Drilldown: Medicines

Betamethasone (valerate, dipropionate, sodium phosphate, acetate) (1) · Chlorhexidine gluconate (CHG) (1) · Hydrocortisone (cortisol) (1) · Nystatin (1) · Triamcinolone (acetonide and other esters) (1)

Celestone (oral/injectable), Diprolene/Diprosone (topical), Luxiq (foam), Celestone Soluspan (depot IM) (1) · Cortef (oral), Solu-Cortef (IV), many topical brands (Cortizone, OTC); Plenadren, Alkindi (modified-release for adrenal insufficiency) (1) · Hibiclens, Hibistat, Peridex (dental rinse), ChloraPrep (1) · Kenalog (injectable), Nasacort (intranasal), Aristocort (topical), Trianex (1) · Mycostatin, Nystop, Nyamyc, Bio-Statin (1)

high-potency)]] (1) · with mineralocorticoid activity)]] (1) · [[:Category:Antifungals|Antifungal]] (1) · [[:Category:Antiseptics|Antiseptic]] (1) · [[:Category:Bisbiguanides|Bisbiguanide]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (3) · [[:Category:Glucocorticoids|Glucocorticoid (intermediate-acting)]] (1) · [[:Category:Glucocorticoids|Glucocorticoid (long-acting (1) · [[:Category:Glucocorticoids|Glucocorticoid (short-acting (1) · [[:Category:Polyene_antifungals|Polyene antifungal]] (1) · [[:Category:Topical_corticosteroids|Topical corticosteroid (high-to-super-high potency depending on ester)]] (1) · [[:Category:Topical_corticosteroids|Topical corticosteroid]] (1)

None (3) · '"`UNIQ--vote-00000D11-QINU`"' Same mechanistic family as amphotericin B but with prohibitive systemic toxicity at therapeutic doses, hence restriction to topical and luminal-gut indications. No clinically meaningful resistance after decades of use'"`UNIQ--ref-00000D12-QINU`"'. (1) · '"`UNIQ--vote-00001014-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. The dipropionate, valerate, and augmented dipropionate ester forms determine topical potency (high to super-high)'"`UNIQ--ref-00001015-QINU`"'. (1)

'"`UNIQ--vote-00000661-QINU`"', '"`UNIQ--vote-00000662-QINU`"', '"`UNIQ--vote-00000663-QINU`"', '"`UNIQ--vote-00000664-QINU`"', '"`UNIQ--vote-00000665-QINU`"' (1) · '"`UNIQ--vote-00000ACD-QINU`"', '"`UNIQ--vote-00000ACE-QINU`"', '"`UNIQ--vote-00000ACF-QINU`"', '"`UNIQ--vote-00000AD0-QINU`"' (1) · '"`UNIQ--vote-00000D13-QINU`"', '"`UNIQ--vote-00000D14-QINU`"', '"`UNIQ--vote-00000D15-QINU`"', '"`UNIQ--vote-00000D16-QINU`"' (1) · '"`UNIQ--vote-00001016-QINU`"', '"`UNIQ--vote-00001017-QINU`"', '"`UNIQ--vote-00001018-QINU`"', '"`UNIQ--vote-00001019-QINU`"' (1) · '"`UNIQ--vote-00001393-QINU`"', '"`UNIQ--vote-00001394-QINU`"', '"`UNIQ--vote-00001395-QINU`"', '"`UNIQ--vote-00001396-QINU`"', '"`UNIQ--vote-00001397-QINU`"' (1)

Antenatal: Celestone Soluspan 12 mg IM q24h × 2 doses; topical: pea-sized amount BID; intra-articular varies by joint (1) · Oral: 4-6 mL (400,000-600,000 units) suspension QID swish-and-swallow; topical: BID-QID; vaginal tablet 1 daily for 2 weeks (1) · Physiologic replacement 15-25 mg/d divided (e.g., 10 mg AM, 5 mg noon, 5 mg afternoon); stress dose 50-100 mg IV q6-8h; adrenal crisis 100 mg IV then 50-100 mg q6h; topical 0.5-2.5% applied 2-4×/d (1) · Surgical scrub 4% CHG; preop skin prep 2% CHG/70% isopropyl alcohol (ChloraPrep); ICU bathing 2% CHG daily; oral rinse 0.12% 15 mL twice daily for 30 seconds (1) · Topical 0.025-0.5% cream/ointment BID; intra-articular 5-40 mg per joint q3-6 months; intranasal Nasacort 110 mcg/spray, 2 sprays/nostril daily; oral paste 0.1% to lesion 2-3×/d (1)

0.6 mg/5 mL oral solution; Celestone Soluspan 6 mg/mL IM/IA (mix of sodium phosphate + acetate); 0.05% and 0.1% topical cream/ointment/lotion/foam (various salts); augmented betamethasone 0.05% (super-high potency) (1) · 100,000 units/mL oral suspension; 500,000 unit tablets; 100,000 units/g cream, ointment, powder; vaginal tablets (1) · 2%, 4% wash; 2% CHG/70% IPA applicators (ChloraPrep); 0.12%, 0.2% oral rinse; impregnated catheter dressings (1) · 5, 10, 20 mg oral tablets; 100, 250, 500, 1000 mg IV (Solu-Cortef); 0.5%, 1%, 2.5% topical creams/ointments; rectal foam and enemas (1) · Topical creams, ointments, lotions, dental paste (0.025-0.5%); Kenalog 10 mg/mL, 40 mg/mL injection; Nasacort 55 mcg/spray intranasal; oral inhaler discontinued in US (1)

None · Indication-specific · 40 mg/d · 10 mg/d · 20 mg/d · 80 mg/d · 10 mg/d (adults) · 100 mg/d · 4 g/d · 400 mg/d · 40 mg/d typical; up to 240 mg/d for Zollinger-Ellison · 5 mg/d · 50 mg/d · 600 mg/d · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals · No fixed maximum; titrated to TSH target · TID per eye · Titrated to glucose; no fixed ceiling · Titrated to glucose; no fixed maximum · '''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60

Other values:

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None · oral · IV · Topical · IM · intranasal · rectal · Subcutaneous · topical ophthalmic · ophthalmic · intramuscular · intravenous · transdermal · vaginal · Subcutaneous (abdomen · Sublingual · thigh · inhaled · intra-articular · nebulized

Other values:

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Hours (2) · Minutes (1) · Symptom relief within days (1) · Topical hours; intra-articular days to weeks (1)

Biologic 36-54 hours (long-acting) (1) · Biologic ~8-12 hours (short-acting) (1) · Hours per application (1) · Intra-articular 3-6 months (depot effect of acetonide microcrystals) (1) · Persistent activity 6+ hours (residual binding to skin and oral surfaces) (1)

Not meaningfully described (negligible systemic absorption from intact skin or oral mucosa)'"`UNIQ--ref-00001398-QINU`"' (1) · Not meaningfully described (not systemically absorbed)'"`UNIQ--ref-00000D17-QINU`"' (1) · Plasma ~1-2 hours; biologic ~8-12 hours'"`UNIQ--ref-00000AD1-QINU`"' (1) · Plasma ~3-5 hours; biologic effect substantially longer (~12-36 hours for intermediate-acting glucocorticoids)'"`UNIQ--ref-00000666-QINU`"' (1) · Plasma ~5 hours; biologic ~36-54 hours'"`UNIQ--ref-0000101A-QINU`"' (1)

Essentially zero systemic absorption from oral or topical routes — the topical-action-only profile is the basis of its safety'"`UNIQ--ref-00000D18-QINU`"' (1) · Oral ~70%; depot IM provides sustained release over weeks'"`UNIQ--ref-0000101B-QINU`"' (1) · Topical/intranasal: high local, low systemic; intra-articular: local depot then systemic absorption'"`UNIQ--ref-00000667-QINU`"' (1) · Topical/oral local action with minimal systemic absorption'"`UNIQ--ref-00001399-QINU`"' (1) · ~96% (oral)'"`UNIQ--ref-00000AD2-QINU`"' (1)

None (1) · Generally considered safe (minimal systemic absorption).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Generally considered safe in pregnancy (no systemic absorption).<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Topical/intranasal generally low-risk; intra-articular and high-dose injection: weigh risk individually.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Use when benefits outweigh; widely used at physiologic doses for adrenal insufficiency.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

OTC (low-dose topicals) and [[USLegal:Prescription only|Rx-only]] (other forms) in US (1) · OTC (lower-concentration washes) and [[USLegal:Prescription only|Rx-only]] (Peridex oral rinse, ChloraPrep) in US (1) · OTC (lowest-strength topicals) and [[USLegal:Prescription only|Rx-only]] (higher strengths, injectable) in US (1) · [[USLegal:Prescription only|Rx-only]] in US (2)