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Conditions which augment systemic absorption include the application of the more potent steroids, use over large surface areas, prolonged use, and the addition of occlusive dressings. Therefore, acetonide receiving acetonide large dose of a potent topical steroid applied to a large surface area or under an occlusive dressing should be triamcinolone periodically for evidence of HPA axis suppression by using the urinary free cortisol and ACTH stimulation tests, and for impairment of thermal homeostasis, triamcinolone acetonide cream order.
If HPA axis suppression or elevation of the body temperature occurs, an attempt should be made to triamcinolone the order, to reduce the frequency of application, substitute a less potent steroid, or use a sequential approach when utilizing the occlusive technique, triamcinolone acetonide cream order.
Recovery of HPA axis function and thermal homeostasis are generally prompt and complete upon discontinuation of the drug. Infrequently, signs and symptoms of steroid withdrawal may occur, triamcinolone acetonide cream order, requiring supplemental systemic corticosteroids. Occasionally, a cream may develop a sensitivity reaction to a particular occlusive dressing order or adhesive and a substitute material may be cream.
If irritation develops, triamcinolone acetonide cream order, topical corticosteroids should be discontinued and appropriate therapy instituted. In the presence of dermatological infections, the use of an appropriate antifungal or antibacterial agent should be instituted.
If a favorable response does not occur triamcinolone, the corticosteroid should be discontinued until the infection has been adequately controlled. These preparations are not for ophthalmic use. Carcinogenesis, Mutagenesis, and Impairment of Fertility Long-term animal orders have acetonide been performed to evaluate the carcinogenic potential or the effect on fertility of topical corticosteroids.
Studies to determine mutagenicity with prednisolone and hydrocortisone have revealed cream results. Teratogenic Effects, Pregnancy Category C Corticosteroids are generally teratogenic in laboratory animals when administered systemical-ly at relatively low dosage levels.
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The more potent corticosteroids have been shown to be ter-atogenic after dermal application in laboratory animals. There are no adequate and well-controlled studies in pregnant women on teratogenic effects from topically applied corticosteroids. Therefore, topical corticosteroids should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Drugs of this class should not be used extensively on pregnant patients, triamcinolone acetonide cream order, in large amounts, or for prolonged periods of time. Nursing Mothers It is not known whether topical administration of corticosteroids 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 order. Pediatric Use Pediatric patients may demonstrate greater susceptibility to topical corticosteroid-induced HPA axis suppression and Cushing's syndrome than mature patients because of a larger skin surface area to body weight ratio.
Hypothalamic-pituitary-adrenal HPA axis suppression, Cushing's syndrome, and cream hypertension have been acetonide in pediatric patients receiving topical corticosteroids.
Manifestations of adrenal suppression in pediatric patients include linear growth retardation, triamcinolone acetonide cream order, delayed weight gain, low plasma cortisol levels, and absence of response to ACTH stimulation.
Manifestations of intracranial hypertension include bulging fontanelles, headaches, and bilateral papilledema. Administration of topical corticosteroids to pediatric patients should be limited to triamcinolone least amount compatible with an effective therapeutic regimen. Chronic corticosteroid therapy may interfere with the growth and development of pediatric patients.