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13 Cards in this Set
- Front
- Back
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Corticosteroids (dermal)
- MOA - Contraindications - Cautions |
MOA:
- antimitotic - immunosuppressive - anti-inflammation Contraindications - Rosacea - Acne vulgaris - Ulcers - Impaired circulation - Uncontrolled infection Cautions - skin atrophy & elderly skin (worsens and increases systemic absorption) - children (decreased SA:V ratio, more permiable skin in infants and neonates) - diabetes (avoid extensive use: systemic absorption: increased BGLs) - immunosupperssion (avoid extensive use) |
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Corticosteroid creams, advice for use in
- Children - Pregnancy - face and flexures - lichenified areas - eyes - BF |
Children: more systemic absorption, esp in neonates and infants. Use hydrocortisone in preference to others, which may be appropriate only for short periods to regain disease control. Consider a steroid free period for 2/52 after 2-3/52 of use.
Pregnancy - Minimise use, strength, duration; use emollients first. Avoid mometasone (B3) but all others are cat A. BF: ensure breast area is free of cream Face/flexures: only use hydrocortisone. use methylprednisolone if required for 2-3/7 (max of 7/7) Lichenified areas: more potent steroids, with occlussion if neccessary - not with BD OV Eyelids - risk of glaucoma |
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Steroids
- A/Es |
Common:
- folliculitis, delayed healing - steroid rosacea, perioral dermatitis - atrophy, telangiectasia, depigmentation, purpura Rare - systemic effects |
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Relative potency of steroid creams?
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Mild: hydrocortisone (face, flexures, nappy dermatitis)
Mod: - triamcinolone - betamethasone valerate (0.02, 0.05%) - clobetasone Potent - betamethasone valerate (0.1%), betamethasone diproprionate - methylprednisolone & mometaone Very potent - betamethasone diproprionate in optomised vehicle (severe disease, hands & feet) |
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How often should steroid creams be applied?
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bd
once daily for mometasone and methylprednisolone There is no benefit from more frequent application |
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What increases effect of a steroid cream
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OINTMENTS are more potent than CREAMS at the same concentration
Absorption enhancing ingredients (urea, salicylic acid) Occlussion Depth of skin (palms, soles, lichenified skin) |
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steroid creams
- counselling |
HOW TO APPLY
1. Apply a thin layer. Use the finger tip unit. One unit covers 2 sides of one hand 2. apply after bathing/showers; and 10-15 mins after moisturisers 3. avoid broken skin HOW LONG TO USE 1. tolerance may develop - use on alternate days or with 5 days on 2 days off SIDE EFFECTS 1. atrophy, telangiectasia, folliculitis, delayed wound healing, steroid rosacea, dermatitis perioral |
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Betamethasone products
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1. Betamethasone valerate
**0.02%.100g[2] CREAM - Celestone-M, Betnovate 1/5, Cortival 1/5, Antoquoril **0.02%.100g[2] OINT - Celestone-M, Antroquoril **0.05% .15g CREAM & OINTMENT - Betnovate 1/2, Cortival 1/2 **0.1%.30g CREAM & OINT - Betnovate 2. Betamethasone diprorionate **0.05% cream & ointment & lotion: Diprosone, Eleuphrat **0.05% cream & ointment OV: Diprosone OV 3. B. diproprionate 0.05% with calcipotriol 0.005%, 15g & 30g (Daivobet 50/500) - private |
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What's in Becoderm-C?
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Clobetasone
0.05%, 15g, applied 1-2 times daily |
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Hydrocortisone products
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Hydrocortisone
0.5% - DermAid, DermAid Soft Cream 1%.30g - DermAid, DermAid Soft 1%.50g - Egocort 1%.30ml spray - Cortef Hydrocorisone acetate 1%.30g,50g cream & ointment - Cortef, Cortic-DS, Sigmacort Hydrocortisone 1% and clioquinol 1% (Hydroform) HC 0.5%,1% with miconazole (Resolve Plus) HC 1% with clotrimazole (Hyrozole) |
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Methylprednisolone products
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0.1% Advantan cream (15g), lotion (20g), ointment (15g), fatty ointment (15g)
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Mometasone products
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Elocon & Novasone 0.1% cream (15g, 45g), ointment (15g, 45g), lotion (30mL)
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Triamcinolone
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Aristocort, Tricortone
0.02%.100g[2] cream & ointment |
