fluocinolone


Also found in: Dictionary, Financial, Encyclopedia, Wikipedia.
Related to fluocinolone: Fluocinolone acetonide

fluocinolone

 [floo″o-sin´o-lōn]
a synthetic corticosteroid used topically as f. acetonide for the relief of inflammation and pruritus in certain dermatoses.

fluocinolone

(floo-oh-sin-oh-lone) ,

Capex

(trade name),

Derma-Smoothe/FS

(trade name),

Fluoderm

(trade name),

Synalar

(trade name)

Classification

Therapeutic: anti inflammatories steroidal
Pharmacologic: corticosteroids
Pregnancy Category: C

Indications

Management of inflammation and pruritis associated with various allergic/immunologic skin problems.

Action

Suppresses normal immune response and inflammation.

Therapeutic effects

Suppression of dermatologic inflammation and immune processes.

Pharmacokinetics

Absorption: Minimal. Prolonged use on large surface areas, application of large amounts, or use of occlusive dressings may increase systemic absorption.
Distribution: Remains primarily at site of action.
Metabolism and Excretion: Usually metabolized in skin.
Half-life: Unknown.

Time/action profile (response depends on condition being treated)

ROUTEONSETPEAKDURATION
Topicalmin–hrshrs–dayshrs–days

Contraindications/Precautions

Contraindicated in: Hypersensitivity or known intolerance to corticosteroids or components of vehicles (ointment or cream base, preservative, alcohol); Untreated bacterial or viral infections.
Use Cautiously in: Hepatic dysfunction; Diabetes mellitus, cataracts, glaucoma, or tuberculosis (use of large amounts of high-potency agents may worsen condition); Patients with pre-existing skin atrophy; Pregnancy, lactation, or children (chronic high-dose usage may result in adrenal suppression in mother, growth suppression in children; children may be more susceptible to adrenal and growth suppression).

Adverse Reactions/Side Effects

Dermatologic

  • allergic contact dermatitis
  • atrophy
  • burning
  • dryness
  • edema
  • folliculitis
  • hypersensitivity reactions
  • hypertrichosis
  • hypopigmentation
  • irritation
  • maceration
  • miliaria
  • perioral dermatitis
  • secondary infection
  • striae

Miscellaneous

  • adrenal suppression (use of occlusive dressings, long-term therapy)

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Topical (Adults) Apply to affected area(s) 2–5 times daily (depends on preparation and condition being treated).
Topical (Children ≥2 yr) Apply to affected area(s) 1–2 times daily (depends on product, preparation, and condition being treated).

Availability (generic available)

Cream: 0.01%, 0.025%
Ointment: 0.025%
Solution: 0.01%
Shampoo: 0.01%
Oil: 0.01%
In combination with: hydroquinone and tretinoin (Tri-Luma). See combination drugs.

Nursing implications

Nursing assessment

  • Assess affected skin before and daily during therapy. Note degree of inflammation and pruritus. Notify health care professional if symptoms of infection (increased pain, erythema, purulent exudate) develop.
  • Lab Test Considerations: Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal (HPA) axis suppression in chronic topical therapy if suspected. Children and patients with dose applied to a large area, using an occlusive dressing, or using high-potency products are at highest risk for HPA suppression.
    • May cause increased serum and urine glucose concentrations if significant absorption occurs.

Potential Nursing Diagnoses

Risk for impaired skin integrity (Indications)
Risk for infection (Side Effects)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Choice of vehicle depends on site and type of lesion. Ointments are more occlusive and preferred for dry, scaly lesions. Creams should be used on oozing or intertriginous areas, where the occlusive action of ointments might cause folliculitis or maceration. Creams may be preferred for aesthetic reasons even though they may be more drying to skin than ointments. Gels, aerosols, lotions, and solutions are useful in hairy areas.
  • Topical: Apply ointments, creams, orsolutions sparingly as a thin film to clean, slightly moist skin. Wash hands immediately after application. Apply occlusive dressing only if specified by health care professional.
    • Apply shampoo oroil to hair by parting hair and applying a small amount to affected area. Rub in gently. Protect area from washing, clothing, or rubbing until medication has dried. Hair may be washed as usual but not immediately after applying medication.

Patient/Family Teaching

  • Instruct patient on correct technique of medication administration. Emphasize importance of avoiding the eyes. If a dose is missed, it should be applied as soon as remembered unless almost time for the next dose.
  • Caution patient to use only as directed. Avoid using cosmetics, bandages, dressings, or other skin products over the treated area unless directed by health care professional.
  • Advise parents of pediatric patients not to apply tight-fitting diapers or plastic pants on a child treated in the diaper area; these garments work like an occlusive dressing and may cause more of the drug to be absorbed.
  • Advise patient to consult health care professional before using medicine for condition other than indicated.
  • Caution women that medication should not be used extensively, in large amounts, or for protracted periods if they are pregnant or planning to become pregnant.
  • Instruct patient to inform health care professional if symptoms of underlying disease return or worsen or if symptoms of infection develop.

Evaluation/Desired Outcomes

  • Resolution of skin inflammation, pruritus, or other dermatologic conditions.

fluocinolone

A powerful CORTICOSTEROID drug used for external applications. A brand name is Synalar. It is marketed with other ingredients as Synalar C and Synalar N.
References in periodicals archive ?
The researchers screened compounds with a chondrogenic cell line for substances that could induce chondrogenesis, and identified enhanced chondrogenesis in the presence of the steroid hormone fluocinolone acetonide (FA).
Recent studies have demonstrated that the biodegradable dexamethasone (DEX) 0.7 mg sustained-release intravitreal implant (Ozurdex; Allergan Inc., Irvine, CA, USA) and a nonabsorbable implant containing 190 [micro]g fluocinolone acetonide (Retisert; Bausch and Lomb, Rochester, NY, USA) are promising new treatment options for patients with persistent DME [28, 29].
ILUVIEN (fluocinolone acetonide intravitreal implant) 0.19 mg is a sustained release intravitreal implant approved in the U.S.
Treatment options for localized /limited LPP include intralesional triamcinolone acetonide and/or several treatments at home, including 0.05% clobetasol propionate lotion or foam, clobetasol propionate shampoo to help decrease itching and burning, fluocinolone acetonide oil one time per week to help with removal of scales, and topical 0.1% tacrolimus ointment (or compounded lotion) as needed.
Implants are either longer-acting and nonresorbable (fluocinolone acetonide implants) or shorter-acting and resorbable (dexamethasone implants).
On the other hand, adduct in LC-MS in negative mode provided the following: nucleoside: azacitidine; glucuronic acid: isovalerylglucuronide; carbohydrate acid: arabinonic acid; polysaccharides: levan; fatty acid: 2-hydroxy-6-oxo-6-(2-hydroxyphenyl)-hexa-2,4-dienoate; steroids: fluocinolone and dexamethasone phosphate; fatty acyls: 18-hydroxy-9S,10R-epoxy-stearic acid, 7-keto-stearic acid, 2,4-dimethyltetradecanoic acid, and DL-9-hydroxy stearic acid; terpenes: antirrhinoside and monotropein; heterocyclic compounds: etanidazole, 5-acetylamino-6-amino-3-methyluracil, nifuradene, 3,7-dimethyluric acid, xanthine, hypoxanthine, scopoletin, rutin, and dioclein; alkaloid: atalanine; amino acid derivatives: fructoselysine 6-phosphate.
They discuss conjunctival symblepharon therapy; the management of uveitic glaucoma; corneal procedures; cataract extraction and intraocular lens placement; various types of biopsies; therapeutic vitreoretinal surgery for non-infectious intermediate, posterior, and panuveitis; epiretinal membrane removal; fluocinolone acetonide sustained drug delivery; dexamethasone biodegradable intravitreal implants; and biopsy analysis.
This intravitreal surgical implant is designed to release corticosteroid fluocinolone acetonide in a sustained manner directly in the vitreous for about 2.5 years [58,59].
In this study, semiallogenic rat hind-limb transplantations were performed under low-dose CsA protocol (4 mg/kg/day) combined with topical steroids, fluocinolone acetonide (6mg/[cm.sup.2]/day), both started at the day of surgery and maintained during the entire follow-up period.
Medium Potency Betamethasone valerate Clocortolone pivalate Desoximetasone Fluocinolone acetonide Flurandrenolide Fluticasone propionate Fluticasone propionate Mometasone furoate Triamcinolone acetonide V.
These include fluocinolone acetonide cream (17,)f fluocinolone scalp gel, betamethasone valerate lotion (18,) clobetasol propionate ointment (19,) dexamethasone in a penetration-enhancing vehicle and halcinonide cream (20).
Most effective topical steroids are the medium potent steroids (triamcinolone), high potent steroids (fluocinolone acetonide) and superpotent halogenated steroids (clobetasol propionate).