Drugs Blog

Type of Drug:Topical anti-inflammatory, anti-itching agents; anti-inflammatory steroids.

How the Corticosteroids, Topical Works:

Topical adrenocortical steroids reduce skin inflammation (eg, redness, swelling), itching, and irritation. The exact manner in which the drug works is not fully understood. The effectiveness of the drug depends on many factors, including: The extent of absorption of the drug, the potency of the drug, the size of the area treated, and the dose form (eg, cream, ointment).

Uses of The Corticosteroids, Topical:

To treat inflammation and itching caused by corticosteroid-responsive skin disorders.

OTC Hydrocortisone: To treat minor skin irritation, itching, and rashes due to eczema; insect bites; poison ivy, oak, or sumac; allergic inflammation from soaps, detergents, cosmetics, or jewelry; itchy genital and anal areas; psoriasis; seborrheic dermatitis; or other minor skin irritations

Precautions:

Do not use in the following situations: acne allergy to corticosteroids or any of their ingredients bacterial infections of the skin, single therapy for cellulitus facial, groin, or armpit areas (high potency agents only) prolonged use near eyes or eye­lids rosacea

Use with caution in the following situations: blistered, raw, or oozing areas of skin diaper dermntosis skin infection

Absorption into the body: Absorption into the body of topical corticosteroids has produced manifestations of Cushing’s syndrome, reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, and increased blood and urine sugar. This is more likely to occur with application to large body surfaces, use of occlusive dressings, and with the more potent steroids. Patients at higher risk include young children.

Side effects may include growth retardation, delayed weight gain, low plasma cortisol levels and absence of response to ACTH stimulation, including bulging “soft spots,” headaches, and bilateral papilledema.

Alcohol-containing preparations: Alcohol-containing preparations may cause drying, burning, or irritation of open lesions.

Formulations: Corticosteroids are specially formulated to maximize their release and potency. Mixing these products with other products is discouraged because it may affect potency and effectiveness.

Occlusive vehicles: A transparent plastic wrap or other vehicles that will not allow air to pass through to the treated area will enhance absorption at least 10 times. These kinds of dressings are not generally recommended (eg, when using clobetasol or halobetasol, when treating children).

Greasy ointment bases are more occlusive and are preferred for dry, scaly lesions. Gels are less occlusive. The aerosols, lotions and solutions are best suited for hairy areas.

Skin atrophy: Skin atrophy may occur in 3 to 4 weeks if the most potent corticosteroids are employed. Skin atrophy occurs most readily at sites where absorption through the skin is highest.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus. Do not use large doses or for prolonged periods of time if you are pregnant.

Breastfeeding: It is not known if topical corticosteroids appear in breast milk. Oral corticosteroids appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Limit therapy to the lowest possible dosage because children may be more susceptible to topical corticosteroid-induced side effects. Safety and effectiveness of alclometasone in children less than 1 year of age have not been established. Clobetasol is not recommended in children less than 12 years of age. Safety and effectiveness of hydrocortisone probutate in children less than 18 years of age have not been established.

Lab tests may be required to monitor therapy. Tests may include urinary­free cortisol, ACTH stimulation, and early morning plasma cortisol test.

Side Effects of Corticosteroids Topical:

Every drug is capable of producing side effects. Many topical corticosteroid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Skin: Burning; itching; irritation; redness; dryness; allergic inflammation; acne; decreased pigmentation in the area being treated; streaks in skin; skin atrophy; infection; stinging; cracking; rash; tingling; scalp pustules (scalp application only); unusual hair growth.

Other: Elevated blood or urine sugar; cataracts and glaucoma (prolonged use near eyes); numbness of fingers; worsening of condition being treated.

Also consider all side effects for oral corticosteroids..

Guidelines for Use:

• Dosage is individualized.
• Application frequency and duration of therapy are dependent on the condition treated, its location, the potency of the drug, and the vehicle employed. For assistance in product-specific drug selection and dos­age guidelines, consult your doctor or pharmacist.
• Wash hands before and after application.
• Wash or soak the affected area before application. This may increase drug penetration.
• Apply sparingly as a thin film. Rub in lightly until the medication disappears.
• For external use only. Avoid contact with the eyes.
• Avoid prolonged use, especially near the eyes, on the face, on genital and rectal areas, and in skin folds.
• The treated area should not be bandaged, covered, or wrapped to be occlusive, unless advised to do so by your doctor.
• Do not use tight-fitting diapers or plastic pants on children treated with topical corticosteroids in the diaper area. Such garments function as occlusive dressings.
• Skin infections may worsen. It may be necessary to stop the corticosteroid and treat the infection.
• Do not use these agents to treat acne, the lesions of rosacea, skin inflammation near the mouth, or for any disorder other than that for which it was prescribed.
• Allergic reactions may Occur. Contact your doctor if the condition being treated worsens or irritation, burning, redness, swelling, or stinging persists. Do not reapply the drug.
• If you do not notice improvement within 2 weeks (or 1 week when using aTC hydrocortisone), consult your doctor.
• Aerosol/Spray - Take care to cover the eyes while spraying close to the face. Avoid inhalation. Spray the affected area for 3 seconds or less at a time and at a distance of at least 6 inches between the nozzle and skin.
• Scalp application - Apply to the affected scalp areas twice daily, once in the morning and once at night. Do not use more than 50 week. Treatment must be limited to 2 consecutive weeks.
• Tape - Skin should be clean and dry before the tape is applied. Tape should always be cut, never torn. Replacement of the tape every 12 hours produces the lowest incidence of side effects, but it may be left in place for 24 hours if it is well­tolerated and adheres well. When replacing the tape, cleanse the skin and allow to dry for 1 hour before applying new tape. When necessary, the tape may be used at night only and removed during the day. If the ends of the tape loosen prematurely, they may be trimmed off and replaced with fresh tape.
• Lab tests may be required to monitor therapy. Bo sure to keep appointments.
• Store at controlled room temperature (59 to 86 F),protect solution and lotions from freezing.

Tagged under:anti inflammatory, anti inflammatory steroids, corticosteroids, drug, eczema, Hormones skin irritation