Inhouse product
Indications
The anti-inflammatory
activity of Topicort is its main therapeutic property. It also has
immunosuppressant and antimitotic actions. Topicort is indicated in:
* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'
Pharmacology
Hydrocortisone binds
to the cytosolic glucocorticoid receptor. After binding the receptor the newly
formed receptor-ligand complex translocates itself into the cell nucleus, where
it binds to many glucocorticoid response elements (GRE) in the promoter region
of the target genes. The DNA bound receptor then interacts with basic
transcription factors, causing the increase in expression of specific target
genes. The anti-inflammatory actions of corticosteroids are thought to involve
lipocortins, phospholipase A2 inhibitory proteins which, through inhibition
arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes.
Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which
then binds to cell membranes preventing the phospholipase A2 from coming into
contact with its substrate arachidonic acid. This leads to diminished
eicosanoid production. The cyclooxygenase (both COX-1 and COX-2) expression is
also suppressed, potentiating the effect. In other words, the two main products
in inflammation Prostaglandins and Leukotrienes are inhibited by the action of
Glucocorticoids. Glucocorticoids also stimulate the lipocortin-1 escaping to
the extracellular space, where it binds to the leukocyte membrane receptors and
inhibits various inflammatory events: epithelial adhesion, emigration,
chemotaxis, phagocytosis, respiratory burst and the release of various
inflammatory mediators (lysosomal enzymes, cytokines, tissue plasminogen
activator, chemokines etc.) from neutrophils, macrophages and mastocytes.
Additionally the immune system is suppressed by corticosteroids due to a
decrease in the function of the lymphatic system, a reduction in immunoglobulin
and complement concentrations, the precipitation of lymphocytopenia, and
interference with antigen-antibody binding.
Dosage &
Administration
Hydrocortisone Acetate
should be applied in a small quantity to the affected area 2 or 3 times daily.
* রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন'
Contraindications
Side Effects
Topicort 1% cream is
usually well-tolerated, but if signs of hypersensitivity appear, application
should be stopped.
Pregnancy &
Lactation
There is inadequate
evidence for safety in human pregnancy. It is recommended that topical
corticosteroids should not be used extensively during pregnancy. It is
highly unlikely that sufficiently high blood levels of Hydrocortisone are
achieved during topical therapy to reach breast milk.
Precautions &
Warnings
In infants and
children, long-term continuous topical therapy should be avoided where
possible, as adrenal suppression can occur. As with all corticosteroids,
prolonged application to the face is undesirable.
Overdose Effects
Acute overdosage is
very unlikely to occur, however, in the case of chronic overdosage or misuse,
the features of hypercorticism may appear and in this situation topical
steroids should be discontinued.
Therapeutic Class
Other Topical
corticosteroids
Storage Conditions
Store in a cool and
dry place, away from light. Keep out of reach of children.
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