코르티손 아세테이트

용도

• Long-term treatment of hypoadrenocorticism (changeover period)
• Long-term treatment of hypoadrenocorticism (maintenance)

투여 방법

가능한 부작용

• Vomiting
• Inappetence
• Diarrhea
• Hypersensitivity reactions (rare)
• Polyuria/Polydipsia/Polyphagia (at supra-physiologic doses)
• Panting (at supra-physiologic doses)
• Immunosuppression (at supra-physiologic doses)

주의사항 및 금기

• Hypersensitivity to cortisone acetate
• Systemic fungal infections (general corticosteroid contraindication)
• > **Laboratory Interference**: Cortisone cross-reacts with cortisol in the ACTH stimulation test. Baseline testing must be performed *before* administering cortisone (Note: Dexamethasone does not cross-react). * **Pregnancy**: FDA Category C. Excessive dosages early in pregnancy may lead to teratogenic effects. Glucocorticoids are necessary for normal fetal development, but high doses should be avoided. * **Nursing**: Unbound glucocorticoids enter milk. High doses or prolonged use may inhibit the growth of nursing newborns. * **Supra-physiologic Doses**: If used at higher than physiologic replacement doses, standard corticosteroid precautions apply (risk of iatrogenic Cushing's, immunosuppression, GI ulceration).

약물 상호작용

• Amphotericin B: Concomitant use may cause hypokalemia; risk of CHF and cardiac enlargement reported in humans.
• Aspirin: Glucocorticoids may reduce salicylate blood levels and increase risk for GI ulceration/bleeding.
• Diuretics, Potassium-Depleting (e.g., furosemide, thiazides): Concomitant administration may cause hypokalemia.
• Estrogens: May potentiate the effects of hydrocortisone/glucocorticoids.
• Insulin and Antidiabetic Agents: Insulin requirements may increase due to glucocorticoid-induced insulin resistance.
• Mitotane: May alter steroid metabolism; higher doses of steroids may be needed to treat mitotane-induced adrenal insufficiency.
• NSAIDs: Increased risk of gastrointestinal ulceration and bleeding.
• Vaccines (Live attenuated): Virus replication may be augmented if given at immunosuppressive doses; diminished immune response to killed vaccines/toxoids.
• Warfarin: May affect INR values; requires monitoring.

자주 묻는 질문