Cortisone

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Drugs Dictionary: Cortisone

Cortisone

Trade Name

Cortone Acetate (historical brand name, rarely used); generic cortisone acetate

Classification

Corticosteroid; glucocorticoid (short-acting)

Dosage/Route

* Dosage:
- – Tablets: 5 mg, 10 mg, 25 mg
- – Injection (IM): 50 mg/mL suspension
* Route: Oral (PO), intramuscular (IM)

Usual Dosage

* Adults:
- – PO: 25-300 mg/day divided BID-QID; titrate to lowest effective dose
- – IM: 20-300 mg/day, single or divided doses
* Children: 0.7-10 mg/kg/day PO or IM, divided q6-12h
* Maintenance: Taper to lowest dose; alternate-day dosing may reduce side effects
* Duration: Short-term (days) for acute conditions; long-term for chronic (with taper)

Mechanism of Action

Mimics endogenous cortisol, binding to glucocorticoid receptors to suppress inflammation, immune response, and cytokine production. Inhibits phospholipase A2, reducing arachidonic acid and prostaglandins/leukotrienes. Also stabilizes lysosomal membranes and reduces edema

Side Effects & Adverse Effects

* Side Effects: Weight gain, insomnia, mood changes, increased appetite
* Adverse Effects:
- – Adrenal suppression (long-term; boxed warning, requires taper)
- – Hyperglycemia, osteoporosis, GI bleeding (high doses)
- – Immunosuppression (infection risk)
- – Cushingoid features (moon face, buffalo hump; chronic use)
- – Rare: Psychosis, cataracts, myopathy

Nursing Management (Implications & Teachings)

* Implications:
- – Monitor BG, BP, weight, electrolytes (K+, Na+); assess for infection signs
- – IM: Shake suspension, deep gluteal injection; avoid IV (not water-soluble)
- – Taper dose if >7-10 days to prevent adrenal crisis (fatigue, hypotension)
- – Avoid abrupt stop; stress-dose steroids if surgery/illness
* Teachings:
- – Take PO with food to reduce GI upset; AM dosing mimics cortisol rhythm
- – Report fever, bruising, or mood swings
- – Carry steroid ID; don’t stop suddenly
- – Avoid live vaccines, limit alcohol/NSAIDs (GI risk)