the package insert of the medicine Cortisonal.
Adrenocortical insufficiency primary or secondary;
Adrenocortical insufficiency acute;
Before surgery, or in the case of trauma or illness, in patients with adrenal insufficiency proven or when it is doubtful the reservation adrenocortical;
Adrenal hyperplasia congenital Tiroidite not suppurativa; hypercalcemia associated with cancer.
Disorders Rheumatic: As adjunctive therapy for short-term administration (as an aid in a episode of acute or exacerbation) in: osteoarthritis, post-traumatic, osteoarthritis, or synovitis, rheumatoid arthritis, including juvenile rheumatoid arthritis; bursitis acute and sub-acute; epicondylitis, tenosynovitis non-specific; arthritis acute gout: psoriatic arthritis; ankylosing spondylitis;
Collagen diseases: During an exacerbation or as maintenance therapy in selected cases of: lüpus erythematosus, cardite acute rheumatic; dermatomyositis, systemic (polymyositis);
Dermatological diseases: Pemphigus, Erythema multiforme severe Syndrome (Steven-Johnson). Dermatitis exfoliative. Dermatitis herpetiformis bullous. Seborrheic dermatitis severe. Severe psoriasis. Mycosis fungoides.
States Allergic: Control of allergic conditions in severe or incapacitating, non-responsive to conventional treatment in: bronchial asthma; contact dermatitis; atopic dermatitis; serum sickness; seasonal allergic rhinitis or perennial; hypersensitivity reactions to the drug, swelling, acute infection of the larynx (epinephrine is the drug of first choice).
Optical Diseases: inflammatory Processes, allergy, chronic and acute severe, involving the eyes, such as: herpes zoster ophthalmic; iritis, iridocyclitis; corio-retinitis; uveite diffuse later and corioidite; optic neuritis; sympathetic ophthalmia, inflammation of the anterior segment; allergic conjunctivitis, ulcers, allergic marginal corneal, arc-eye.
Gastrointestinal Illnesses: To assist the patient during a critical period of the disease in: ulcerative colitis (systemic therapy), regional enteritis (systemic therapy).
Respiratory Diseases: Sarcoidosis, symptomatic, Beriliose pulmonary Tuberculosis fulminating or disseminated (used concomitantly with chemotherapy antituberculosis appropriate) Syndrome, Loeffler, that can not be controlled by other means. Pneumonitis, aspiration.
Hematologic Disorders: hemolytic Anemia acquired (autoimmune) idiopathic thrombocytopenic Purpura in adults (only I. V.; administration I. M. is contraindicated). Eritroblastopenia, Anemia hipoplástica congenital (red cell). Thrombocytopenia secondary in adults.
Disease Neoplastic: For palliative management of: leukemia and lymphomas in adults; acute leukemia of childhood.
Edematous States: To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.
Medical Emergencies: Cortisonal – is indicated in the treatment of shock secondary to adrenocortical insufficiency or shock not responsive to conventional therapy (the possibility of failure, cortical); allergic disorders acute (status asthmatic, anaphylactic reactions, insect stings, etc), once you have tried epinephrine. Although there are no clinical studies well-controlled, data obtained in experimental animals indicate that corticosteroids may be useful in the treatment of shock-hemorrhagic, traumatic, or surgical not responsive to traditional therapy.
Miscellaneous: tb Meningitis with lock subaracnóideo blocking or impending when used in conjunction with chemotherapy antituberculosis appropriate; trichinosis with neurological involvement or the myocardium.
When should I not use?
The use of the product is contraindicated in cases of fungal infections systemic. Its use is also contraindicated for patients having hypersensitivity to the components of the medicine.
In the first three months of pregnancy, should not use, in principle, no preparation corticosteroid.
you Should avoid long-term treatment with corticosteroids.
How to use?
This preparation can be administered by intravenous injection, intravenous infusion or intramuscular injection, the intravenous preferred, especially when dealing with urgent cases. After the initial period of emergency, use a prepared injectable of the action more prolonged.
The treatment with corticosteroids in high doses should be continued only until the patient’s health status has stabilized, which usually occurs 48 to 72 hours.
The initial dose is 100mg to 500mg, depending on the severity of the case. The dose should be repeated at intervals of 2, 4 and 6 hours, as indicated by patient response and clinical conditions.
The dosages vary according to the pathology. Working with large limits, that is, from 35 to 40mg the 12 to 15g/ day.
Although the dose may be reduced in children, should be considered more by the severity of the disease and response of the patient, than by age or body weight. Should not be, however, less than 25 mg/ day.
What are the evils that can cause me?
Disturbances in fluid and electrolyte: Retention of sodium, fluid retention, congestive heart failure in susceptible patients, potassium loss, alcalose hipocalcêmica and hypertension.
musculoskeletal: muscle Weakness, myopathy steroid, loss of muscle mass, osteoporosis, compression fractures of the spine, necrosis aseptic of the heads of the femur and of the humerus, pathological fracture of long bones, and rupture of the tendons.
Gastrointestinal: peptic Ulcer with possible perforation and hemorrhage, perforation of the small intestine, and thick, particularly in patients with bowel disease, pancreatitis, abdominal distention, and esofagia ulcerative colitis.
Skin: Prejudice in the healing of the wounds, the skin thin and fragile, petechiae and ecchymoses, erythema, hipersudorese, possible suppression of reactions to skin tests, other skin reactions, such as allergic contact dermatitis, urticaria, and edema angioneurótico.
Neurological: Convulsions, increased intracranial pressure with papilledema (pseudo tumor cerebral), usually after treatment, vertigo, and headache.
Endocrine: menstrual Irregularities, development of state cushingoide, suppression of the axis, the pituitary, supra-renal manifestations of diabetes melitus (latent).
Ophthalmic: Cataract, sub-capsular-to-back, increased eye pressure, exophthalmos.
the Immune System: Masking of infections, activation of latent infections, opportunistic infections, and suppression of reaction to skin tests. Can appear symptoms of anaphylactic reactions such as bronchospasm, edema of the larynx and urticaria.
Warnings and Precautions
what should I know before using?
In patients on corticosteroid therapy subject to stress the unusual, increased dosage of corticosteroids, fast-acting, before, during, and after the stressful situation. The adrenocortical insufficiency secondary source of drug can be reduced to a minimum by gradual reduction posológica. Such type of failure concerning may persist for months after cessation of treatment, therefore, in any situation of stress occurring during that period, should reinstitute the hormone therapy. If the patient is already receiving steroids, may be necessary to increase the dosage. Once the secretion mineralocorticóide may be impaired, shall administer simultaneously the salt and/or mineralocorticóides. Corticosteroids can cause thinning of resistance and the inability of the infection focuses. Additionally corticosteroids can compromise the testing of nitro-blue-tetrazolio for bacterial infection and produce cataract subcapsular posterior, glaucoma with possible damage to the optic nerves and may stimulate the establishment of eye infections secondary due to fungi or viruses. While in treatment with corticosteroids, patients should not be vaccinated against smallpox. Other methods of immunization should not be used in patients receiving corticosteroids, especially at high doses, by the possible risk of neurological complications and lack of antibody response. However, they can be carried out immunizations in patients receiving corticosteroids as replacement therapy. Dependence psychological and/or physiological can arise with long-term use of corticosteroids. The withdrawal symptoms that may occur include fever, anorexia, pain, vague weakness and lethargy.
In patients with hyperthyroidism and in patients with cirrhosis, there is an accentuation of the effect of the corticosteroids. When using corticosteroids may appear to treat psychological problems, ranging from euphoria, insomnia, changes in mood, personality changes and severe depression, even frank psychotic manifestations. Also the emotional instability or trends in psychotic pre-existing conditions may be aggravated by corticosteroids. The growth and development of children on prolonged treatment with corticosteroids should be carefully observed. In some patients, the steroids may increase or decrease motility and number of sperm.
what to do if someone use a larger amount than is recommended?
The treatment in overdose is symptomatic.
In the event of accidental ingestion or administration of doses far above the recommended, it is recommended to adopt the mediated usual control of the vital functions.