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INTRODUCTION

prednicarbate (pred-ni-kar-bate)

Dermatop

Classification

Therapeutic: anti-inflammatories (steroidal), immune modifiers

Pharmacologic: corticosteroids (topical)

Indications

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

Action

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

Adverse Reactions/Side Effects

Derm: allergic contact dermatitis, atrophy, burning, dryness, edema, pruritus, hypertrichosis, hypopigmentation, irritation, maceration. Misc: adrenal suppression (use of occlusive dressings, long-term therapy).

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

  • 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.

Interventions

  • Protect skin from breakdown, especially over bony prominences.

Patient/Client-Related Instruction

  • 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, notify 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.

Pharmacokinetics

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

Distribution: Remains primarily at site of action.

Metabolism and Excretion: Usually metabolized in skin.

Half-life: Unknown.

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

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

Contraindications/Precautions

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

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; Pregnancy, lactation, or children (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).

Interactions

Drug-Drug: None significant.

Route/Dosage

Topical (Adults and Children ≥12 yr): Apply to affected area bid.

Availability

Cream: 0.1%.

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