Corticosteroid potency chart

The inhaler device efficiency is expected to influence inhaled corticosteroid therapeutic dose equivalence. Device efficiency (lung deposited dose/nominal dose) varies for dry-powder (DPI) and metered-dose (MDI) inhalers. The largest differences are seen between DPIs and chlorofluorocarbon (CFC) MDIs of low- to mid-range efficiency that emit particles mostly in the 3–5 µm range when compared with MDIs that contain drug dissolved in hydrofluoroalkane (HFA) propellant and generate an ultrafine aerosol plume with smaller particles (≈1 µm) and a greater proportion of the particles in the respirable range (<5 µm) [ 16 ]. The impact of device efficiency on therapeutic dose is explored in Figure  3 , which has on the y-axis the total daily dose estimated to be deposited in the lungs, obtained by correcting the nominal dose for the device efficiency. Figure  3 also includes data for DPIs and MDIs of both the CFC and higher-efficiency ultrafine aerosol HFA MDIs (FLU, BDP, CIC) (Table  1 ). Also included are low-, mid- and high-dose regimens of all currently available inhaled corticosteroids, illustrating for each dose level a distinct exponential decline in therapeutic daily dose with increasing potency. Therefore, one might expect that all dose regimens in the low-, mid- or high-dose categories, as defined by each regression line, should have equivalent efficacy. This may be the case, but is difficult to verify as the extent to which each product's recommended doses are based on comprehensive dose ranging in all severities of asthma is variable.

Direct intravenous injection:
Use only methylprednisolone sodium succinate.
Reconstitute with provided diluent or add 2 ml of bacteriostatic water (with benzyl alcohol) for injection.
May be administered undiluted.
Administer directly into a vein over 3—15 minutes. Doses >= 2 mg/kg or 250 mg should be given by intermittent infusion (see below), unless the potential benefits of direct IV injection outweigh the potential risks (., life-threatening shock).
 
Intermittent intravenous infusion:
Use only methylprednisolone sodium succinate.
Dilute in D5W, % Sodium Chloride (NS), or D5NS injection. Haze may form upon dilution.
Infuse over 15—60 minutes. Large doses (., >= 500 mg) should be administered over at least 30—60 minutes.

Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

Corticosteroid potency chart

corticosteroid potency chart

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

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