Ocular steroid potency chart

Glucocorticoids are potent anti-inflammatories, regardless of the inflammation's cause; their primary anti-inflammatory mechanism is lipocortin-1 (annexin-1) synthesis. Lipocortin-1 both suppresses phospholipase A2 , thereby blocking eicosanoid production, and inhibits various leukocyte inflammatory events ( epithelial adhesion , emigration , chemotaxis , phagocytosis , respiratory burst , etc.). In other words, glucocorticoids not only suppress immune response, but also inhibit the two main products of inflammation, prostaglandins and leukotrienes . They inhibit prostaglandin synthesis at the level of phospholipase A2 as well as at the level of cyclooxygenase /PGE isomerase (COX-1 and COX-2), [29] the latter effect being much like that of NSAIDs , potentiating the anti-inflammatory effect.

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The most common side effect of topical corticosteroid use is skin atrophy. All topical steroids can induce atrophy, but higher potency steroids, occlusion, thinner skin, and older patient age increase the risk. The face, the backs of the hands, and intertriginous areas are particularly susceptible. Resolution often occurs after discontinuing use of these agents, but it may take months. Concurrent use of topical tretinoin (Retin-A) % may reduce the incidence of atrophy from chronic steroid applications. 30 Other side effects from topical steroids include permanent dermal atrophy, telangiectasia, and striae.

Microbiology: The anti-infective components in CORTISPORIN Ophthalmic Ointment are included to provide action against specific organisms susceptible to it. Neomycin sulfate and polymyxin B sulfate are active in vitro against susceptible strains of the following microorganisms: Staphylococcus aureus, streptococci including Streptococcus pneumoniae , Escherichia coli , Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa . The product does not provide adequate coverage against Serratia marcescens (see INDICATIONS ).

Relatively little published work on the use of ACH during treatment though what is available is not encouraging. Rodent studies showed that combining ACH and antibiotic therapy (using penicillin) in the acute treatment of infection can have negative effects – the ACH seemingly has no effect at all and can even reduce the potency of the antibiotic leading to decreased patient outcomes.
One human case reported was a gravely ill patient with leptospirosis and severe hypoxaemia. There was diffuse alveolar haemorrhage and myositis thus a bolus of corticosteroids was used over the first 24 hours complementary to the traditional treatment. Outcome was good though the paper does not indicate the effect ACH therapy may have had on the antibiotic agents as there was only one patient.
ACH therapy for chronic infection is a difficult area to draw conclusions on. For a patient with a significant leptospiral residency who is still receiving antibiotic therapy the addition of ACH could reduce the existing treatment effectiveness as described above. For patients suffering from post-infection pathologies there is a case for ACH treatment. As an example, some patients can develop parainfectious encephalomyelitis after an infection of leptospira. In one reported case the progressive course of this condition was reversed rapidly with eventual full recovery after corticosteroid therapy. In cases such as this the leptospiral cause of the condition can in effect be forgotten when treating the pathologies.

The National Heart, Lung, and Blood Institute (NHLBI) recommended dosing for systemic prednisone, prednisolone, or methylprednisolone in pediatric patients whose asthma is uncontrolled by inhaled corticosteroids and long-acting bronchodilators is 1–2 mg/kg/day in single or divided doses. It is further recommended that short course, or "burst" therapy, be continued until the patient achieves a peak expiratory flow rate of 80% of his or her personal best or until symptoms resolve. This usually requires 3 to 10 days of treatment, although it can take longer. There is no evidence that tapering the dose after improvement will prevent a relapse.

Ocular steroid potency chart

ocular steroid potency chart

Microbiology: The anti-infective components in CORTISPORIN Ophthalmic Ointment are included to provide action against specific organisms susceptible to it. Neomycin sulfate and polymyxin B sulfate are active in vitro against susceptible strains of the following microorganisms: Staphylococcus aureus, streptococci including Streptococcus pneumoniae , Escherichia coli , Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa . The product does not provide adequate coverage against Serratia marcescens (see INDICATIONS ).

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