Corticosteroids combinations with

Initial therapy consisting of twice daily applications of a medium strength topical corticosteroid combined with once daily topical calcipotriene should provide adequate control for this patient s localized psoriasis. A coal tar shampoo should be initiated for her scalp psoriasis with nightly application of a corticosteroid solution to recalcitrant plaques. 

Bijl-Hofland, I.D. Cloosterman, S.G. Folgering, H.T. van Den Elshout, F.J. van Weel, C. van Schayck, C.P. Inhaled corticosteroids, combined with long-acting beta(2)-agonists, improve the perception of bronchocon-striction in asthma. Am. J. Respir. Crit. Care Med. 2001,... 

KountoureUis, J.E. Markopoulou, C.K. Ebete, K.O. Stratis, J.A. Separation and determination of some corticosteroids combined with bamipine in pharmaceutical formulations by high performance liquid chromatography. J.Liq.Chromotogr., 1995, 18, 3507-3517... 

The topical and oral use of retinoids for treatment of hyperkeratotic disorders such as psoriasis and Darier s disease has long been established. Systemic retinoid therapy is often combined with topical diugs such as corticosteroids, dithranol, tar, and also UVA/UVB phototherapies where synergistic effects have been reported. 

Risk factors for NSAID-induced peptic ulcers and complications are presented in Table 15-2. Several important principles should be considered when estimating the risk for developing PUD in a patient taking an NSAID (1) risk factors are generally additive (2) some risk factors (e.g., corticosteroid therapy) are not by themselves a risk factor for ulceration but increase PUD risk substantially when combined with NSAID therapy and (3) many of the risk factors postulated to increase PUD... 

Maintenance of remission of ulcerative colitis may be achieved with oral or topical aminosalicylates. Mesalamine suppositories 1 g daily may prevent relapse in up to 90% of patients with proctitis.1 Mesalamine enemas are appropriate for left-sided disease and may often be dosed three times weekly. Oral mesalamine at lower doses (e.g., 1.6 g per day) may be combined with topical therapies to maintain remission. Topical or oral corticosteroids are not effective for maintaining remission of distal UC and should be avoided. 

Fucicort contains fusidic acid (antibacterial) and betamethasone (corticosteroid), which is more potent than hydrocortisone (corticosteroid). Fucidin H contains fusidic acid and hydrocortisone Daktacort contains miconazole (imidazole antifungal) and hydrocortisone Canesten HC contains clotrimazole (imidazole antifungal) and hydrocortisone. Otosporin contains hydrocortisone in combination with two antibacterial agents, namely neomycin and polymyxin. 

Salbutamol is a selective beta2-receptor agonist indicated in the management of asthma as a bronchodilator relieving acute attacks. It may be used in combination with inhaled corticosteroids such as beclometasone. Salbutamol acts within a few minutes and tends to be short-acting, unlike salmeterol. Side-effects of salbutamol include tachycardia and palpitations. It does not cause drowsiness and does not precipitate oral candidiasis. Inhaled corticosteroids may precipitate oral candidiasis. 

Docusate sodium is a preparation used for softening ear wax before removal. Hydrocortisone is a corticosteroid, whereas gentamicin, neomycin and clioquinol are antibacterial agents. Otitis externa may be managed by the use of antibacterial preparations used alone or in combination with topical corticosteroids. 

Several types of immunosuppression have also been tried. Azathioprine alone was found to have no effect on PBC [82], but additional benificial effects were found in combination with ursodeoxychohc add and corticosteroids [78]. Cyclosporin showed some success, espe-dally in corticosteroid-resistant autoimmune hepatitis [83], but its use is generally considerably hmited by severe side-effects. Corticosteroids were effective in the management of several types of autoimmune chronic active hepatitis [84,85] and in the management of acute al-cohohc hepatitis [86]. Their use, however, has to be brief hi order to minimize side-effects. In the treatment of PBC, corticosteroids alone were found to be toxic and had only limited efficacy [77]. 

Combination with prednisone Combination therapy of inhaled corticosteroids with systemic corticosteroids may increase the risk of HPA suppression compared with a therapeutic dose of either one alone. Use inhaled corticosteroids with caution in patients already receiving prednisone. 

Concurrent immunosuppressants Sirolimus has been administered concurrently with cyclosporine and corticosteroids. The efficacy and safety of the use of sirolimus in combination with other immunosuppressive agents have not been determined. Renai function impairment Mean serum creatinine was increased and mean glomerular filtration rate was decreased in patients treated with sirolimus and cyclosporine compared with those treated with cyclosporine and placebo or azathioprine controls. Monitor renal function during the administration of maintenance immunosuppression regimens including sirolimus in combination with cyclosporine, and consider appropriate adjustment of the immunosuppression... 

Allogeneic transplants For prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants. Gengraf and A/eora/have been used in combination with azathioprine and corticosteroids. Sanc//n n nne always is to be used with adrenal corticosteroids. Sandimmune a so may be used in the treatment of chronic rejection in patients previously treated with other immunosuppressive agents. Because of the risk of anaphylaxis, reserve Sandimmune injection for patients who are unable to... 

Corticosteroids suppress proliferation of lymphocytic cells, thus they are useful at combating acute lymphoblastic or undifferentiated leukemia of childhood, chronic lymphocytic leukemia, Hodgkin s lymphoma, other lymphomas. Therapy is often initiated with a steroid in combination with other agents. There is no evidence of cross resistance to unrelated agents. Mostly prednison is used however at appropriate dosages similar effects can be obtained with other glucocorticosteroids. 

The immunosuppressive effects of corticosteroids are employed in organ transplantation programs in combination with other immunosuppressive modalities, for the management of a variety of autoimmune diseases and to suppress allergic reactions. 

ReA refractory to NSAIDs, DMARDs and physiotherapy can be treated with SBC-5-IMNs. When also refractory to SBC-5-IMNs then add on infliximab at week 0-2-6 combined with IVT - - PA. Corticosteroids and dilating eye drops are used to suppress ocular inflammation to prevent scaring and alleviate pain. When required to prevent blindness, corticosteroids are injected into the eye. 

Metyrapone is a competitive inhibitor of 11 beta hydroxylation in the adrenal cortex, and effectively inhibits cortisol production. It is used in low doses, titrated to achieve plasma cortisol levels as close as possible to normal day-time values. Occasionally it is used in higher doses combined with replacement corticosteroid treatment. Its main side effects relate to overdosage and resulting hypoadrenalism, but it can also cause hirsutism and hypertension, due to accumulation of precursor steroids. Ketoconazole is also sometimes used to suppress adrenal steroid production, but its potential for hepatotoxicity limits its... 

Fluorouracil (Efudex, Fluoroplex) is an antimetabolite used for the topical treatment of actinic keratoses. It is also useful for the treatment of superficial basal cell carcinomas when conventional surgical modalities are impractical. Local inflammatory reactions characterized by erythema, edema, crusting, burning, and pain are common (and, some would argue, desirable) but may be minimized by reduced frequency of application or use in combination with a topical corticosteroid. 

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