Corticosteroids topical include-

Alcometasone dipropionate, Amcinonide, Betamethasone benzoate, dipropionate, valerate, Clobetasol propionate, clocortolone pivalate, Desonide, Desoximetasone, Dexamethasone, Diflorasone, Fluocinolone acetonide,Fluocinonide, Flurandrenolide, Fluticasone propionate, Halcinode, Halobetasol Propionate, Hydrocortisone, Methylprednisolone acetate, Mometasone furoate, Prednicarbate, Triamcinolone acetonide

Refer - Betamethasone

U.S. FDA APPROVED DRUGS FROM 01-01-08 TO 31-12-08

Anti-inflammatory conditions

Corticosteroids topical include-

Alcometasone dipropionate, Amcinonide, Betamethasone benzoate, dipropionate, valerate, Clobetasol propionate, clocortolone pivalate, Desonide, Desoximetasone, Dexamethasone, Diflorasone, Fluocinolone acetonide,Fluocinonide, Flurandrenolide, Fluticasone propionate, Halcinode, Halobetasol Propionate, Hydrocortisone, Methylprednisolone acetate, Mometasone furoate, Prednicarbate, Triamcinolone acetonide

Refer - Betamethasone

Local -

Burning, itching, irritation, erythema, folliculitis, hypertrichosis, pruritus, acneform eruptions, hyperpigmentation, perioral dermatitis, allergic contact dermititis, numbness of the fingers, stinging and cracking /tightening of skin, maceration of skin, secondary infection, skin atrophy, stariae.

These may occur more frequently with occlusive dressings

Systemic-

Systemic absoprtion of topical corticosteroids have produced reversible HPA axis suppression, manifestations of Cushings syndrome,hypeglycemia and glycosuria. This is more likely to occur with occlusive dressings and with potent steroids.

Patients with liver failure or children with children may at higher risk. Following prolonged application around the eyes , cataracts and glaucoma may occur. In diffused atrophied skin, blood vessels may become visible on the skin surface

Hypersensitivity to any component,

monotherapy in primary bacterial infections such as impetigo, paryonchia, celluititis.

Warnings-

Pregnancy - Corticosteroids are teratogenic in animlas when administered systemically at relatively doses.

Therefore use during pregnancy only if potential benefits outweigh thepotential hazards to the fetus. In pregnant women do not use extensively, do not use in large amounts or for prolonged periods of time

. Lactation- excercise caution when administering topical corticosteroids to a nursing mother

Children- Children may be more susceptible to topical corticosteroid induced hypothalamic -pituitary-adrenal (HPA ) axis suppression and Cushings syndrome than adults because of a larger skin surface area to body ratio

Special precautions:

Systemic effects- Systemic absorption of topical corticosteroids has produced reversible HPA axis suppression, Cushings syndrome, hyperglycemia, and glycosuria Conditions that augument systemic absoprtion include

• - application of more potent steroids
• - use over large surface areas
• - prolonged use and addition of occlusive dressings

Local irritation- if local irritation develops discontinue use and institute appropiate therapy Medications containing alcohol may produce skin or buring sensation/irritation in open lesions

Skin atrophy is common and may be clinically significant in 3 to 4 weeks with potent preparations

Take care when using periorbitally or in the genital areas.

Avoid use of high potency topical corticosteroids on the face

Psoriasis- do not use topcal corticosteroids as sole therapy in wide spread plaque psoriasis

Infections- in the presence of infections institute therapy with an antifungal or antibacterial agent

For exernal use only - avoid inhalation of aerosols ingestion, or contact with eyes

Occlusive dressings- discontinue use of occlusive medicines if infection develops and institute appropiate antimicrobial therapy

Date of approval         July 1984

Indications:

Anti-inflammatory conditions

Dosage:

 0.5 to 5mg daily.

1. Apply ointments, creams, or gel sparingly in a light film, rub it gently. Washing or soaking the areas before application may increase drug penetration

2. To use a lotion, solution or gel on your scalp, part your hair , apply a small amount of the medicine on the affected area and rub it gently. protect the area from washing, clothing, rubbing, until the lotion dries. you may wash your hair as usual but not right after applying the medicine

3. To apply aerosols, shake well and spray on the affected area holding the container about 3 to 6 inchs away. Sprauy about 2 seconds to cover the area the size of your hand Take care not to inhale the vapors. If you are spraying your or near your face, cover your eyes.

4. Use only as directed. Do not put bandages, dressings, cosmetics or other skin prepn. over the treated areas unless directed by the physician

5. Notify physician, if condition being treated gets worse or if buring , swelling or redness develop.

6. Avoid prolong use around the eyes, in the genital and rectal areas, on the face, armpits, and in skin creases unless directed by your physician. Avoid contact with your eyes.

7. If you forget a dose, apply as as you remember and continue on your regular schedule. If it is time for for the next application, wait and then continue your regular schedule. Do not double doses.

8. For parents and pediatric patients- do not use tight fitting diapers or plastic pants on a child treated in the diaper area, these garments work like occlusive dressings and cause moe of the drug to be absorbed nto your childs body

Take with food

Pregnancy -

Corticosteroids are teratogenic in animlas when administered systemically at relatively doses. Therefore use during pregnancy only if potential benefits outweigh thepotential hazards to the fetus. In pregnant women do not use extensively, do not use in large amounts or for prolonged periods of time.

Lactation-

Excercise caution when administering topical corticosteroids to a nursing mother

Children-

Children may be more susceptible to topical corticosteroid induced hypothalamic -pituitary-adrenal (HPA ) axis suppression and Cushings syndrome than adults because of a larger skin surface area to body ratio