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INTRODUCTION

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amcinonide (am-sin-oh-nide)

Cyclocort

Classification

Therapeutic: anti-inflammatories (steroidal)

Pharmacologic: corticosteroids

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Indications
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Management of inflammation and pruritus associated with various allergic/immunologic skin problems.

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Action
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Suppresses normal immune response and inflammation. Therapeutic Effects: Suppression of dermatologic inflammation and immune processes.

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Adverse Reactions/Side Effects
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Derm: allergic contact dermatitis, atrophy, burning, dryness, edema, folliculitis, hypersensitivity reactions, hypertrichosis, hypopigmentation, irritation, maceration, miliaria, perioral dermatitis, secondary infection, striae. Misc: adrenal suppression (use of occlusive dressings, long-term therapy).

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Assess the area being treated to help document whether drug therapy is successful in resolving skin conditions.

  • Monitor any new or increased reactions at the site of application, including inflammation, irritation, infection, burning, swelling, exfoliation, and rash. Report severe or prolonged skin reactions to the physician.

  • Report signs of adrenal suppression, including hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, and restlessness.

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Interventions
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  • Protect skin from breakdown, especially over bony prominences.

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Patient/Client-Related Instruction
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  • Advise patients on long-term treatment to consult physician before stopping this medication. Stopping the medication suddenly may result in adrenocortical shock (severe hypotension, hypoglycemia, weakness, vomiting). If these signs appear, physician immediately; may be life threatening.

  • Check that the patient and family or caregivers understand topical application procedures, and adhere to the recommended dosing schedule.

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Pharmacokinetics
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Absorption: Minimal. Prolonged use on large surface areas or large amounts applied or use of occlusive dressings may increase systemic absorption.

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Distribution: Remains primarily at site of action.

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Metabolism and Excretion: Usually metabolized in skin.

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Half-life: Unknown.

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TIME/ACTION PROFILE (response depends on condition being treated)

ROUTE ONSET PEAK DURATION
topical min–hrs hrs–days hrs–days

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity or known intolerance to corticosteroids or components of vehicle (ointment or cream base, preservative); Untreated bacterial or viral infections.

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Use Cautiously in: Hepatic dysfunction; Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition); Patients with preexisting skin atrophy; OB/Lactation/Pedi: Chronic high-dose usage may result in adrenal suppression in mother, growth suppression in children; children may be more susceptible to adrenal and growth suppression.

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Interactions
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Drug-Drug: None significant.

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Route/Dosage
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Topical (Adults): Apply to affected area(s) 2–3 times daily (depends on preparation and condition being treated).

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Topical (Children): Apply to affected area(s) 2–3 times daily (depends on preparation and condition being treated).

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Availability (generic available)
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Cream: 0.1%. Lotion: 0.1%. Ointment: 0.1%.

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