Ocular steroid potency chart

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.

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.

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 ).

Neuropsychiatric: A wide range of psychiatric reactions including affective disorders (such as irritable, euphoric, depressed and labile mood, and suicidal thoughts), psychotic reactions (including mania, delusions, hallucinations, and aggravation of schizophrenia), marked euphoria leading to dependence; aggravation of epilepsy, behavioural disturbances, irritability, nervousness, anxiety, sleep disturbances, and cognitive dysfunction including confusion and amnesia have been reported. Reactions are common and may occur in both adults and children. In adults, the frequency of severe reactions has been estimated to be 5-6%. Psychological effects have been reported on withdrawal of corticosteroids; the frequency is unknown.

Ocular steroid potency chart

ocular steroid potency chart

Neuropsychiatric: A wide range of psychiatric reactions including affective disorders (such as irritable, euphoric, depressed and labile mood, and suicidal thoughts), psychotic reactions (including mania, delusions, hallucinations, and aggravation of schizophrenia), marked euphoria leading to dependence; aggravation of epilepsy, behavioural disturbances, irritability, nervousness, anxiety, sleep disturbances, and cognitive dysfunction including confusion and amnesia have been reported. Reactions are common and may occur in both adults and children. In adults, the frequency of severe reactions has been estimated to be 5-6%. Psychological effects have been reported on withdrawal of corticosteroids; the frequency is unknown.

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