Introduction

• Addison, examines patients with adrenal gland damage (1855)

• Cushing, symptoms of hypercorticosis due to corticosteroid
hypersecretion (1932)
Cortex
Secretion:
1. Glucocorticoid: Cortisol & Corticosteron
(Zona Fasiculata)
2. Mineralokortikoid: Aldosteron
(Zona Glomerulosa)
Mechanism Pathway
• Anti-Inflamation: Block Phospholipase-A2 Enzym
• Imunosupresif
• Ant-Alergic: block Ig-E Mastcells Degranulation ↑ Sensitivity
𝜷2-Receptor
Indication
• Subtitution Therapy
• Respiratory Distress Syndrom
• Arthritis
• Rheumatic Heart Disease
• Renal Failure
• Dermatomiositis
• Asthma
• Alergic
• Conjungtivitis
• Eczematous eruption
• Chronic Hepatitis
• Alcoholic Hepatitis
• Malignancy
• Hematologic
• Shock
• Medulla spinalis trauma
• Edema Cerebral
Corticosteroid Systemic
Prednisolon, Methylprednisolon, Dexametason

- Per Oral
- Using high doses for the first time, then within 2 weeks reduced
- Caution long-term use!!
- Side Effect:
1. Cushing Sindrom: Ostheoporosis, Moonface, Hipertrichosis,
Impotency)
2. Renal Damage
Corticosteroid Topical
• Inhalation
Beclometason (Quar), Triamsinolon, Flunisolida (Aerobid), &
Budesomida (Pulmicort), Flutikason (Aerospan), Mometason (Asmanex)
& Siklesonida (Alvesco)
- First line 𝜷2-Mimetics
- Benefit: directly to the organs
- Side Effect:
1. Local : Hoarse voice, candidiasis, Cough
2. Systemic : Thinning of the skin, cataract, glaukoma, pneumonia,
metabplic disorder (glucosa, insulin, trigliserid), psychologic
disorder (Euphoria & depression)
• Dermal
- Benefit: Anti-Inflamation & Anti-mitosis
- Can effectively cure various forms of eczema and dermatitis,
psoriasis and prurigo, bee sting
- Side Effect:
Atrofia, striae, inflamation, telengaectasia, acne, rosacea, glaukoma,
keratitis herpetica
- Contraindication: should not be used in bacterial infection, viruses,
fungi, parasites, acne and ulcers
Drug of choice
• Level 1: Hidrokortison 1%, eczema; prurigo, pruritus; dermatitis, bee
sting, alergic reaction
• Level 2: Triamsinolon 0.1 % eczema alergica/contact, eczema atopic
• Level 3: reduces mitosis ex: psoriasis, lichen, lupus discoid
• Level 4: High risk
Tingkat I. Lemah

Hidrokortison Asetat 1%

Metilprednisolon Asetat 2.5 Neo Medrol

Tingkat II. Sedang

Desoksimetason + salis 0.25% Esperson

Deksametason + klorheksidin 0.04 *Dexatopic

Hidrokortison butirat 0.1 Locoid

Flukortolon pivalat 0.25 Ultralan

flumetason pivalat 0.02 Locacorten

fluosinolon asetonida 0.025 *Synalar

flupredniden +neomisin 0.5% 0.1 *Decoderm3

klobetason butirat 0.05 Emovate

triamsinolon asetonida 0.1 Kenacort-A

Tingkat III. Kuat

Beklometason dipropionat 0.025% Cleniderm

alklometason dipropionat 0.05 Perderm, Aclosone

betametason valerat 0.1 Celestoderm-V

betametason dipropionat 0.05 Diprosone-OV

budesonida - 0.025 Preferid

diflukortolon valerat 0.1 Nerisona

fluklorolon asetonida 0.025 Topilar-N

flutikason propionat 0.05 Cutivate

halometason - 0.05 Sicorten

halsinonida - 0.1 Halog

mometason furoat 0.1 Elocon

prednikarbat - 0.25 Dermatop

Tingkat IV. Sangat Kuat
Klobetasol Propionat 0.05% Desmovate
Penggunaan pada penyakit