Corticosteroids hydrocortisone

Corticosteroids (hydrocortisone, COCs may inhibit metabolism of corticosteroids Increase side effects of corticosteroids... 

Napkin dermatitis can be soothed and prevented with the use of barrier creams and ointments such as zinc and castor oil, Vasogen, Sudocrem and Drapolene. Canesten HC contains an antifungal clotrimazole and the corticosteroid hydrocortisone. Such combination products are only indicated severe napkin dermatitis and are used only for 1 week, after which... 

Ciprofloxacin hydrochloride and hydrocortisone otic suspension contains the synthetic broad spectrum antibacterial agent, ciprofloxacin hydrochloride, combined with the anti-inflammatory corticosteroid, hydrocortisone, in a preserved, nonsterile suspension for otic use. Each milliliter contains ciprofloxacin hydrochloride (equivalent to 2 mg... 

Replacement therapy for secondary or tertiary adrenocortical insufficiency These deficiencies are caused by a defect either in CRF production by the hypothalamus or corticotropin production by the pituitary (see p. 247). [Note Under these conditions, the adrenal cortex synthesis of mineralocorticoids is less impaired than that of glucocorticoids.] The adrenal cortex responds to corticotropin administration by synthesizing and releasing the adrenal corticosteroids. Hydrocortisone is also used for these deficiencies. 

These are only indicated in cases of serious edema or pruritus during the first few days after an aggressive peel. It is always best to start with a short-acting corticosteroid (hydrocortisone or betamethasone). A cortisone-based cream can be used during the first few days after a peel to reduce excessive edema or pruritus. The deeper the peel, the greater is the need for emollients. Hydration after a peel is vital (except after a peel with Unna s paste) the hydrating cream should contain no alcohol or perfumes. 

A number of other agents may be required for the treatment of anaphylactic reactions. Corticosteroids (hydrocortisone sodium succinate intravenously) are recommended to reduce the risk of late-phase reactions. Aminophylline may be used as adjunctive therapy for bronchospasm. Histamine (Hi) receptor blockers (such as diphenhydramine) may be administered to reduce some of the symptoms associated with anaphylaxis however, these agents are not effective as primary therapy. 

The cream, ointment, and topical solution contain the topical corticosteroid hydrocortisone butyrate, a nonflu-orinated hydrocortisone ester. It has the chemical name pregn-4-ene-3,20-dione, 11,21 -dihydroxy-17- [(1 -oxobu-tyl)oxy-,(ll(beta))- the molecular formula is C25H3606 and the molecular weight is 432.54. Each gram of cream contains 1 mg hydrocortisone butyrate in a hydrophilic... 

Detection and result The chromatogram was freed from mobile phase and evenly sprayed with reagent solution. After a short time at room temperature violet-colored chromatogram zones appeared for the corticosteroids tetrahydrocortisol hRf 10-15), tetrahydrocortisone (hR( 15 — 20), prednisolone hRf 15-20), hydrocortisone (hR( 20 — 25), prednisone hRf 30 — 35), cortisone hRf 35 — 40), corticosterone hRf 45 — 50), cortexolone (Reichstein S., hRf 50 — 55), 11-dehydro-corticosterone hRf 60 — 65), 11-desoxycorticosterone hRf 75 — 80). 

Fig. 1 Separation of the corticosteroids. (A) Detection in UV light (A = 254 nm, (B) staining with blue tetrazolium. Tetrahydrocortisol (1), tetrahydrocortisone (2), prednisolone (3), hydrocortisone (4), prednisone (5), cortisone (6), corticosterone (7), cortexolone (8), 11-dehydrocorticosterone (9), 11-desoxycorticosterone (10), mixture (Mi),...

Corticosteroid intrarectal foam, hydrocortisone acetate intrarectal foam Cortifoam Adjunctive therapy in treatment of ulcerative proctitis of the distal portion of the rectum Local pain or burning, rectal bleeding, apparent exacerbations or sensitivity reactions 1 applicatorful once or twice daily for 2 wk and every second day thereafter... 

Examples of topical corticosteroids include amdnonide (Cyclocort), betamethasone dipropionate (Diprosone), fluocinolone acetonide (Flurosyn), hydrocortisone (Cort-Dome), and triamcinolone acetate (Aristocort). 

Hydrocortisone, desonide—corticosteroids for anti-inflammatoiy and antipruritic effects... 

The recent CORTICUS trial (hydrocortisone vs placebo) does not support the routine use of corticosteroids in the management of septic shock. No difference in 28-d mortality was observed between groups, regardless of baseline relative adrenal insufficiency. Duration of shock was shorter in the hydrocortisone group however, an increased incidence of hyperglycemia, sepsis, and recurrent septic shock was observed. This section reflects the 2004 consensus guidelines... 

High-dose corticosteroid therapy (e.g., hydrocortisone 200 mg/d or greater or its equivalent)... 

Severe or Fulminant Hydrocortisone 300 mg IV daily (or equivalent) Change to oral corticosteroid and taper as soon as... 

Patients with severe UC symptoms require hospitalization for management of their disease. If the patient is unresponsive to oral or topical mesalamine and oral corticosteroids, then a course of intravenous corticosteroids should be initiated.1 Hydrocortisone 300 mg/day given in three divided doses or methylprednisolone 60 mg daily for 7 to 10 days are the preferred therapies. 

Clearly the physicochemical properties of a drug are a decisive factor in its overall activity. Where possible, molecular structures should be optimized to obtain best clinical performance. Rarely does an oral drug have physicochemical features suitable for topical or transdermal therapy, and it can take a great deal of systematic research to identify where the best balance of activity and permeability lies. Experience with corticosteroids suggests that as much as a 100-fold improvement in clinical activity may be attainable through molecular design, for today s most potent topical corticosteroids are more active than hydrocortisone by a factor at least this large. 

Corticosteroids can be initiated in septic shock when adrenal insufficiency is present or when weaning of vasopressor therapy proves futile. A daily dose equivalent to 200 to 300 mg hydrocortisone should be continued for 7 days. Adverse events are few because of the short duration of therapy. 

Because most adrenal crises occur because of glucocorticoid dose reductions or lack of stress-related dose adjustments, patients receiving corticosteroid-replacement therapy should add 5 to 10 mg hydrocortisone (or equivalent) to their normal daily regimen shortly before strenuous activities such as exercise. During times of severe physical stress (e.g., febrile illnesses, after accidents), patients should be instructed to double their daily dose until recovery. 

Hydrocortisone given parenterally is the corticosteroid of choice because of its combined glucocorticoid and mineralocorticoid activity. The starting dose is 100 mg IV by rapid infusion, followed by a continuous infusion or intermittent bolus of 100 to 200 mg every 24 hours. IV administration is continued for 24 to 48 hours. If the patient is stable at that time, oral hydrocortisone can be started at a dose of 50 mg every 8 hours for another 48 hours. A hydrocortisone taper is then initiated until the dosage is 30 to 50 mg/day in divided doses. 

A mixture of six corticosteroids, namely deoxycortisone, hydrocortisone acetate, cortisone, prednisone, hydrocortisone and prednisolone can be assayed by HPLC method. The chromatogrpahic parameters for the assay are as follows ... 

ProctoFoam HC Anesthetic Corticosteroid Aerosol foam Pramoxine 1%, hydrocortisone 1% [10 gm] Apply to affected area(s) tid-qid... 

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. 

Daktacort cream is a trade name for a preparation containing miconazole (imidazole antifungal) and hydrocortisone (corticosteroid). 

Triamcinolone is a corticosteroid that is more potent than hydrocortisone and has a longer duration of action. Triamcinolone has only slight mineralocorticoid activity, whereas hydrocortisone has high mineralocorticoid activity and therefore triamcinolone is unsuitable for disease suppression on a long-term basis. Triamcinolone is available as injection, dental paste, nasal spray and as cream or ointment preparations. Hydrocortisone is available as cream, tablets and injections. 

The application of a mild topical corticosteroid, such as hydrocortisone, is effective in patients presenting with multiple mosquito bites. Paracetamol, which is an antipyretic agent is not indicated in mosquito bites. Fusidic acid cream is an anti-infective agent and is indicated if the mosquito bites have been scratched and there is risk of infection. Benzocaine (anaesthetic) and mepyramine (antihistamine) may relieve itchiness but are less effective in multiple mosquito bites than hydrocortisone. 

Furuncles (boils) are caused by staphylococci. Fusidic acid is very effective against boils. Hydrocortisone is a lov/-potency corticosteroid. Aciclovir (antiviral) is indicated for the treatment and prophylaxis of herpes infections. Promethazine is an antihistamine cream and zinc oxide acts as a barrier v/hen used in creams. 

---