Glucocorticoids are a type of medication used to treat adrenal insufficiency. In this handout, you will learn how to give your child a stress dose of a glucocorticoid called Solu-Cortef®. You will also learn what to do after giving your child the medication.

In case of an emergency away from home, always keep a Solu-Cortef® kit and extra glucocorticoid pills with you.

What Are Glucorticoids?

Glucocorticoids are a type of medication used to treat conditions such as adrenal insufficiency (when the adrenal glands do not make enough or any of the hormones cortisol or aldosterone). Glucocorticoids can be given as a pill, liquid or as an injection.

When Do I Give a Glucocorticoid Injection?

Giving extra doses of glucocorticoids along with your child’s usual glucocorticoid dose is called stress dosing. Give a stress dose if your child:

  • Is sick, has a fever, or is having surgery
  • Is vomiting (the dose may need to be given as an injection)

How Much Glucocorticoid Does My Child Need for a Stress Dose?

Your child’s doctor will help you figure out the right dose for a stress dose.

Which Supplies Do I Need to Give a Glucocorticoid Injection?

  • A Solu-Cortef® kit with a syringe (needle)
  • An alcohol wipe
  • A sharps container
  • A bandage, if needed
  • Soap and water or alcohol-based hand sanitizer

How to Give a Glucocorticoid Injection

These instructions are for giving a stress dose of a glucocorticoid called Solu-Cortef®. This is given as an injection. If your child takes a different glucocorticoid, ask the care team for instructions.
  1. Wash your hands with soap and water or use an alcohol-based hand sanitizer.
  2. Use the alcohol wipe to clean your child’s skin where you will give the injection.
  3. Open the Solu-Cortef® kit. Press down firmly on the cap of the Solu-Cortef® bottle.
  4. Gently swirl the bottle to mix the liquid and powder in the bottle.
  5. Remove the cap on the needle. Pull back on the plunger to the dose your child needs.
  6. Insert the needle into the Solu-Cortef® bottle. Press down on the plunger to release the air from the needle into the bottle.
  7. Turn the bottle and needle upside-down. Pull back on the plunger to the dose your child needs.
  8. Remove the needle from the bottle. Gently press the plunger until a small drop of medication comes out from the tip of the needle.
  9. Pinch up your child’s skin where you will give the injection. Inject the medication under your child’s skin. The needle might hurt, but it will be over quickly.
  10. Remove the needle. Place the needle into a sharps container. Put a bandage where you gave the injection, if needed.

Why Does My Child Need to Take Glucocorticoids?

The adrenal glands (small glands on top of the kidneys) make many hormones. Two of these hormones are cortisol (a glucocorticoid) and aldosterone (a mineralocorticoid). Cortisol has many jobs, including maintaining your child’s blood pressure and blood sugar levels. Aldosterone helps maintain your child’s sodium (salt) and potassium levels.

When your child is sick or under stress, the adrenal glands typically make more cortisol than usual. This is important for your child to be able to manage the stressful situation well.

In children who have adrenal insufficiency, the adrenal glands do not make enough of cortisol and sometimes aldosterone. Their bodies cannot make the extra cortisol needed for situations of stress. At such times, your child needs extra doses of glucocorticoids (stress doses).

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