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The diagnosis and management of preterm labor with intact membranes
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Roberto Romero, Tinnakorn Chaiworapongsa, Francesca Gotsch, Lami Yeo, Ichchha Madan, Sonia S. Hassan
The agents administered are either dexamethasone or betamethasone because they cross the placenta readily, are weaker immunosuppressors than other glucocorticoid steroids, and have a longer duration of action than cortisol. The standard dosage of betamethasone consists of two intramuscular 12-mg doses (24 hours apart), while four intramuscular doses of 6mg of dexamethasone should be administered at 6-hour intervals. Oral administration of dexamethasone is not recommended, because it has been associated with an increased risk of neonatal intraventricular hemorrhage (IVH) and sepsis compared with intramuscular administration (278,279).
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 50-year-old woman developed eczema on the backs of her legs, mainly in the popliteal fossae, while applying hydrocortisone aceponate cream to psoriatic lesions strictly limited to the lower back. There was no eczema on or around the site of application itself. An identical reaction occurred when betamethasone dipropionate was used to treat the psoriasis on the back. Extensive patch testing, including a corticosteroids series with dilution testing and the 2 commercial corticosteroid preparations used by the patient, revealed only negative reactions at day 2, 4 and 7. A repeated open application test with hydrocortisone aceponate cream and with hydrocortisone aceponate 0.127% elicited an annular positive reaction surrounding the site of application at D4. Some other corticosteroids were tested in a ROAT, showing a positive result to tixocortol pivalate 1% pet. on day 15 (3). This case was highly unusual in the sense that eczema only appeared at distant sites and not at the application site. Systemic contact dermatitis (localization in the popliteal fossae is suggestive) with suppression of the allergic reaction at the application site (and the patch tests) from the anti-inflammatory action of the corticosteroid is a possibility.
Oral Corticosteroids
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Pulse therapy is defined as the administration of higher (suprapharmacologic) doses of drugs in an intermittent manner so that the therapeutic effects are enhanced and the side effects are reduced. In vitiligo, OMP therapy is widely used [16,17]. OMP is usually given at doses of 2.5−7.5 mg per day dexamethasone or betamethasone, or 0.5–0.8 mg per kg body weight methylprednisolone on two consecutive days per week in patients with progressive disease until control of disease activity or maximum 6 months. OMP corticosteroids have been shown to stop the disease progression in rapidly progressing vitiligo but are less effective in inducing repigmentation. Side effects seen are also fewer as compared to conventional daily regimen. In a study in which 2.5 mg per day was given on two consecutive days per week, 91.8% of patients had control of disease progression achieved at mean duration of 13.1 weeks, and mean disease-free interval until relapse was 55 weeks [18]. In another study, oral dexamethasone minipulse with 10 mg per week on two consecutive days showed arrest of disease activity in 88% of patients, moderate to marked repigmentation in 16% of patients, and side effects in 69% of patients [19]. In another study, 5 mg betamethasone per day used for two consecutive days in a week, for a duration of 16 weeks, showed arrest of disease progression in 90% of patients and repigmentation of more than 10% of area in 65% of patients, while side effects occurred in 42% of patients [20].
Successful treatment of alopecia universalis with abrocitinib: a case report
Published in Journal of Dermatological Treatment, 2023
Compound betamethasone was injected intramuscularly once a month two times with minimal improvements. Then tofacitinib at a dose of 5 mg orally once a day for 2 months was introduced, and her hair loss continued. The patient was treated with abrocitinib (100 mg), administered orally once daily for 2 months. Regrowth of a patch of hair on the occiput was noted (Figure 2). Abrocitinib was increased to 200 mg once daily for 2 months with great improvements and then tapered to 100 mg once daily; 6 months after the initiation of abrocitinib therapy, she experienced significant improvements as regrowth of terminal hairs on her scalp (Figure 3). Meanwhile, no significant adverse effects were reported in clinical symptoms and laboratory tests. The patient then stopped taking medication and is currently undergoing follow-up. The limitation of our case was a lack of trichoscopy, histopathology, and data for long-term follow-up.
No effect of remdesivir or betamethasone on upper respiratory tract SARS-CoV-2 RNA kinetics in hospitalised COVID-19 patients: a retrospective observational study
Published in Infectious Diseases, 2022
Birger Sourander, Lars-Magnus Andersson, Magnus Brink, Aylin Yilmaz, Nicklas Sundell, Emelie Marklund, Staffan Nilsson, Magnus Lindh, Josefina Robertson, Magnus Gisslén
Remdesivir (GS-5734) is an adenosine analogue pro-drug whose active metabolite inhibits viral RNA polymerases with efficacy against Coronaviridae in vitro and in animal models [16–18]. Betamethasone is a synthetic steroid that modifies gene expression by binding to intracellular glucocorticoid receptors, altering the synthesis of pro- and anti-inflammatory proteins, resulting in anti-inflammatory and immunosuppressive effects [19]. Of seven publications studying remdesivir in the treatment of hospitalised patients with COVID-19 [7–9,11,20–22], only two reported reduced mortality [9,20]. The existing evidence for reduced mortality is more robust for corticosteroids [23–25]. Both remdesivir and corticosteroids are recommended for the treatment of patients with COVID-19 who require oxygen support, according to the Infectious Diseases Society of America (IDSA) guidelines [26] and national Swedish guidelines (https://infektion.net/wp-content/uploads/2021/12/nationellt-vardprogram-covid-version-3-4.pdf).
PLGA-based microspheres containing ropivacaine and betamethasone for sciatic nerve block in mice
Published in Pharmaceutical Development and Technology, 2022
Chunquan Wang, Jinjun Yang, Weimin Chang
The analysis of RPC levels in vitro and in vivo was carried out using RP-HPLC on a system equipped with an Agilent 1100 Series and an HS2000 interface (Agilent Technologies, Santa Clara, CA, USA) operated at 262 nm. The column was a Diamonsil C18 HPLC column (Dikma Technologies Inc, Lake Forest, CA, USA; 5 μm, 200 × 4.6 mm). The mobile phase consisted of 50% PBS and 50% acetonitrile (containing 0.1% trifluoroacetic acid), and the flow rate was 1.0 ml/min. The column temperature was 30 °C. A 100 μl volume of the plasma sample was transferred to a 5 ml plastic test tube together with 10 μl of internal standard solution (10 μg/ml). After vortex shaking for 1 min, 300 μl of acetonitrile was added for precipitation. After centrifugation at 3500 × g for 10 min, the clear supernatant was removed, and 20 μl of the sample was taken for the HPLC analysis. Betamethasone was used as an internal standard in this study.