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Name: Cortisone

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Pregnancy Category C

Drug classes

• Adrenal cortical hormone
• Corticosteroid, short acting
• Hormonal agent

Therapeutic actions

Enters target cells where it has anti-inflammatory and immunosuppressive (glucocorticoid) and salt-retaining (mineralocorticoid) effects.

Indications

• Replacement therapy in adrenal cortical insufficiency
• Hypercalcemia associated with cancer
• Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders
• Hematologic disorders: thrombocytopenic purpura, erythroblastopenia
• Trichinosis with neurologic or myocardial involvement
• Ulcerative colitis, acute exacerbations of multiple sclerosis, and palliation in some leukemias and lymphomas

Contraindications/cautions

Contraindicated in the presence of infections, especially tuberculosis, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections, pregnancy, lactation.

Use caution in the presence of renal or hepatic disease; hypothyroidism, ulcerative colitis with impending perforation; diverticulitis; active or latent peptic ulcer; inflammatory bowel disease; CHF, hypertension, thromboembolic disorders; osteoporosis; convulsive disorders; diabetes
mellitus.

Adverse effects

• CNS: Convulsions, vertigo, headaches, pseudotumor cerebri, euphoria, insomnia, mood swings, depression, psychosis, intracerebral hemorrhage, reversible cerebral atrophy in infants, cataracts, increased intraocular pressure, glaucoma
• GI: Peptic or esophageal ulcer, pancreatitis, abdominal distention
• CV: Hypertension, CHF, necrotizing angiitis
• Hematologic: Fluid and electrolyte disturbances, negative nitrogen balance, increased blood sugar, glycosuria, increased serum cholesterol, decreased serum T3 and T4 levels
• GU: Amenorrhea, irregular menses
• MS: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, spontaneous fractures
• Endocrine: Growth retardation, decreased carbohydrate tolerance, diabetes mellitus, cushingoid state, secondary adrenocortical and pituitary unresponsiveness
• Hypersensitivity: Anaphylactoid or hypersensitivity reactions
• Other: Impaired wound healing, petechiae, ecchymoses, increased sweating, thin and fragile skin, acne, immunosuppression and masking of signs of infection, activation of latent infections including tuberculosis, fungal and viral eye infections, pneumonia, abscess, septic infection, GI and GU infections

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