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General information The adrenocorticotrophic hormone ACTH (corticotropin) stimulates the adrenal cortex to secrete the glucocorticoids hydrocortisone (cortisol) and corticosterone, the mineralocorticoid aldosterone, and a number of weakly androgenic substances, as well as a small amount of testosterone. Aldosterone synthesis is also regulated by renin and angiotensin. This monograph should be read in conjunction with the monograph on glucocorticoids. It is not always clear which adverse effects…

General information Aldosterone is the principal physiological salt-retaining mineralocorticoid, but it is unsuitable for routine medical use since it is rapidly inactivated when given orally. Desoxycorticosterone (DCA, DOCA, desoxycortone) was used for a long time, but it had to be taken sublingually (or implanted or injected) to avoid inactivation during passage through the liver. Overdosage of desoxycorticosterone, leading to hypertensive encephalopathy and permanent brain damage, has…

General information The local adverse effects of topical glucocorticoids [ , ] are listed in Table 1 . They include transient local erythema, calcinosis cutis, cramps (due to injection of crystals into a vessel), amaurosis (a dubious report), depigmentation, skin atrophy, and skin necrosis [ ]. Table 1 Adverse reactions to topical glucocorticoids Effects on the pilosebaceous unit Effects on the immune system Perioral dermatitis […

General information Eye-drops Glucocorticoids that have been used for local ophthalmic treatment as eye-drops include medrysone, fluorometholone, tetrahydroxytriamcinolone, and clobetasone. Loteprednol etabonate 0.5% increases intraocular pressure less than dexamethasone. Studies on animal models of uveitis and two randomized double-masked trials have shown that loteprednol etabonate 0.5% is less potent than dexamethasone, prednisolone acetate 1%, or fluorometholone, which may partly explain the improved toxicity profile of loteprednol…

General information The safety of nasal glucocorticoids in the treatment of allergic rhinitis has been reviewed [ , ]. The local application of glucocorticoids for seasonal or perennial rhinitis often results in systemic adverse effects. The use of nasal sprays containing a glucocorticoid that has specific topical activity (such as beclomethasone dipropionate or flunisolide) seems to reduce the systemic adverse effects, but they can nevertheless occur,…

General information Intralesional triamcinolone acetonide has been used extensively for the treatment of hypertrophic and keloid scars. Complications are few, usually being local skin color changes, prominent vascular markings, or subcutaneous atrophy. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

General information Local injections of glucocorticoids into and around the joints can have a dramatic therapeutic effect, but the catabolic effect can have serious consequences, including adverse effects on joint structure [ ] and on local tendons, subcutaneous atrophy, and possibly osteonecrosis. Provided the state of the joint is carefully inspected before any new injection is given, and the interval between the injections is not less…

See also Inhaler propellants General information Treatment with inhaled glucocorticoids reduces the need for oral glucocorticoids in the treatment of severe asthma. The compounds used for inhalation have high local activity and low systemic availability when delivered to the lung. However, if sufficient amounts of glucocorticoids reach the bronchioles be absorbed, systemic effects will occur. Furthermore, a proportion of the dose intended for inhalation is actually…

General information Epidural The indications, rationale, techniques, alternatives, contraindications, complications, and efficacy of lumbar and caudal epidural glucocorticoid injections have been reviewed [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

General information Nomenclature The two main classes of adrenal corticosteroids are properly known as glucocorticoids and mineralocorticosteroids. The former are often known by shorter names and are commonly referred to as “glucocorticoids”, “corticosteroids”, “corticoids”, or even simply “steroids”; the latter are often referred to as “mineralocorticoids”. Here we shall use the terms “glucocorticoids” and “mineralocorticoids”. When referring to both we shall use the term “corticosteroids”. Relative…

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See also Etherified starches General information Corn starch is a white, tasteless, odorless powder, used in food processing, papermaking, and the production of industrial adhesives; it is also a component of many cosmetics and oral pharmaceutical products. It has been used as a lubricant in surgical gloves. Various adverse reactions to corn starch have been reported after surgical use. Corn starch is not by itself allergenic,…

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General information Copper is a reddish metallic element (symbol Cu; atomic no. 29). Its symbol derives from the Latin word cuprum, because it was originally discovered in Cyprus. It is widely found as different salts in minerals such as atacamite (chloride); azurite and malachite (carbonates); bornite, chalcocite, chalcopyrite, stannite, tennantite, and tetrahedrite (sulfides); chalcanthite (sulfate); dioptase (silicate); erinite and olivenite (arsenates); tenorite (oxide); torbernite (phosphate); and…

General information The genera in the family of Convolvulaceae ( Table 1 ) include bindweed and morning glory [ ]. Table 1 Genera of convolvulaceae Aniseia (aniseia) Argyreia (argyreia) Bonamia (lady’s nightcap) Calystegia (false bindweed) Convolvulus (bindweed) Cressa (alkaliweed) Dichondra (pony’s foot) Erycibe Evolvulus (dwarf morning glory) Ipomoea (morning glory; sweet potato) Jacquemontia (cluster vine) Merremia (wood rose) Operculina (lidpod) Poranopsis (poranopsis) Stictocardia (stictocardia) Stylisma (dawn…

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General information There are two types of contact lenses, soft and hard; most are manufactured from methacrylate polymer [ ]. Soft lenses are made of hydrophilic hydrogel polymers that contain 36–74% water. Other plastics and co-polymers are added to alter the physical characteristics of the lens. The diameter is 10.5–15.5 mm and the thickness at the center 0.03–20 mm. Soft lenses can correct most optical defects,…

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General information Complementary and alternative medicine (also referred to as “non-orthodox,” “unconventional,” “holistic”, and "integrative" medicine) comprises a heterogeneous array of interventions, from acupuncture to spinal manipulation and from herbal medicine to homeopathy. The techniques referred to in this monograph are: Acupuncture Animal cell therapy Anthroposophy Aromatherapy Cupping Homeopathy Hypnosis Manipulation Massage Skin branding Herbal products and animal products are covered in separate monographs. Complementary medicine…