺乳期妇女用药
(1)妊娠期用药:本品可通过胎盘。动物实验研究证实孕期给药可增加胚胎腭裂,胎盘功能不全、自发性流产和子宫内生长发育迟缓的发生率。可增加胎盘功能不全、新生儿体重减少或死胎的发生率。
(2)哺乳期用药:由于本品可由乳汁中排泄,对婴儿造成不良影响,如生长受抑制、肾上腺皮质功能抑制等。孕妇及哺乳期妇女在权衡利弊情况下,尽可能避免使用。
儿童用药
小儿如长期使用肾上腺皮质激素,须十分慎重。肾上腺皮质功能低下症及先天性肾上腺皮质增生症例外。
老年患者用药
老年患者用糖皮质激素易发生高血压及糖尿病。老年患者尤其是更年期后的女性应用糖皮质激素易加重骨质疏松。
药物相互作用
1.非甾体消炎镇痛药可加强本品致消化道溃疡作用。
2.可增强对乙酰氨基酚的肝毒性。
3.与两性霉素B或碳酸酐酶抑制剂合用,可加重低钾血症,长期与碳酸酐酶抑制剂合用,易发生低血钙和骨质疏松。
4.与蛋白质同化激素合用,可增加水肿的发生率,使痤疮加重。
5.与抗胆碱能药(如阿托品)长期合用,可致眼压增高。
6.三环类抗抑郁药可使本品引起的精神症状加重。
7.与降糖药如胰岛素合用时,因本品可使糖尿病患者血糖升高,应适当调整降糖药剂量。
8.甲状腺激素可使本品代谢清除率增加,故与甲状腺激素或抗甲状腺药合用,应适当调整后者的剂量。
9.与避孕药或雌激素制剂合用,可加强本品治疗作用和不良反应。
10.与强心苷合用,可增加洋地黄毒性及心律失常的发生。
11.与排钾利尿药合用,可致严重低血钾症,并由于水钠潴留而减弱利尿药的排钠利尿效应。
12.与麻黄碱合用,可增强其代谢清除。
13.与免疫抑制剂合用,可增加感染的危险性,并可能诱发淋巴瘤或其他淋巴细胞增生性疾病。
14.可增加异烟肼在肝脏代谢和排泄,降低异烟肼的血药浓度和疗效。
15.可促进美西律在体内代谢,降低血药浓度。
16.与水杨酸盐合用,可减少血浆水杨酸盐的浓度。
17.与生长激素合用,可抑制后者的促生长作用。
药物过量
可引起类肾上腺皮质功能亢进综合症。如及时发觉并停药症状可自行消退,症状严重者可行相应对症治疗。
English drug name: Hydrocortisone Tablets 5mg
Chinese drug name: hydrocortisone tablets
Manufacturer: Douglas Pharmaceuticals Ltd
Drug Name
[Alias] to the cable; cortisol; cortisol; hydrogen cortisone; hydrocortisone
[Foreign Name] Hydrocortisone
[Ingredient main ingredients]: hydrocortisone
[Properties]:white sheet.
Pharmacology and Toxicology
This product glucocorticoid drugs. With a variety of pharmacological effects anti-inflammatory, anti-drug, anti-shock and immune suppression.
(1) anti-inflammatory effects: In addition to a variety of causes for the inflammation caused by the virus outside of both the role of glucocorticoids to reduce and prevent tissue response to inflammation, thereby reducing the symptoms of inflammation, may inhibit inflammation late tissue repair, reduce sequelae.
(2) immunosuppressive effect: to prevent or inhibit the cell-mediated immune responses, delayed hypersensitivity reactions and reduce the expansion of the primary immune response.
(3) anti-drug and anti-shock effect: corticosteroids can improve the body's tolerance, reduce cell damage and play a role in protecting the body. There dilate blood vessels, enhance myocardial contractility, improve microcirculation effect.
Pharmacokinetic
This product is easily absorbed from the digestive tract, about one hour peak plasma concentration, T1/2 of approximately 100 minutes, biological half-valid about 8 to 12 hours. In the blood of more than 90% bound to plasma proteins, of which 80% with corticosteroids transporter protein (CBG) combined, this product is mainly metabolized by the liver, converted to tetrahydro cortisone and hydrocortisone tetrahydro Most metabolite combined into glucuronic acid ester, a handful of prototype through urinary excretion.
Indications
1.for adrenal insufficiency caused by disease, arthritis, type "> rheumatoid arthritis, rheumatic fever, gout, bronchial asthma.
2.for atopic dermatitis, seborrheic dermatitis, itching psychosis.
3.for iridocyclitis, keratitis, scleritis, conjunctivitis.
4.for neurodermatitis.
5.for tuberculous meningitis, pleurisy, arthritis, tenosynovitis, acute and chronic sprain, strain, etc. sheath.
Douglas Pharmaceuticals Ltd
1.hydrocortisone acetate tablets: Each time an oral (including drug 5mg), 1 Japan 1 ~ 2 times.
2. hydrocortisone acetate ointment, 1% ointment, topical.
3.hydrocortisone acetate eye drops: a bottle 5mg (3ml), eye drops, each 1 to 2 drops.
4.dermatitis membrane (neurodermatitis aerosol film): aerosol spray on the surface of the skin lesions, which form a thin film, can be isolated from the outside world for a variety of stimuli lesions, skin lesions remain stable so long time, coupled with the anti-inflammatory effect of hydrocortisone, it has a certain effect on neurodermatitis. After generally reduce or completely disappear with itching, skin lesions gradually improved, short duration of effective faster cure rate is high, but recovered after recurrence.
5. shake-articular injection with intrathecal injection for. Intra-articular injections, each 1 ~ 2ml (per ml containing drug 25mg); intrathecal injection, each 1ml.
6.replacement therapy: adult daily 20 ~ 25mg, serving two-thirds of the morning, after lunch, serving one-third.
Any questions, please doctor!
Adverse reactions
The goods in the application of physiological doses generally no significant adverse reactions alternative treatment. Adverse reactions occurred in the application of pharmacological doses, and with the course of treatment, dosage, medication type, usage and route of administration are closely related. Common adverse reactions following categories:
1.long use can cause the following side effects: Iatrogenic Cushing's syndrome face and body, weight gain, lower extremity edema, purple pattern, easy bleeding tendency, wound healing, acne, menstrual disorders, brachial or avascular necrosis , osteoporosis and fractures (including vertebral compression fractures, long pathologic fracture), muscle weakness, muscle atrophy, hypokalemia syndrome, gastrointestinal irritation (nausea, vomiting), pancreatitis, peptic ulcer or perforation, children's growth was inhibited, glaucoma, cataracts, benign intracranial hypertension syndrome, impaired glucose tolerance and diabetes increase.
2.patients with psychiatric symptoms may occur: euphoria, excitement, delirium, anxiety, disorientation, also showed inhibition. Psychiatric symptoms especially prone to suffer from chronic wasting diseases and in the past there have been mentally normal.
3.concurrent infection corticotropin major adverse reactions. In fungi, tuberculosis, staphylococcus, Proteus, Pseudomonas aeruginosa, and various herpes viruses based.
4.glucocorticoid withdrawal syndrome: Sometimes patients with dizziness, fainting tendency after discontinuation, abdominal or back pain, fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue, weakness, after careful examination if they can exclude the resurgence of adrenal insufficiency and the original disease, could be considered as dependent on glucocorticoids syndrome.
Contraindications
The chemicals and other steroid allergy. Should not be used in patients with these diseases in general, should be weighed against the use of the special circumstances, but it should be noted that the condition may worsen: serious mental illness (past or present) and epilepsy, active peptic ulcer disease, recent gastrointestinal anastomosis, fractures, wound healing period , corneal ulcers, adrenal hyperactivity disorder, hypertension, diabetes, pregnant women, antibiotics can not control the fungal infection, chicken pox, measles, heavier osteoporosis.
Precautions
1. Infection: the role of hormones in the original infection has been controlled activities together, the most common is TB infection recurrence. When certain hormone can reduce damage to tissue infection, reducing leakage, reduce infection symptoms, but must at the same time with an effective antibiotic treatment, close observation of changes in short-term use of the drug, which should prompt reduction, stop drugs.
2. Interfere with the diagnosis:
(1) glucocorticoid make blood sugar, blood cholesterol and blood fatty acids, elevated serum sodium level, so that calcium, potassium levels drop.
(2) on peripheral blood lymphocytes, eukaryotic cells and eosinophils, basophils cells decreased, polymorphonuclear leukocytes, and platelets, which can also be decreased.
(3) long-term large doses of corticosteroids can make the skin test results were false negative, such as the tuberculin test, histoplasmin skin test and other tests and allergic reactions.
(4) also allows the thyroid 131I uptake rate of decline decreased thyroid stimulating hormone (TSH) for TSH-releasing hormone (TRH) stimulation, so TRH stimulation test results were false positives. Interfere with luteinizing hormone releasing hormone (LHRH) stimulation test results.
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