Procedure or clinical condition | Dosing of glucocorticoids |
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Minor surgical procedure or illness
- Inguinal hernia repair
- Colonoscopy
- Mild febrile illness
- Mild gastroenteritis
| - Before the procedure, hydrocortisone 25 mg orally or intravenously in addition to the normal dose.
- On the days of illness (see the left column), double the normal dose.
|
Moderate surgical procedure or illness
- Cholecystectomy
- Hemicolectomy
- Pneumonia
- Severe gastroenteritis
| - Before the procedure, hydrocortisone 50-75 mg (or alternatively methylprednisolone 10-15 mg) intravenously in addition to the normal dose. The dose is tapered over 1-2 days to the usual dose.
- On the days of illness, hydrocortisone 50-75 mg orally, intramuscularly or intravenously divided into 2-3 doses in addition to the normal dose. The dose is tapered to the usual dose according to recovery from the illness.
|
Major procedure or illness
- By-pass surgery
- Liver resection
- Pancreatectomy
- Pancreatitis
| - On the day of the procedure, hydrocortisone 100 mg (or alternatively methylprednisolone 20 mg) intravenously divided into 2-3 doses in addition to the normal dose. The dose is tapered over 1-2 days to the usual dose.
- On the days of illness, hydrocortisone 100 mg intravenously divided into 2-3 doses in addition to the normal dose. The dose is tapered to the usual dose according to recovery from the illness.
|
Critical illness
| - Hydrocortisone 100 mg intravenously, followed by 50 mg intravenously every 6-8 hours. Gradual tapering off (table T1)
|