Hydrocortisone

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Hydrocortisone (brand names Cortef, Solu-Cortef) — Anti-inflammatory, adrenal replacement; Short-acting corticosteroid with mineralocorticoid activity.

Identification

• Therapeutic class: Anti-inflammatory, adrenal replacement.
• Pharmacologic class: Short-acting corticosteroid with mineralocorticoid activity.

Pharmacology

• Mechanism of action: Replaces cortisol and reduces inflammation; has salt-retaining activity useful in adrenal insufficiency.
• Onset / peak / duration: Short to intermediate duration.
• Half-life / therapeutic level: Biologic effect 8 to 12 hours.

Clinical use

• Indications: Adrenal insufficiency, adrenal crisis (IV), inflammation, shock, topical dermatoses.
• Usual dose, route, frequency: PO replacement in divided doses; IV for crisis; topical for skin.
• Maximum dose / adjustments: Stress dosing during illness or surgery for adrenal insufficiency.

Safety

• Contraindications: Systemic fungal infection (systemic use).
• Black box warning: None.
• Interactions: Same corticosteroid interactions.
• Pregnancy / lactation: Used when needed.
• High-alert: No.

Adverse effects

• Common side effects: Fluid retention, increased appetite, mood changes.
• Serious effects to report: Adrenal crisis if doses are missed, infection, hyperglycemia.
• Antidote / reversal: None.

Nursing process

• Assessment before administration: Blood pressure, glucose, electrolytes, signs of crisis.
• Interventions during therapy: Teach stress-dosing and never to abruptly stop replacement.
• Monitor: Blood pressure, electrolytes, glucose.
• Evaluation / expected outcome: Stable adrenal function or reduced inflammation.

Patient teaching

• Patient teaching: Carry medical identification; increase dose with illness as directed; never skip.
• Notify provider if: Vomiting and unable to take the dose, weakness, dizziness.
• Administration tips: With food; divided doses mimic the natural cortisol rhythm.