Steroid injection kit

Steroid injection kit

Postby member_42176 » Fri Oct 06, 2017 2:16 pm

My anterior pituitary gland was destroyed by immunotherapy for cancer, so my adrenal glands are inactive. I know that the changes of needing an emergency steroid injection are low but I have realised that the nature of my kit worries me.

Basically, I have a vial of hydrocortisone powder, a vial of saline, a hypodermic needle and a syringe. It's in a small sandwich box and it lives in my fridge. I have no confidence that I could make up the solution and inject in if I was in crisis.

Is there really nothing better available?
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Re: Steroid injection kit

Postby Carl » Sat Oct 07, 2017 9:04 pm

There absolutely is something better, it is Liquid hydrocortisone sodium phosphate (1ml ampoule)

It is a ready mixed equivalent of the Solu-Cortef you have. Go back to your GP and ask them to prescribe it or failing that to your hospital consultant who would be able to or write to your doctor. You can pre-mix the Solu-Cortef and it keeps in the fridge for quite a few weeks (can't remember how long) but go for the liquid version if you can.
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Re: Steroid injection kit

Postby member_41389 » Sun Oct 08, 2017 7:40 pm

The preferred emergency injection is Hydrocortisone Sodium Phosphate 100mg/1ml (this used to be called Efcortisol) and if the GP queries it then refer him to the following: https://cks.nice.org.uk/addisons-disease#!scenario. This is the Clinical Knowledge Set defined by NICE as being what the GP should know and do. Specific reference to the liquid being better is in the section on Crisis management. The major difference between Addison's and Secondary AI is there is generally no need to replace Aldosterone (that's the mineralcorticoid) in Secondary patients.

All the best
Tim.

P.S. Made up Solucortef solution will keep for 80 days if your fridge is set at 4 degrees C.
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Re: Steroid injection kit

Postby KitKat » Wed Aug 22, 2018 2:58 pm

Hi there,
Really agree with Tim about preparing a syringe of the hydrocortisone powder and water and putting it on standby in the fridge, dated and labelled in a light-proof container, if you re feeling at all queasy or if other members of the household come down with a gastric infection that they might share with you.
If fortune smiles and you don't need to use it straight away, then bin it after 80 days. If you have a history of instability or know that you get blurry eyesight/shaky hands when you go downhill, then there is no harm in mixing up the next one and storing it, dated, labelled and in a light-proof container, in the fridge on permanent standby.
I came to this conclusion after my only experience of attempting to mix it at 1am, under a dim bedside light, just before I started to throw up. Even in good daylight with a clear head, it is hard enough to get the needle down the hollow channel in the rubber bung and draw it up into the syringe. And at £1.16 a pop, binning a syringe after 80 days costs the NHS not much more than would be wasted if you vomited back a single 10mg hydrocortisone tablet.
Could the GP prescribe you more than 1 ampoule at a time? What happens if you crush the water ampoule while snapping it open, so it is unusable?
Best
KitKat
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