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Description:
Topical corticosteroids suggest an important class of synthetic steroids used as anti-inflammatory and anti-parasitic agents. Hydrocortisone Cream 2, 5% and Hydrocortisone Ointment 2, 5% include hydrocortisone Veldhydrocortisone is a broken white or literally broken white crystalline powder. Chemicals, hydrocortisone IS Bergy-4-and-3, 20-dione, 11, 17, 21-trihydroxy, (11β)-. Structural formula. of hydrocortisone is:
Each gram 2, 5% cream contains 25 mg of hydrocortisone glyceryl monostearate, polyoxyl-40 stearate, glycerin, paraffin, staryl alcohol, isopropyl cap-miting, sorbitanate monostearate, benzyl alcohol, potassium sorb, and base bright water.
Each gram of 2, 5% ointment contains 25 mg of hydrocortisone broken white venlatum and mineral oil at the base.
Clinical Pharmacology:
Topical corticosteroids have anti-inflammatory, anti-uric oxidative, and vasoexcitatory effects.
The mechanism of the anti-inflammatory capacity of topical corticosteroids is unknown. Various laboratory techniques, including vasoconstriction test testing tests, are used to compare and predict the potential and/or medical effects of topical corticosteroids. There are indications that there is a well-known correlation between vasoconstrictor factors and people’s treatment efficacy.
Pharmacokinetics: The degree of transdermal absorption of topical corticosteroids is controlled by almost all causes, including the carrier, the uniformity of the epidermal barrier, and the placement of occlusive connections.
Topical corticosteroids have every opportunity to be absorbed into normal intact skin. Inflammation and/or other disease processes in the skin increase transdermal absorption.
Obstructive connections greatly increase transdermal absorption of topical corticosteroids. This is why occlusive linkages can be a valuable addition to the treatment of stubborn dermatoses (see DOSAGE AND ADMINISTRATION).
Live corticosteroids are absorbed through the skin and processed via pharmacokinetic pathways similar to systemically administered corticosteroids. Corticosteroids bind to plasma proteins to varying degrees. Corticosteroids are metabolized primarily in the liver and then differentiated in the kidneys. Some topical corticosteroids and their metabolites are still excreted in bile.
Indications and Applications:
Topical corticosteroids are indicated for the reduction of inflammatory and pruritic symptoms of corticosteroid-sensitive skin diseases.
Contraindications:.
Topical corticosteroids are contraindicated in patients with a history of hypersensitivity to any component of the product.
Prophylaxis: Precautionary measures
General: Systemic absorption of topical corticosteroids has caused reversible suppression of the hypothalamo-parietal axis (HPA), signs of Cushing’s syndrome, hyperglycemia and urination in some patients.
Conditions that increase systemic absorption include the use of more potent steroids, widespread administration, prolonged administration, and the addition of occlusive bandages.
Therefore, patients receiving high-dose, high-mass steroids over a wide range of planes or under closed bandages should be evaluated periodically for evidence of HPA axis suppression using non-cortisol studies, urine and ACTH stimulation; if HPA axis suppression is observed, the product should be discontinued, used more frequently reduction in frequency of use, or switching to a less potent steroid should be attempted.
Usually, HPA axis function is quickly and reliably restored after product discontinuation.
Rarely, symptoms or signs of steroid withdrawal may occur and additional systemic corticosteroids may be required.
Children are more likely to ingest relatively high doses of regional corticosteroids and are therefore more susceptible to systemic toxicity (see Precautions – Differences).
If complaints develop, the use of topical corticosteroids should be discontinued and appropriate treatment initiated.
In the case of skin infections, appropriate antifungal or fungicidal agents should be administered. If an appropriate response does not occur immediately, corticosteroid use should be discontinued until the infection is adequately controlled.
Patient Information: Patients using topical corticosteroids should be appropriately informed and supervised.
1. this medication should be used only as directed by a physician. It is for external use only. Avoid eye contact; 2. patients should not be advised to use this medication for disorders other than as prescribed; 3. treated skin areas cannot be helped to occlude, covered over, or packed down unless prescribed by a physician; 4. patients should report symptoms of side effects, especially in in the context of OCDAND should report symptoms of side effects in the area; 5. parents of pediatric patients should not use unacceptable diapers or plastic pants on babies treated in the diaper area because these clothing items can form an occlusive fixation should be advised.
Laboratory Tests: Appropriate tests may be helpful in the evaluation of HPA axis suppression: urine-free analysis. ACTH stimulation analysis.
Carcinogenesis, mutagenesis, and fertility disorders: No long-term studies on animals have been conducted to evaluate the carcinogenic or fertility effects of district corticosteroids.
Investigation of mutagenicity with prednisolone. and hydrocortisone Negative results.
Pregnancy: teratogenic effects – Pregnancy category c. Corticosteroids are generally considered teratogenic in experimental animals when administered systemically at relatively low doses. Larger doses of corticosteroids have been demonstrated that they are teratogenic after use in experimental animals. There are no necessary and fully controlled studies on the teratogenic effects of topical corticosteroids in pregnant women. Therefore, topical corticosteroids may be used during pregnancy only when the potential fetal risk may justify it. Substances of this class should not be used in large, high doses or over long periods of time in pregnant women.
Breastfeeding mothers: it is not known whether live administration of corticosteroids leads to the systemic absorption necessary to produce detectable amounts in breast milk. Systemically administered corticosteroids are excreted in breast milk in amounts that are not detrimental to the baby. In any case, it is prudent to administer district corticosteroids to breastfeeding women.
Pediatric version: pediatric patients, as a result of their greater weight and body weight, have a greater chance of district corticosteroid-induced hypothalamic-pharyngeal depression (HPA) and enormous susceptibility to Cushing’s syndrome than adult patients.
Suppression of hypothalamic and supracardiac adrenal shafts (HPA), Cushing’s and intracranial hypertension has been reported in pediatric patients taking corticosteroids in the neighborhood. Symptoms of adrenal suppression in pediatric patients include a delayed linear increase, decreased weight gain, low plasma cortisol levels, and response to ACTH stimulation. Symptoms of intracranial hypertension include inflamed fontanelle, headache, and bilateral papilledema.
Admission of area corticosteroids to pediatric patients should be limited to the minimum number compatible with an effective treatment regime. Treatment with corticosteroids may increase and impede development in pediatric patients.
Side Effects:
In the topic corticosteroids, the following topical side effects are rarely reported, but may occur more frequently with obstructive relationships. deze reacts volgorde van Afnemend Voorkomen in Staan Bij Benadering: Branderigheid, Jeuk, Pruritus, Ontevredenheid, Droogheid, Folliculitis, Hypertrichosis, Acne – medication, Phypigmentie, Periorale dermatiit Rofie, striae en miriallen, Skin erosion,
Overdose:
Internal corticosteroids have every opportunity to be absorbed in the numbers needed to cause systemic effects (see dark precautions).
Medication and Administration:
Apply 2-4 times daily as a nice film on the affected area, depending on the severity of the disorder.
Occlusive connections can be used to treat psoriasis or non-permeable criteria. If infection occurs, use of the occlusive context should be stopped and appropriate antimicrobial therapy should be instituted.
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