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What Are The Repercussions Of Excessive Intake Of Solu-cortef Injections?

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Posted on Mon, 28 Nov 2016
Question: I have Addisons disease and have been hospitalized for acute adrenal failure several times at different hospitals for lack of cortisol in my system.The hospitals usually administer 100 mg. of solu-cortef and I come right back to normal in a short time.The last time I was hospitalized at anew hospital they administered 100 mgs Solu-Cortef 3 tmes in an 8 hr. period which put me into delirium.I believe that 300 mgs of Solu- Cortef is excessive and the administering Dr, even told me they realized they had given me too much. I would appreciate any input you have on this .TY Best,XXXX
doctor
Answered by Dr. Shehzad Topiwala (20 minutes later)
Brief Answer:
Addison's disease

Detailed Answer:
Sorry to learn about your medical condiion.

The amount of solu cortef to be given depends on the degree of stress the patient is in. A major medical illness, for example, requiring ICU care, would typically need 100 mg three times daily every 8 hours which would be gradually weaned down to much lower doses as days pass and the medical situation improves.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (14 hours later)
I just reviewed the medications given list. it does say every eight hrs on the solu-cortef hospital's instuctions, but actual IVs of 100mgs were administered from 12:30 PM to 9:30 PM on the same day and yes they did all the tests you mentioned. Two done within one hour upon admission and two done within one hour 8 hrs later also one 4 hrs after 1st set =500 mgs in an eight hour period. I was extremely delusional and when they discovered their mistake did not give me any solu-cortef on the second day of treatment. I was in the hospital for 5 days. the third day they resumed solu-cortef at 50 mgs at a time.
doctor
Answered by Dr. Shehzad Topiwala (6 hours later)
Brief Answer:
Follow up

Detailed Answer:
It is fairly conventional to use 100 mg solu-cortef every 6 to 8 hours to start with if the illness is severe, then quickly taper down to 50 mg three times daily and then even less on successive days, if the medical condition shows improvement
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (1 hour later)
yes .TY. I understand that. My question is ....Doesn't it seem excessive to administer 500 mgs within an eight hr period? Especially the last two injections were only ten minutes apart. Ty again,XXXX.
doctor
Answered by Dr. Shehzad Topiwala (24 hours later)
Brief Answer:
Doses

Detailed Answer:
Hydrocortidone is sometimes given as a bolus dose of 100 mg followed by 50-75 mg every 6 hours for the next 24 hours. Bolus means a direct push into the blood through the veins. Then as the crisis improves , Lower doses are given at 4 hour intervals on successive days
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (2 days later)
I think you must mean Hydrocortisone or Solu-cortef not Hydrocortidone. Thank you for your answers. Best regards ,XXXX
doctor
Answered by Dr. Shehzad Topiwala (51 minutes later)
Brief Answer:
Third follow up

Detailed Answer:
Indeed. Apologies for the typo.
Yes I meant Hydrocortisone.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Are The Repercussions Of Excessive Intake Of Solu-cortef Injections?

Brief Answer: Addison's disease Detailed Answer: Sorry to learn about your medical condiion. The amount of solu cortef to be given depends on the degree of stress the patient is in. A major medical illness, for example, requiring ICU care, would typically need 100 mg three times daily every 8 hours which would be gradually weaned down to much lower doses as days pass and the medical situation improves. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH (checks your thyroid) 25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter) None of these tests require any fasting and can be done at any time of the day Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.