Therapeutic: anti-inflammatories (steroidal), immune modifiers
Pharmacologic: corticosteroids (topical)
Management of inflammation and pruritus associated with various allergic/immunologic skin problems.
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.
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.
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.
TIME/ACTION PROFILE (response depends on condition being treated)
|ROUTE ||ONSET ||PEAK ||DURATION |
|topical ||mins–hrs ||hrs–days ||hrs–days |
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).
Drug-Drug: None significant.
Topical (Adults and Children ≥12 yr): Apply to affected area bid.