Pharmacology Case No10.Potency

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Pharmacology Case No10.Potency

Potency মানে কি?

একটা ড্রাগ এর potency বেশি মানে অল্প concentration এ দিলেই কাজ হয়, ভালো efficacy পাওয়া যায়.

যে গুলি less potent,. সে গুলি দিয়ে response পেতে অনেক বেশি concentration এ দিতে হয়,

আর যাদের potency বেশি, সে গুলি অল্প দিলেই হয়.

according to potency topical steroid গুলি ৪ ভাগে ভাগ করা যায়—-

1..

Mild potent steroid :

Example :

Hydrocortisone

Desonide

Brand name : Topicort cream and Desotop নামে পাওয়া যায়

কোথায় ব্যবহার হয়?

Face, female genital area, eyelids, এবং বাচ্চাদের ক্ষেত্রে ব্যবহার হয়.. ডায়াপার র‍্যাশ ইত্যাদি use kora hoi.

Cream 1:Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

The anti-inflammatory activity of Topicort is its main therapeutic property. It also has immunosuppressant and antimitotic actions. Topicort is indicated in:

Primary irritant dermatitis
Contact allergic dermatitis
Eczema: atopic, infantile, discoid, stasis
Seborrheic dermatitis
Lichen simplex and pruritus ani
Flexural psoriasis
Skin irritations, itching and rashes, for example those caused by insect bites, minor thermal burns, sunburn, etc

Pharmacology Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Hydrocortisone binds to the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes. The anti-inflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. This leads to diminished eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed, potentiating the effect. In other words, the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space, where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst and the release of various inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen activator, chemokines etc.) from neutrophils, macrophages and mastocytes. Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.

Dosage & Administration Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Hydrocortisone Acetate should be applied in a small quantity to the affected area 2 or 3 times daily.

Contraindications Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Infections: bacterial, viral, fungal.
Skin ulcers.
Hypersensitivity to the preparation.

Side Effects Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Topicort 1% cream is usually well-tolerated, but if signs of hypersensitivity appear, application should be stopped.

Pregnancy & Lactation Indications of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

There is inadequate evidence for safety in human pregnancy. It is recommended that topical corticosteroids should not be used extensively during pregnancy. It is highly unlikely that sufficiently high blood levels of Hydrocortisone are achieved during topical therapy to reach breast milk.

Therapeutic Class of Cream :Topicort 1% 20gm tube (AS A Topicort Hydrocortisone Acetate AS A Other Topical corticosteroids).

Other Topical corticosteroids

GEL 2:Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Indications of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Desotop gel is indicated for the treatment of mild to moderate atopic dermatitis in patients 3 months of age and older.

Pharmacology of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Desonide gel contains Desonide which is a synthetic nonfluorinated corticosteroid for topical dermatologic use. Topical corticosteroids have anti-inflammatory, antipruritic and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Once absorbed through the skin, topical corticosteroids are handled through pharmacokinetic pathways similar to systemically administered corticosteroids.

Dosage & Administration of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Desonide gel is for external use only. Gel should be applied as a thin layer to the affected areas two times daily and rubbed in gently. Therapy should be discontinued when control is achieved. If no improvement is seen within 4 weeks, treatment should be discontinued and Desonide gel should not be used with occlusive dressings.

Pediatric use: The safety and effectiveness of Desonide gel in pediatric patients less than 3 months of age have not been evaluated, and therefore its use in this age group is not recommended.

Contraindications of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Desonide gel is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.

Side Effects of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

The most common local side effects are burning, rash and pruritus at the application site. The following additional local side effects have been reported infrequently with topical corticosteroids. They may occur more frequently with the use of occlusive dressings, especially with higher potency corticosteroids: folliculitis, acneiform eruptions, hypopigmentation, perioral dermatitis, secondary infection, skin atrophy, striae, and miliaria.

Pregnancy & Lactation of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Therefore, Desonide gel should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk. Caution should be exercised when Desonide gel is administered to a nursing woman.

Therapeutic Class of GEL :Desotop 0.05% 15gm tube (As a Desonide AS A Other Topical corticosteroids).

Other Topical corticosteroids

2..Moderately potent steroid :

hydrocortisone থেকে 2-25 গুন পাওয়ারফুল –

1.Clobetasone Butyrate

Clobecort নামে পাওয়া যায়,

Cream 2:-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations).

Indications of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Clobecort preparations are indicated for the treatment of eczema and dermatitis of all types including atopic eczema, photodermatitis, otitis externa, primary irritant allergic dermatitis (including napkin rash), intertrigo, prurigo nodularis, seborrhoeic dermatitis and insect bite reactions. Clobecort may be used as a maintenance therapy between courses of one of the more active topical steroids.

Pharmacology of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Clobetasone Butyrate is a topically active corticosteroid, which provides an exceptional combination of activity and safety. It is more effective in the treatment of eczemas than 1% Hydrocortisone, or the less active synthetic steroid preparations that are in common use. It has little effect on hypothalamic-pituitary-adrenal function. All topical corticosteroids can cause cutaneous atrophy if grossly misused. However, study in animal and human models indicates that Clobetasone Butyrate causes less thinning of the epidermis than the other topical steroid tested.

Dosage & Administration of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Apply to the affected area up to four times a day until improvement occurs, when the frequency of application may be reduced.

Interaction of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Potentially hazardous interactions- none has been reported. Potentially useful interactions- none has been reported.

Contraindications of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Skin lesions caused by infection with viruses (e.g. herpes simplex, chicken pox), fungi (e.g. candidiasis, tinea) or bacteria (e.g. impetigo), hypersensitivity to the preparations.

Although generally regarded as safe, even for long-term administration in adults, there is a potential for overdosage, and in infants and children this may result in adrenal suppression. Extreme caution is required in
dermatoses in such patients including napkin eruption (as the napkin may act as an occlusive dressing and increase absorption) and treatment should not normally exceed seven days.

Appropriate antimicrobial therapy should be used whenever treating inflammatory lesions, which have infected. Any spread of infection requires withdrawal of topical corticosteroid therapy, and systemic administration of antimicrobial agents.

As with all corticosteroids, prolonged application to the face is undesirable. Topical corticosteroids may be hazardous in psoriasis for a number of reasons including rebound relapses, development of tolerance, and risk of generalized toxicity due to impaired barrier function of the skin. If used in psoriasis, careful patient supervision is important.

If applied to the eyelids, care is needed to ensure that the preparation does not enter the eye as glaucoma might result.

Side Effects of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

In the unlikely event of signs of hypersensitivity appearing, application should stop immediately. When large areas of the body are being treated with Clobecort, it is possible that some patients will absorb sufficient steroid to cause transient adrenal suppression despite the low degree of systemic activity associated with Clobecort.

Local atopic changes could possibly occur in situations where moisture increases absorption of Clobecort, but only after prolonged use.

There are reports of pigmentation changes and hypertrichosis with topical steroids.

Exacerbation of symptoms may occur.

Pregnancy & Lactation of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

There is inadequate evidence of safety in human pregnancy. Topical administration of corticosteroids to pregnant animals can cause abnormalities of fetal development including cleft palate and intrauterine growth retardation. There may therefore be a very small risk of such effects in the human fetus.

Therapeutic Class of Cream :-Clobecort 0.05% 25gm tube (As a Clobetasone Butyrate As a Clobetasol / Clobetasone & Combined Preparations):-

Clobetasol / Clobetasone & Combined Preparations

2. Triamcinolone acetonide

Aristocort নামে পাওয়া যায়.

যেসব ক্ষেত্রে ব্যবহার হয়

Moderate eczema

Atopic dermatitis

Lichen planus

Nummular eczema

Scabies (after scabicide)

Seborrheic dermatitis

Severe dermatitis

Severe intertrigo (short-term)

Stasis dermatitis.

Face, genital area, lips ব্যবহার করবেনা,

২ বছরের নিছে বাচ্চাদের ক্ষেত্রে ব্যবহার না করা ভালো।

Cream 3.Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Indications of Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Aristocort topical preparation is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae.

Pharmacologyof Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Triamcinolone Acetonide (a derivative of Triamcinolone) in a compatible base. Topical steroids are primarily effective because of their anti-inflammatory, antipruritic & vasoconstrictive actions.

Dosage & Administration Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

A small amount of Triamcinolone is gently rub to the affected area 1-2 times daily. Some cases of eczematised psoriasis may be treated more effectively by the application of Triamcinolone under an occlusive dressing.

Occlusive dressing technique: Gently rub a small amount of Triamcinolone on the lesion until it disappears. Then reapply, leaving a thin coating and cover with a pliable non porous film. For convenience apply Triamcinolone intermittently (12 hour occlusion during the night) followed by reapplication without occlusion, during the day.

Pediatric use: Triamcinolone should not be used in children under 8 years. Administration of topical corticosteroids to children should be limited to the least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of children. As children are more likely to get side effects, they should not normally be treated for longer than 5 days.

Contraindications Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Triamcinolone Acetonide is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation. It is also contraindicated in tuberculosis of the skin, fungus infections and viral diseases of the skin (Herpes simplex, chickenpox and vaccinia), perioral dermatitis, rosacea and ulcerative conditions.

Side Effects Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

The following local side effects have been reported with topical corticosteroids, either with or without occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis and allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.

Pregnancy & Lactation Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical administration of corticosteroid could result in sufficient systemic absorption to produce detectable quantities in breast milk. Systemically administered corticosteroids are secreted into breast milk in quantities not likely to have a deleterious effect on the infant. Nevertheless, caution should be exercised when topical corticosteroids are administered to a nursing woman.

Therapeutic Class Cream :-Aristocort 0.1% 10gm tube (AS A Triamcinolone Acetonide AS A Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations

Highly potent:

1. Betamethasome valerate

Betameaon নামে পাওয়া যায়.

Cream 4:-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Indications of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Aristobet cream or ointment is indicated for the treatment of-

Eczema in children and adults including atopic
Infantile and descoid eczema
Prurigo nodularis
Psoriasis (excluding wide spread plaque psoriasis)
Neurodermatoses including lichen simplex and lichen planus
Seborrhoic dermatitis
Contact sensitivity reaction
Discoid lupus erythematoses and may be used as adjunct to systemic steroid therapy in generalized erythroderma.

Pharmacology of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Betamethasone Valerate BP is a synthetic adrenocorticosteroid, which is glucocorticoid in nature. It is an analog of prednisolone that also possesses a slight degree of mineral corticosteroid activity. Due to its anti-inflammatory, antipruritic and vasoconstrictive activity, it is very effective and suitable for dermatological use. It is absorbed from the skin and inflammation and/or another disease process in the skin increase percutaneous absorption from the skin. Occlusive dressings substantially increase its percutaneous absorption.

Dosage & Administration of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Apply sparingly to the affected area two or three times daily until improvement occurs, then twice daily or less. The usual maximum duration of therapy is three weeks.

Interaction of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

There are no significant drug interactions reported with Aristobet Cream/Ointment.

Contraindications of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Betamethasone Valerate cream or ointment is contraindicated in the following conditions :

Hypersensitivity to any of the ingredients in the preparation.
Rosaceae & acne vulgaris.
Perioral dermatitis, perianal & genital pruritis.
Viral infections of the skin, e.g. herpes simplex & chicken pox.
Primary infected skin lesions caused by fungi or bacteria.
Dermatoses in children under one year of age.

Side Effects of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

The following local adverse reactions are more common with the use of high doses, long term use and with the use of occlusive dressings of Cream/Ointment: dryness, itching, burning, skin thinning, local irritation, features of hypercorticolism, telagiectasia, striaea, skin atrophy. hypertrichosis, change in pigmentation, secondary infection, perioral dermatiis, allergic contact dermatitis, maceration of the skin, acneform eruption, exacerbation of symptoms.

Pregnancy & Lactation of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

It should not be used extensively in pregnancy.

Therapeutic Class of Cream :-Aristobet 0.1% 20gm tube (As A Betamethasome valerate AS A Corticosteroid).

Corticosteroid

2. Mometason furoate

Cream: momeson নামে পাওয়া যায়

use: Hyperkeratotic skin condition, lichen planus, LSC, psoriasis, ইত্যাদিতে ব্যবহার হয়, palm and sole এর Dermatitis এ ব্যবহার হয়

Cream 5:- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Indications of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Momeson Cream is indicated for the relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses, such as psoriasis and atopic dermatitis.

Pharmacology of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Mometasone is a corticosteroid demonstrating anti-inflammatory properties. The precise mechanism of corticosteroids action on allergic rhinitis is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (e.g., mast cells, eosinophils, neutrophils, macrophages, and lymphocytes) and mediators (e.g., histamine, eicosanoids, leukotrienes, and cytokines) involved in inflammation.

Dosage & Administration of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

A thin film of Mometasone Furoate Cream should be applied to the affected skin areas once daily. Mometasone Furoate cream is suitable for moist lesions.

Contraindications of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Mometasone Furoate cream is contraindicated in patients who are hypersensitive to Mometasone Furoate or to other corticosteroids. Like other topical corticosteroids, Mometasone Furoate is contraindicated in most viral infections of the skin, tuberculosis, acne rosacea, perioral dermatitis, fungal skin infections and ulcerative conditions.

Side Effects of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Momeson cream is generally well tolerated. Pruritis, burning, tingling, stinging, signs of skin atrophy, folliculitis and acneiform reaction have been reported in less than 5% of patients. Other local adverse reactions reported in less than 1% of patients include erythema, furunculosis, dermatitis, abscess, aggravated allergy, increased lesion size, disease exacerbation, paraesthesia, dry skin, pimples and papular and pustular formation.

Pregnancy & Lactation of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

If irritation or sensitisation develops with the use of Mometasone Furoate cream, treatment should be discontinued and appropriate therapy instituted.

Use in Pregnancy: Safe use of Mometasone Furoate cream in pregnant women has not been established.

Use in Lactation: It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk.

Therapeutic Class of Cream :- Momeson 0.1% 5gm tube (AS A Mometason furoate AS A Other Topical corticosteroids).

Other Topical corticosteroids

4.Super potent ultra high:

1.Clobetasol –

Dermasol নামে পাওয়া যায়, Acute severe eczema/ psoriasis /LSC ইত্যাদিতে ব্যবহার –kora hoi.

Cream 6.Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids).

Indications of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Dermasol is indicated for adults, elderly and children over 1 year in following dermatoses.

Psoriasis (excluding widespread plaque psoriasis)
Recalcitrant dermatoses
Lichen planus
Discoid lupus erythematosus
Other skin conditions which do not respond satisfactorily to less potent steroids.

Composition of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Clobetasol Propionate Cream: Each gram cream contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Ointment: Each gram ointment contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Scalp Application: Each gram lotion contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Shampoo: Each gram shampoo contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Lotion: Each gram lotion contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Clobetasol Propionate Spray: Each gram spray contains Clobetasol Propionate BP 0.5 mg (0.05% w/w).

Pharmacology of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.

Dosage of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Cream, Ointment: Adults, elderly and children over 1 year: Apply a thin layer of Clobetasol Propionate Cream or Ointment to the affected skin areas twice daily and rub in gently and completely. Repeated short courses of Clobetasol Propionate may be used to control exacerbations. In more resistant lesions, especially where there is hyperkeratosis, the effect of Clobetasol can be enhanced, if necessary, by occluding the treatment area with polythene film. Overnight occlusion only is usually adequate to bring about a satisfactory response.

Clobetasol Propionate is super-high potency topical corticosteroids; therefore, treatment should be limited to 2 consecutive weeks. The maximum weekly dose should not be exceeded 50 gm/week. In case of children, courses should be limited if possible to five days and reviewed weekly.

Spray: Apply required quantity of spray of once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Propionate scalp solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Propionate scalp solution for brief periods only.

Shampoo: It should be applied to the dry (not wet) scalp once a day to the affected areas only. It should be massaged gently into the lesions and left in place for 15 minutes before lathering and rinsing. Treatment should be limited to 4 consecutive weeks. Total dosage of shampoo should not exceed 50 g per week. Under 18 years this preparation is not recommended.

Scalp Solution: Apply required quantity of spray of Clobetasol Scalp Solution once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Scalp Solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Scalp Solution for brief periods only.

Administration of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Route of administration: Cutaneous. Creams are especially appropriate for moist or weeping surfaces. Ointments are especially appropriate for dry, lichenified or scaly lesions.

Interaction of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Co-administered drugs that can inhibit CYP3A4 (eg ritonavir, itraconazole) have been shown to inhibit the metabolism of corticosteroids leading to increased systemic exposure.

Contraindications of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Rosacea, acne vulgaris and perioral dermatitis. Primary cutaneous viral infections (e.g. herpes simplex, chickenpox).
Hypersensitivity to the preparation.
The use of Clobetasol Propionate skin preparations is not indicated in the treatment of primarily infected skin lesions caused by infection with fungi (e.g. candidiasis, tinea), or bacteria (e.g.impetigo): perianal and genital pruritus.
Dermatoses in children under one year of age, including dermatitis and napkin eruptions.

Side Effects of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

As with other topical corticosteroids prolonged use of large amounts, or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercorticism.
Prolonged and intensive treatment with a highly active corticosteroid preparation may cause local atrophic changes in the skin such as thinning, striae and dilatation of the superficial blood vessels, particularly when occlusive dressings are used or when skin folds are involved.
In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the disease.
There are reports of pigmentation changes and hypertrichosis with topical steroids. Dermasol is usually well tolerated, but if signs of hypersensitivity appear, application should be stopped immediately. Exacerbation of symptoms may occur.

Pregnancy & Lactation of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

There are limited data from the use of Clobetasol Propionate cream in pregnant women. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development. The relevance of this finding to humans has not been established. However, the administration of Clobetasol Propionate Cream during pregnancy and lactation should only be considered if the expected benefit to the mother outweighs the possible risks of treatment.

It is unknown whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Clobetasol Propionate Cream is administered to a nursing woman.

Therapeutic Class of Cream:-Dermasol 0.05% 20gm tube (AS A Clobetasol Propionate AS a Other Topical corticosteroids):-

Other Topical corticosteroids

2. Halobetasol

Halobet নামে পাওয়া যায় Acute severe eczema/ psoriasis /LSC ইত্যাদিতে ব্যবহার –kora hoi.

ব্যবহার –

Acute severe eczema/ psoriasis /LSC ইত্যাদিতে

Short period এর জন্য ব্যবহার হয়

Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Indications of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Halobet 0.05% is a super-high potent corticosteroid indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Treatment beyond two consecutive weeks is not recommended, and the total dosage should not exceed 50 gm/week because of the potential for the drug to suppress the Hypothalamic-Pituitary-Adrenal (HPA) axis.

Pharmacology of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Like other topical corticosteroids, halobetasol propionate has anti-inflammatory, antipruritic and vasoconstrictive actions. The mechanism of the anti-inflammatory activity of the topical corticosteroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2 .

Dosage & Administration of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Apply a thin layer of Halobetasol Cream or Ointment to the affected skin once or twice daily, as directed by the physician, and rub in gently and completely. Halobetasol 0.05% is a super-high potency corticosteroid; therefore, treatment should be limited to two weeks, and amounts greater than 50 gm/week should not be used. As with other highly active corticosteroids, therapy should be discontinued when control has been achieved. If no improvement is seen within 2 weeks, reassessment of the diagnosis may be necessary. Halobetasol should not be used with occlusive dressings.

Contraindications of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Halobetasol Propionate Cream/Ointment is contraindicated in those patients with a history of hypersensitivity to any of the components of the preparation.

Side Effects of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

The following adverse effects have been reported infrequently with topical corticosteroids. These reactions include burning, itching, dryness, folliculitis acne, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin atrophy, secondary infections, striae and miliaria.

Pregnancy & Lactation of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. Therefore caution should be exercised when topical corticosteroids are administered to a nursing woman.

Precautions & Warnings of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Systemic absorption of topical corticosteroids may cause reversible Hypothalamic-Pituitary-Adrenal (HPA) axis suppression, manifestations of cushing’s syndrome, hyperglycemia, and glucosuria. Patients receiving large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be evaluated periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests. If HPA axis suppression is noted, an attempt should be made to withdraw the drug, to reduce the frequency of application, or to substitute a less potent steroid.

Use in Special Populations of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Use in children under 12 years of age is not recommended. Safety and effectiveness of Halobet cream & ointment in paediatric patients have not been established. Paediatric patients are at greater risk than adults of HPA axis suppression when they are treated with topical corticosteroids.

Therapeutic Class of Cream 7:- Halobet 0.05% 20gm tube AS A (Halobetasol Propionate AS A Other Topical corticosteroids).

Other Topical corticosteroids

Raiyyan Tahsan Date:-7-11-2025 Time:-5-21-45 Pm

Raiyyan Tahsan

Raiyyan Tahsan