General use

Question 1

Topical

Answer 1

Inflammatory skin conditions e.g.

Avoid or specialist use for psoriasis

Question 2

Pro-long life and high doses

Answer 2

1. exfoliative dermatitis
2. pemphigus
3. acute leukemia
4. acute transplant rejection

Question 3

Long-term use

Answer 3

adverse effects > disease effect

lowest maintenance dose

Question 4

Crohn’s Disease

Answer 4

1. Topical - rectum

2. Systemically - mouth and IV

Question 5

Ulcerative Colitis

Answer 5

1. Topical (rectum)
2. Systemic
3. IV

Question 6

Haemorrhoids

Answer 6

Locally applied creams/ointments/suppositories

1. BENZYL BENZOATE WITH BISMUTH OXIDE, BISMUTH SUBGALLATE, HYDROCORTISONE ACETATE, PERU BALSAM AND ZINC OXIDE
   Example: Anusol Plus HC Ointment
2. CINCHOCAINE HYDROCHLORIDE WITH FLUOCORTOLONE CAPROATE AND FLUOCORTOLONE PIVALATE
   Example: Ultraproct ointment
3. CINCHOCAINE WITH HYDROCORTISONE
   Example: Uniroid-HC Ointment
4. CINCHOCAINE WITH PREDNISOLONE
   Example: Scheriproct Ointment
5. Lidocaine cream, ointments (5%), injections, sprays, medicated plasters
   Example: Vagisil 2% cream, LMX 4 cream, Xylocaine 10mg/dose spray, Ralvo 700mg plasters

Question 7

Fludrocortisone acetate

Answer 7

Postural hypotension
High mineralocorticoid activity = fluid retention (beneficial in low BP)
1. Neuropathic postural hypotension (diabetes)
2. Adrenal insufficiency due to septic shock
Anti-inflammatory effect of no clinical relevance
MOST POTENT

Question 8

Hydrocortisone

Answer 8

50:50

High mineralocorticoid effect = fluid retention = Adrenal replacement therapy, short-term IV for emergency
AND
Moderate glucocorticoid effect = anti-inflammaroty = topical use