Which medications in the drug class Corticosteroids are used in the treatment of Systemic Inflammatory Response Syndrome (SIRS)?

Updated: May 07, 2018
  • Author: Lewis J Kaplan, MD, FACS, FCCM, FCCP; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Corticosteroids

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune system to diverse stimuli. The initial research in sepsis and septic shock showed a trend toward worse outcomes when treating with high doses of steroids (methylprednisolone sodium succinate 30 mg/kg every 6 h for 4 doses) compared with placebo. However, research into low-dose steroids (200-300 mg of hydrocortisone for 5-7 days) improved survival and the reversal of shock in vasopressor-dependent patients.

Hydrocortisone sodium succinate or phosphate (Cortef, Solu-Cortef)

This is the drug of choice for steroid replacement in acute adrenal crisis and for daily maintenance in patients with Addison disease or secondary adrenocortical insufficiency. It has glucocorticoid and mineralocorticoid properties. The biologic half-life is 8-12 hours. The easiest way to set up an infusion is to have the pharmacy mix 100 mg of hydrocortisone in 100 mL of 0.9% saline.


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