氢羟肾上腺皮质素

氢羟肾上腺皮质素
临床资料
商品名（英语：Drug nomenclature）	A-hydrocort, Cortef, Solu-cortef, others
其他名称	Cortisol; 11β,17α,21-Trihydroxypregn-4-ene-3,20-dione; 11β,17α,21-Trihydroxyprogesterone
AHFS/Drugs.com	Monograph
MedlinePlus	a682206
核准状况	美 DailyMed: Hydrocortisone;
怀孕分级	澳: A ; ;
给药途径	口服给药 (片剂), 静脉注射, 外涂, 肛门给药（英语：rectal administration）
药物类别（英语：Drug class）	皮质类固醇; 糖皮质素; 矿物皮质素
ATC码	A01AC03 (WHO) A07EA02, C05AA01, D07AA02, D07XA01, H02AB09, S01BA02, S01CB03, S02BA01;
法律规范状态
法律规范	澳：限医生处方（S4） / S3 / S2; 欧：OTC/ Rx-only; 英：处方药（℞-only） (POM) / P / GSL; 美：OTC/ Rx-only;
药物动力学数据
生物利用度	口服: 96 ± 20%
血浆蛋白结合率	92 ± 2% (92–93%)
药物代谢	11β-HSDs, 其它
代谢产物	可体松, 其它
药效起始时间（英语：Onset of action）	口服: 1.2 ± 0.4 hours (Tmax)
生物半衰期	1.2–2.0 小时
作用时间	8–12 小时
识别信息
	IUPAC命名法 (8S,9S,10R,11S,13S,14S,17R)-11,17-Dihydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-2,6,7,8,9,11,12,14,15,16-decahydro-1H-cyclopenta[a]phenanthren-3-one; ;
CAS号	50-23-7
PubChem CID	5754;
DrugBank	DB00741 ;
ChemSpider	5551 ;
UNII	WI4X0X7BPJ;
KEGG	D00088 ; D00165 ;
ChEBI	CHEBI:17650 ;
ChEMBL	ChEMBL389621 ;
化学信息
化学式	C21H30O5
摩尔质量	362.47 g·mol−1
3D模型（JSmol（英语：JSmol））	交互式图像;
	SMILES O=C4\C=C2/[C@]([C@H]1[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@H]3[C@@H]1CC2)C)(C)CC4;
	InChI InChI=1S/C21H30O5/c1-19-7-5-13(23)9-12(19)3-4-14-15-6-8-21(26,17(25)11-22)20(15,2)10-16(24)18(14)19/h9,14-16,18,22,24,26H,3-8,10-11H2,1-2H3/t14-,15-,16-,18+,19-,20-,21-/m0/s1 ; Key:JYGXADMDTFJGBT-VWUMJDOOSA-N ;

氢羟肾上腺皮质素（英语：Hydrocortisone），又称氢化皮质酮或氢化可体松，是皮质醇作为药物的名称^[13]。它是一种糖皮质激素，具有抗炎和免疫抑制作用。可以治疗：肾上腺机能不全（英语：Adrenal_insufficiency）、肾上腺生殖器综合症、高血钙、甲状腺炎、类风湿性关节炎、皮肤炎、哮喘和慢性阻塞性肺病（COPD）等疾病^[1]。它是治疗肾上腺机能不全的首选药物^[14]。此药可以口服、局部涂抹或注射给药^[1]。在长期使用而要停药时，应逐渐减少后才能完全停用^[1]。

它的副作用包括情绪改变、增加感染风险和水肿等^[1]。长期使用后，常见副作用包括骨质疏松、胃部不适、身体虚弱、容易瘀青和念珠菌感染^[1]。虽然可以在怀孕期使用，但安全性仍未确认^[15]。

此药于 1936 年获得专利，并于 1941 年获准用于治疗^[16] ^[17]。并列入世界卫生组织基本药物标准清单^[18]，市面上有多家学名药^[1]。2014年发展中国家每日口服药物的每日费用约0.27美元^[19]。在美国，一个月的治疗费用通常不到 25美元^[20]。 2017 年，它是美国最常用处方药的第 154 名，开立的处方超过 400 万张^[21] ^[22]。

参考资料

^ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 ^1.6 Hydrocortisone. Drugs.com. American Society of Health-System Pharmacists. February 9, 2015 [30 August 2016]. （原始内容存档于20 September 2016）.
^ Prescribing medicines in pregnancy database. Therapeutic Goods Administration (TGA). [21 February 2021]. （原始内容存档于20 December 2016）.
^ Hydrocortisone Notice of enforcement policy (PDF). FDA. [31 December 2022]. （原始内容存档 (PDF)于12 March 2023）.
^ Ala-cort- hydrocortisone cream. DailyMed. [21 February 2021]. （原始内容存档于27 October 2020）.
^ Ala-scalp- hydrocortisone lotion. DailyMed. [21 February 2021]. （原始内容存档于21 April 2021）.
^ Alkindi Sprinkle- hydrocortisone granule. DailyMed. [21 February 2021]. （原始内容存档于10 February 2022）.
^ Anusol HC- hydrocortisone acetate suppository. DailyMed. [21 February 2021]. （原始内容存档于10 February 2022）.
^ Cortef- hydrocortisone tablet. DailyMed. [21 February 2021]. （原始内容存档于17 April 2021）.
^ Efmody EPAR. European Medicines Agency (EMA). 24 March 2021 [14 June 2021]. （原始内容存档于14 June 2021）. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
^ ^10.0 ^10.1 ^10.2 ^10.3 Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clinical Pharmacokinetics. 2005, 44 (1): 61–98. PMID 15634032. S2CID 24458998. doi:10.2165/00003088-200544010-00003.
^ ^11.0 ^11.1 ^11.2 ^11.3 ^11.4 Lennernäs H, Skrtic S, Johannsson G. Replacement therapy of oral hydrocortisone in adrenal insufficiency: the influence of gastrointestinal factors. Expert Opinion on Drug Metabolism & Toxicology. June 2008, 4 (6): 749–758. PMID 18611115. S2CID 73248541. doi:10.1517/17425255.4.6.749.
^ Liu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcorn ED, Leigh R, Brown JP, Cohen A, Kim H. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. August 2013, 9 (1): 30. PMC 3765115 . PMID 23947590. doi:10.1186/1710-1492-9-30 .
^ Becker, Kenneth L. Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. 2001: 762. ISBN 9780781717502. （原始内容存档于2016-09-14）（英语）.
^ Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 202. ISBN 9781284057560.
^ Hydrocortisone Pregnancy and Breastfeeding Warnings. Drugs.com. [1 September 2016]. （原始内容存档于20 September 2016）.
^ 美国专利第2,183,589号
^ Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 484 [2019-03-01]. ISBN 9783527607495. （原始内容存档于2019-03-02）（英语）.
^ WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [8 December 2016]. （原始内容存档 (PDF)于13 December 2016）.
^ Hydrocortisone. International Drug Price Indicator Guide. [1 September 2016]. （原始内容存档于2018-08-27）.
^ Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 202. ISBN 9781284057560.
^ The Top 300 of 2020. ClinCalc. [11 April 2020]. （原始内容存档于12 February 2021）.
^ Hydrocortisone - Drug Usage Statistics. ClinCalc. [11 April 2020]. （原始内容存档于12 April 2020）.

[AHFS2016-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 ^1.5 ^1.6 Hydrocortisone. Drugs.com. American Society of Health-System Pharmacists. February 9, 2015 [30 August 2016]. （原始内容存档于20 September 2016）.

[2] Prescribing medicines in pregnancy database. Therapeutic Goods Administration (TGA). [21 February 2021]. （原始内容存档于20 December 2016）.

[3] Hydrocortisone Notice of enforcement policy (PDF). FDA. [31 December 2022]. （原始内容存档 (PDF)于12 March 2023）.

[4] Ala-cort- hydrocortisone cream. DailyMed. [21 February 2021]. （原始内容存档于27 October 2020）.

[5] Ala-scalp- hydrocortisone lotion. DailyMed. [21 February 2021]. （原始内容存档于21 April 2021）.

[6] Alkindi Sprinkle- hydrocortisone granule. DailyMed. [21 February 2021]. （原始内容存档于10 February 2022）.

[anusol-acetate-7] Anusol HC- hydrocortisone acetate suppository. DailyMed. [21 February 2021]. （原始内容存档于10 February 2022）.

[8] Cortef- hydrocortisone tablet. DailyMed. [21 February 2021]. （原始内容存档于17 April 2021）.

[Efmody_EPAR-9] Efmody EPAR. European Medicines Agency (EMA). 24 March 2021 [14 June 2021]. （原始内容存档于14 June 2021）. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.

[pmid15634032-10] 10.0 ^10.1 ^10.2 ^10.3 Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clinical Pharmacokinetics. 2005, 44 (1): 61–98. PMID 15634032. S2CID 24458998. doi:10.2165/00003088-200544010-00003.

[pmid18611115-11] 11.0 ^11.1 ^11.2 ^11.3 ^11.4 Lennernäs H, Skrtic S, Johannsson G. Replacement therapy of oral hydrocortisone in adrenal insufficiency: the influence of gastrointestinal factors. Expert Opinion on Drug Metabolism & Toxicology. June 2008, 4 (6): 749–758. PMID 18611115. S2CID 73248541. doi:10.1517/17425255.4.6.749.

[pmid23947590-12] Liu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcorn ED, Leigh R, Brown JP, Cohen A, Kim H. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol. August 2013, 9 (1): 30. PMC 3765115 . PMID 23947590. doi:10.1186/1710-1492-9-30 .

[13] Becker, Kenneth L. Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. 2001: 762. ISBN 9780781717502. （原始内容存档于2016-09-14）（英语）.

[Ric2015-14] Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 202. ISBN 9781284057560.

[15] Hydrocortisone Pregnancy and Breastfeeding Warnings. Drugs.com. [1 September 2016]. （原始内容存档于20 September 2016）.

[16] 美国专利第2,183,589号

[Fis2006-17] Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 484 [2019-03-01]. ISBN 9783527607495. （原始内容存档于2019-03-02）（英语）.

[WHO19th-18] WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [8 December 2016]. （原始内容存档 (PDF)于13 December 2016）.

[19] Hydrocortisone. International Drug Price Indicator Guide. [1 September 2016]. （原始内容存档于2018-08-27）.

[Ric20152-20] Hamilton, Richart. Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. 2015: 202. ISBN 9781284057560.

[ref1-21] The Top 300 of 2020. ClinCalc. [11 April 2020]. （原始内容存档于12 February 2021）.

[ref2-22] Hydrocortisone - Drug Usage Statistics. ClinCalc. [11 April 2020]. （原始内容存档于12 April 2020）.

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