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- Pediatric prednisone dose for poison ivy |
- Poison ivy update
Choosing the type of steroid to use, as well as the dose to give, is very important in ensuring that your child's poison ivy goes away as quickly as possible. Common mistakes that are often made in treating poison ivy include:. Even just getting a steroid shot for poison ivy can sometimes be a mistake.
While some parents request a steroid shot because they maybe assume it will work faster or is stronger, these types of shots only last for about 24 to 48 hours. That can allow anything but a minor case of poison ivy to flare back up. The best treatments for poison ivy usually include some combination of:. Keep in mind that oral steroids and steroid shots are typically reserved for children with moderate to severe poison ivy.
These children have a poison ivy rash on several areas of their body, may have swelling of their face, or have an intensely itchy rash. Curtis G, Lewis AC. Treatment of severe poison ivy: a randomized, controlled trial of long versus short course oral prednisone. J Clin Med Res. Pork L, McGovern T. Patient education: poison ivy beyond the basics.
The average household teaspoon may not hold the right amount of liquid. If you use this medicine for a long time, do not suddenly stop using it without checking first with your doctor.
You may need to slowly decrease your dose before stopping it completely. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you miss a dose of this medicine, take it as soon as possible.
However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Recovery of HPA axis function is generally prompt and complete upon discontinuation of short-term or topical corticosteroid therapy. Cushing's syndrome and adrenal suppression may also occur after very frequent use of ophthalmic prednisolone, particularly in very young children.
Like all corticosteroids, systemic prednisolone therapy may impair immune and adrenocortical function. HPA-suppressed patients may need supplemental corticosteroid treatment during periods of physiologic stress, such as surgery, acute blood loss, or infectious conditions, even after the corticosteroid has been discontinued.
Patients should advise the attending physician of the corticosteroid they have received within the last 12 months, and the disease for which they were being treated. Identification cards which include the name of the patient's disease, the currently administered type and dose of corticosteroid, and the patient's physician should be carried with the patient at all times.
Systemic corticosteroid therapy, including prednisolone therapy, has been associated with left ventricular free-wall rupture in patients with recent myocardial infarction, and should therefore be used cautiously in these patients. As sodium retention with resultant edema and potassium loss may occur in patients receiving systemic corticosteroids, these agents should be used with caution in patients with congestive heart failure, hypertension, or renal disease or insufficiency.
Systemic corticosteroids, such as prednisolone, may decrease glucose tolerance, produce hyperglycemia, and aggravate or precipitate diabetes mellitus. Metabolic clearance of corticosteroids is decreased in hypothyroidism and increased in hyperthyroidism.
Changes in thyroid disease status of a patient may necessitate adjustment in dosage. Systemic corticosteroids should be used with caution in patients with active or latent peptic ulcer disease, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, since steroids may increase the risk of a gastrointestinal GI perforation.
Signs of peritoneal irritation following GI perforation in patients receiving corticosteroids may be minimal or absent.
Corticosteroids should not be used in patients where there is a possibility of impending GI perforation, abscess, or pyogenic infection. There is an enhanced effect due to decreased metabolism of corticosteroids in patients with severe hepatic disease with cirrhosis; however, prednisolone is preferred to prednisone in significant hepatic disease because prednisolone does not require hepatic activation.
An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with neuromuscular disease disorders e. This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis. Elevation of creatinine kinase may occur. Clinical improvement or recovery after stopping corticosteroids may require weeks to years. Use prednisolone with caution in patients with glaucoma; corticosteroids can elevate intraocular pressure with possible damage to the optic nerves.
If systemic corticosteroid therapy is continued for more than 6 weeks, intraocular pressure should be monitored. Use of corticosteroids may produce posterior subcapsular cataracts and may enhance the establishment of secondary ocular infection due to bacteria, fungi or viruses.
The use of oral corticosteroids is not recommended in the treatment of optic neuritis and may lead to an increase in the risk of new episodes. Corticosteroids should not be used in active ocular herpes simplex because of possible corneal perforation. Ophthalmic prednisolone should be used with caution in patients with corneal abrasion and the use of prednisolone ophthalmic products is always contraindicated after uncomplicated removal of a superficial corneal foreign body. Prednisolone can cause increased intraocular pressure; monitor intraocular pressure IOP in patients receiving ophthalmic products every 2 to 4 weeks for the first 2 months and every 1 to 2 months after that.
Patients with a history of glaucoma, diabetes, or Krukenberg's spindle may be at increased risk of developing ocular hypertension during ocular therapy.
Bacterial keratitis has been reported in patients who have received ophthalmic preparations that were dispensed in multidose containers. This reaction most likely is due to contamination of the solution, so patients should be instructed not to allow the tip of the applicator to touch the eye or any other surfaces.
Existing emotional instability or psychosis may be aggravated by corticosteroids. Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychosis. Use prednisolone with caution in patients with a seizure disorder; systemic steroids can lower the seizure threshold.
Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation i. This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism, and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteopenia or osteoporosis at any age. Growth and development of pediatric patients on prolonged corticosteroid therapy should be carefully observed.
Special consideration should be given to patients at increased risk of osteoporosis e. Consider interventions to reduce bone loss or treat glucocorticoid-induced osteoporosis in affected patients. To minimize the risk of glucocortoicoid-induced bone loss, the smallest possible effective dosage and duration should be used. Current recommendations suggest that all interventions be initiated in any patient in whom glucocorticoid therapy at 5 mg of prednisone or equivalent for at least 3 months is anticipated.
Prednisolone has been used in infants, children, and adolescents; however, consider pediatric-specific issues before initiating treatment. Safety and efficacy have not been established for the use of corticosteroids in neonates. Adverse effects in newborns have included complications of treatment such as gastrointestinal bleeding, intestinal perforation, hyperglycemia, and hypertension.
The potential for growth inhibition in any pediatric patient should be monitored during prolonged therapy, and the potential for growth effects should be weighed against the clinical benefit obtained and the availability of other treatment alternatives. Administration of corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen. Further, children receiving corticosteroids are immunosuppressed, and are therefore more susceptible to infection.
Normally innocuous infections can become fatal in these children, and care should be taken to avoid exposure to these diseases. Published studies provide evidence of efficacy and safety in pediatric patients for the treatment of nephrotic syndrome pediatric patients more than 2 years of age , and aggressive lymphomas and leukemias patients greater than 1 month of age. Other indications for pediatric use of corticosteroids e. Indicated vaccination procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids as replacement therapy e.
Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered. However, the response to such vaccines may be diminished and cannot be predicted. In patients who have received high-dose, systemic corticosteroids for 2 weeks or longer, it is recommended to wait at least 3 months after discontinuation of therapy before administering a live-virus vaccine.
Prednisolone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Based on findings from human and animal studies, corticosteroids can cause fetal harm when administered to a pregnant woman. Published epidemiological studies suggest a small but inconsistent increased risk of orofacial clefts with the systemic use of corticosteroids during the first trimester.
Intrauterine growth restriction and decreased birth weight have also been reported with maternal use of corticosteroids during pregnancy; however, the underlying maternal condition may also contribute to these risks. Published animal studies show prednisolone to be teratogenic in rats, rabbits, hamsters, and mice with an increased incidence of cleft palate in offspring. Advise a pregnant woman about the reproductive risk and the potential harm to a fetus. Neonates born to pregnant women who have received corticosteroids should be carefully monitored for signs and symptoms of hypoadrenalism, and appropriate therapy should be initiated, if necessary.
Ophthalmic prednisolone and other ocular corticosteroids were applied to both eyes of pregnant mice 5 times per day on days 10 through 13 of gestation ; a significant increase in the incidence of cleft palate was observed in the fetuses of the treated mice. Systemic corticosteroids distribute into breast milk, and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects in nursing infants; some manufacturers of prednisolone advise a decision be made to discontinue the drug or to discontinue nursing.
However, in clinical use, systemic use of prednisone and prednisolone is usually considered compatible with breast-feeding. It is not known whether topical ophthalmic administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in breast milk. At higher daily prednisolone doses, avoidance of breast-feeding during times of peak milk concentrations can help limit infant exposure.
Due to lowered systemic absorption, ophthalmic use of prednisolone poses little concern to the nursing infant and is considered compatible with breast-feeding. There are published case reports of systemic prednisolone use during pregnancy that indicate little risk to a nursing infant due to a lack of reported side effects. Peak concentrations in human milk appear in about 1 hour after a dose, and the total daily dose reaching the infant is approximately 0.
Prednisone and methylprednisolone have similar data available regarding systemic use during lactation. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.
Use systemic corticosteroids with caution in the geriatric patient; the risks and benefits of therapy should be considered for any individual patient. According to the Beers Criteria, systemic corticosteroids are considered potentially inappropriate medications PIMs for use in geriatric patients with delirium or at high risk for delirium and should be avoided in these patient populations due to the possibility of new-onset delirium or exacerbation of the current condition.
The Beers expert panel notes that oral and parenteral corticosteroids may be required for conditions such as exacerbation of chronic obstructive pulmonary disease COPD but should be prescribed in the lowest effective dose and for the shortest possible duration. According to the OBRA guidelines, the need for continued use of a glucocorticoid, with the exception of topical, ophthalmic, or inhaled formulations, should be documented, along with monitoring for and management of adverse consequences.
Intermediate or longer-term use may cause hyperglycemia, psychosis, edema, insomnia, hypertension, osteoporosis, mood lability, or depression. Instruct patients to avoid wearing soft contact lenses prior to the application of prednisolone acetate ophthalmic suspensions.
The suspensions contain benzalkonium chloride, which may be absorbed by soft contact lenses; the lenses may be reinserted 15 minutes following its administration. Prednisolone acetate ophthalmic suspensions also contain sodium bisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite hypersensitivity in the general population is unknown and probably low.
Sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people. Abatacept: Moderate Concomitant use of immunosuppressives, as well as long-term corticosteroids, may potentially increase the risk of serious infection in abatacept treated patients.
Advise patients taking abatacept to seek immediate medical advice if they develop signs and symptoms suggestive of infection. Acetaminophen; Aspirin, ASA; Caffeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Concomitant use increases the risk of GI bleeding. In patients receiving concomitant corticosteroids and chronic use of salicylates, withdrawal of corticosteroids may result in salicylism because corticosteroids enhance renal clearance of salicylates and their withdrawal is followed by return to normal rates of renal clearance. Acetaminophen; Aspirin: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Acetaminophen; Aspirin; Diphenhydramine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Monitor patients for increased pressor effect if these agents are administered concomitantly. Acetaminophen; Chlorpheniramine; Phenylephrine : Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Acetaminophen; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Acetaminophen; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Acetazolamide: Moderate Corticosteroids may increase the risk of hypokalemia if used concurrently with acetazolamide.
Hypokalemia may be especially severe with prolonged use of corticotropin, ACTH. Acetohexamide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Corticosteroids may increase blood glucose concentrations. Risk factors for impaired glucose tolerance due to corticosteroids include the corticosteroid dose and duration of treatment. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance.
Decreased insulin production may occur in the pancreas due to a direct effect on pancreatic beta cells. Adalimumab: Moderate Closely monitor for the development of signs and symptoms of infection if coadministration of a corticosteroid with adalimumab is necessary. Adalimumab treatment increases the risk for serious infections that may lead to hospitalization or death.
Patients taking concomitant immunosuppressants including corticosteroids may be at greater risk of infection. Albiglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Alemtuzumab: Moderate Concomitant use of alemtuzumab with immunosuppressant doses of corticosteroids may increase the risk of immunosuppression.
Monitor patients carefully for signs and symptoms of infection. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Both corticosteroids and thiazide diuretics cause increased renal potassium loss.
Aliskiren; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Alogliptin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Alpha-glucosidase Inhibitors: Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued.
Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. The main risk factors for impaired glucose tolerance due to corticosteroids are the dose of steroid and duration of treatment.
Altretamine: Minor Concurrent use of altretamine with other agents which cause bone marrow or immune suppression such as corticosteroids may result in additive effects. Ambenonium Chloride: Moderate Concomitant use of anticholinesterase agents, such as ambenonium chloride, and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents used to treat myasthenia should be withdrawn at least 24 hours before initiating corticosteroid therapy.
Amifampridine: Moderate Carefully consider the need for concomitant treatment with systemic corticosteroids and amifampridine, as coadministration may increase the risk of seizures. If coadministration occurs, closely monitor patients for seizure activity. Seizures have been observed in patients without a history of seizures taking amifampridine at recommended doses. Systemic corticosteroids may increase the risk of seizures in some patients.
Amiloride; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Aminolevulinic Acid: Minor Corticosteroids administered prior to or concomitantly with photosensitizing agents used in photodynamic therapy may decrease the efficacy of the treatment.
Aminosalicylate sodium, Aminosalicylic acid: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Amphotericin B cholesteryl sulfate complex ABCD : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B. Serum potassium levels should be monitored in patients receiving these drugs concomitantly. Amphotericin B lipid complex ABLC : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B.
Amphotericin B liposomal LAmB : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B. Amphotericin B: Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B.
Aprepitant, Fosaprepitant: Moderate Use caution if prednisolone and aprepitant, fosaprepitant are used concurrently and monitor for an increase in prednisolone-related adverse effects for several days after administration of a multi-day aprepitant regimen. Prednisolone is a CYP3A4 substrate. As a single mg or 40 mg oral dose, the inhibitory effect of aprepitant on CYP3A4 is weak, with the AUC of midazolam increased by 1.
After administration, fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. However, as a single mg intravenous dose, fosaprepitant only weakly inhibits CYP3A4 for a duration of 2 days; there is no evidence of CYP3A4 induction.
Fosaprepitant mg IV as a single dose increased the AUC of midazolam given on days 1 and 4 by approximately 1. Less than a 2-fold increase in the midazolam AUC is not considered clinically important. Arsenic Trioxide: Moderate Caution is advisable during concurrent use of arsenic trioxide and corticosteroids as electrolyte imbalance caused by corticosteroids may increase the risk of QT prolongation with arsenic trioxide. Articaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Corticosteroids may potentiate the hypokalemic effects of epinephrine. Asparaginase Erwinia chrysanthemi: Moderate Concomitant use of L-asparaginase with corticosteroids can result in additive hyperglycemia.
L-Asparaginase transiently inhibits insulin production contributing to hyperglycemia seen during concurrent corticosteroid therapy. Insulin therapy may be required in some cases. Administration of L-asparaginase after rather than before corticosteroids reportedly has produced fewer hypersensitivity reactions. Aspirin, ASA: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Monitor for decreased response to prednisolone during concurrent use.
Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Caffeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Caffeine; Dihydrocodeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Caffeine; Orphenadrine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Carisoprodol: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Carisoprodol; Codeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Dipyridamole: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Omeprazole: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Oxycodone: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Pravastatin: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Atenolol; Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Atracurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy. An acute myopathy has been observed with the use of high doses of corticosteroids in patients receiving concomitant long-term therapy with neuromuscular blockers.
Clinical improvement or recovery after stopping therapy may require weeks to years. Azilsartan; Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Belladonna Alkaloids; Ergotamine; Phenobarbital: Moderate Coadministration may result in decreased exposure to prednisolone. Benazepril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Bendroflumethiazide; Nadolol: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Bismuth Subsalicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Bismuth Subsalicylate; Metronidazole; Tetracycline: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Bisoprolol; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Boceprevir: Major Close clinical monitoring is advised when administering prednisolone with boceprevir due to an increased potential for corticosteroid-related adverse events.
If prednisolone dose adjustments are made, re-adjust the dose upon completion of boceprevir treatment. Although this interaction has not been studied, predictions about the interaction can be made based on the metabolic pathway of prednisolone. Prednisolone is metabolized by the hepatic isoenzyme CYP3A4; boceprevir inhibits this isoenzyme. Coadministration may result in elevated prednisolone plasma concentrations.
Brompheniramine; Carbetapentane; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Brompheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Brompheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Bupivacaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary. Bupropion: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use.
Bupropion is associated with a dose-related seizure risk; concomitant use of other medications that lower the seizure threshold, such as systemic corticosteroids, increases the seizure risk. Bupropion; Naltrexone: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use. Butabarbital: Moderate Coadministration may result in decreased exposure to prednisolone. Butalbital; Acetaminophen: Moderate Coadministration may result in decreased exposure to prednisolone.
Butalbital; Acetaminophen; Caffeine: Moderate Coadministration may result in decreased exposure to prednisolone. Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Coadministration may result in decreased exposure to prednisolone. Caffeine; Sodium Benzoate: Moderate Corticosteroids may cause protein breakdown, which could lead to elevated blood ammonia concentrations, especially in patients with an impaired ability to form urea.
Corticosteroids should be used with caution in patients receiving treatment for hyperammonemia. Canagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Candesartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Captopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Carbamazepine: Moderate Hepatic microsomal enzyme inducers, including carbamazepine, can increase the metabolism of prednisolone. Carbetapentane; Chlorpheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbetapentane; Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbetapentane; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbetapentane; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbetapentane; Phenylephrine; Pyrilamine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbinoxamine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbinoxamine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Ceritinib: Minor Monitor for steroid-related adverse reactions if coadministration of ceritinib with prednisolone is necessary, due to increased prednisolone exposure.
Certolizumab pegol: Moderate The safety and efficacy of certolizumab in patients with immunosuppression have not been evaluated.
Patients receiving immunosuppressives along with certolizumab may be at a greater risk of developing an infection. Many of the serious infections occurred in patients on immunosuppressive therapy who received certolizumab. Chlophedianol; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorothiazide: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorpheniramine; Dihydrocodeine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorpheniramine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Chlorpheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorpropamide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Chlorthalidone; Clonidine: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Choline Salicylate; Magnesium Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Cisatracurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy.
Codeine; Phenylephrine; Promethazine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Dapagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Monitor patients for corticosteroid-related side effects if prednisone or prednisolone and ritonavir are taken. Close clinical monitoring is advised with concurrent use; in the presence of serious infections, continuation of the corticosteroid or immunosuppressive agent may be necessary but should be accompanied by appropriate antimicrobial therapies as indicated.
Deferasirox: Moderate Because gastric ulceration and GI bleeding have been reported in patients taking deferasirox, use caution when coadministering with other drugs known to increase the risk of peptic ulcers or gastric hemorrhage including corticosteroids.
Denosumab: Moderate The safety and efficacy of denosumab use in patients with immunosuppression have not been evaluated. Patients receiving immunosuppressives along with denosumab may be at a greater risk of developing an infection. Desmopressin: Major Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia.
Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Dextromethorphan; Bupropion: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use. Dextromethorphan; Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Dextromethorphan; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Digoxin: Moderate Hypokalemia, hypomagnesemia, or hypercalcemia increase digoxin's effect. Corticosteroids can precipitate digoxin toxicity via their effect on electrolyte balance.
It is recommended that serum potassium, magnesium, and calcium be monitored regularly in patients receiving digoxin. Dipeptidyl Peptidase-4 Inhibitors: Moderate Monitor blood glucose during concomitant corticosteroid and dipeptidyl peptidase-4 DPP-4 inhibitor use; a DPP-4 dose adjustment may be necessary. Diphenhydramine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Dofetilide: Major Corticosteroids can cause increases in blood pressure, sodium and water retention, and hypokalemia, predisposing patients to interactions with certain other medications.
Corticosteroid-induced hypokalemia could also enhance the proarrhythmic effects of dofetilide. Doxacurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy. Prednisolone is a substrate for CYP3A4. The concomitant administration of dronedarone and CYP3A substrates may result in increased exposure of the substrate and should, therefore, be undertaken with caution.
❿Pediatric prednisone dose for poison ivy.Poison Ivy
Pediatric prednisone dose for poison ivy. The Best Treatments for Poison Ivy
Keep in mind that oral steroids and steroid shots are typically reserved for children with moderate to severe poison ivy. These children have a poison ivy rash on several areas of their body, may have swelling of their face, or have an intensely itchy rash. Curtis G, Lewis AC. Treatment of severe poison ivy: a randomized, controlled trial of long versus short course oral prednisone.
J Clin Med Res. Pork L, McGovern T. Patient education: poison ivy beyond the basics. Froberg B. Plant poisoning. Emerg Med Clin North Am; 25 2 : Iannelli has cared for children for more than 20 years. Skin Health. More Skin Conditions. Many rashes are the result not of direct contact with a plant but of transfer of urushiol from the hand to another part of the body.
For example, someone who has touched poison ivy wipes a sweaty brow, and later the forehead is bumpy and itchy. Urushiol trapped under the fingernails will land on skin idly scratched, so it is important to scrub under the nails after touching poison ivy. Because urushiol is an oil, it penetrates the skin easily. Animals can carry the oil on their fur and leave it on furniture or on the skin of an affectionate human companion.
An unsuspecting athlete might end up with dermatitis after retrieving a ball that rolled into a poison ivy patch weeks earlier. Someone who gathers clothes for the laundry could break out after picking up urushiol-soaked attire. The allergic reaction may begin as early as six hours after exposure, with a linear group of itchy, red spots at the point of contact with urushiol. More typically, the onset of symptoms is 24 to 72 hours after exposure.
Pruritus and erythema are accompanied by edema, and urticarial plaques and bullae may develop Figure 1. Linear vesicles or papulovesicles strongly suggest that a rash is caused by poison ivy. Several days or even as long as two weeks after the initial eruption, the rash may appear on other areas of the body. This has led to the mistaken notion that poison ivy dermatitis is spread by the blister fluid.
Actually, there are two reasons why the outbreak may occur in stages. First, the skin that erupts at a later time may have been exposed to less urushiol. The more likely explanation, however, is believed to be a difference in the rate of absorption and differences in skin reactivity at various anatomic sites.
The thin skin around the eyes will absorb urushiol much faster than the thicker skin on the arms. Although the hands probably make contact with these noxious plants more often than any other part of the body, rashes are uncommon on the hands because the skin is much thicker.
While not likely to break out itself, the hand often is the transfer agent for urushiol. Many times, a rash that develops on the face or arm may resemble a handprint, and linear lesions may trace the marks of scratching fingers.
Severe edema on the delicate skin of the face and genitalia may be the only symptom of an encounter with a poisonous plant. The genital and perianal areas usually become affected when someone defecates in the woods and either accidentally brushes against poison ivy or selects a urushiol-tainted leaf as toilet paper.
In addition, poison ivy dermatitis has been acquired in intimate moments of skin contact by people whose sexual partners failed to wash off urushiol.
Before gathering around the fireplace or campfire, people should inspect the logs for clinging vines, brown rootlets, and black spots of urushiol. Smoke from burning plants that carries particles of the sap can cause a diffuse dermatitis.
If inhaled, urushiol may cause bronchitis or pneumonitis. Nearly one third of forestry workers and firefighters in the Pacific Northwest develop rashes or lung irritations from contact with poison oak. The diagnosis of poison ivy dermatitis is usually obvious, and the source generally can be determined even in atypical presentations.
However, you may have to put on your Sherlock Holmes cap to get to the source of the problem if a patient keeps returning with dermatitis or if the lesions fail to heal in a few weeks. Recurrent or persistent dermatitis indicates repeated contamination with urushiol.
The patient may be coming in contact with fomites such as pets, clothing, or tools. Washing every possible source of contamination should eliminate the problem. The contact dermatitis from poison ivy is a self-limiting condition. Without any treatment, a mild case will often resolve in about two weeks. But the discomfort is too much for most of the afflicted to ignore. The treatments discussed here do not cure the condition; they simply ease the suffering.
Patients will find relief by using cool compresses with astringents like aluminum acetate solution or soaks with colloidal oatmeal. Calamine lotion is soothing, but products that contain a topical antihistamine, such as diphenhydramine, should be used only with the understanding that sensitization can occur.
Fortunately, sensitization is uncommon. For children with mild reactions to poison ivy, simple compresses, soaks, and lotions will probably be adequate, and the lesions will then heal spontaneously. Many experts feel that oral corticosteroid therapy is not the best way to approach the routine treatment of a limited condition like poison ivy. Corticosteroids should be reserved for more serious cases, especially those in which the rash is severe and accompanied by swelling.
For some patients, the discomfort may be so distressing that a short course of corticosteroids would be beneficial. In any case, oral systemic corticosteroids can be quickly tapered and discontinued; dosages should be kept relatively small and tailored to the individual patient.
Injected corticosteroids are warranted in the unusual cases in which urushiol has been inhaled or swallowed. An injection of fast-acting corticosteroids will quickly stop the reaction. Patients in extreme discomfort also may experience quicker relief from injection of medications such as betamethasone sodium phosphate. The earlier the injection is given, the better the relief from symptoms. Topical corticosteroids such as clobetasol propionate have some usefulness; they may be helpful in treating acute lesions that are not blistering.
The full-blown reaction may be avoided if the earliest itchy, red lesions are treated with a potent topical corticosteroid such as mometasone furoate Elocon Cream 0. However, patients rarely come for treatment so quickly. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. There is a problem with information submitted for this request. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID, plus expertise on managing health.
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Recognizing each plant in various stages of growth and during the different seasons will help you avoid the plant and its potential rash. The image on the right is one example. Treatment is focused on relieving the itch and halting the spread of the rash. Here are a few tips to help you:. One more thing: the rash is not contagious in spite of the blisters or oozing from the rash. Again, the key to prevention of poison ivy is to recognize the plant and avoid it.
So here, once more, is a link to a Wikipedia page with excellent information and many photos. Godinez, a Kids Plus Doc sincespends a lot of time outdoors, so his expertise on this subject is both personal and professional.
Kids Plus Pediatrics. Search for: Search. Poison Ivy is part of a group of plants that causes plant dermatitis — in other words, a hypersensitive reaction of the skin to a toxin from a plant.
Poison Ivy, Poison Sumac, and Poison oak are all part of this group and any part of the plant can leave the toxin on the skin roots, stem, trunk, leaves. Here are a few tips to help you: Avoid scratching to prevent a secondary bacterial infection Apply a cool compress for 12 minutes to reduce inflammation, itchiness, and oozing Antihistamines are the anti-itch medicines.
Over the counter OTC products like Benadryl oral or topical formCalamine topical and Ivy Dry will temporarily relieve the itch as needed. Follow the directions listed on the product label Topical steroids will reduce itchiness and inflammation. You can keep the cream in the refrigerator to keep it cool — cool will calm the itch better. When the rash is extensive or involves the face especially near the eyes and the groin areas then a tapering course of an oral steroid will help.
Follow the directions for the steroid carefully and complete the entire course to avoid a rebound effect. Expect the rash to last up to 2 weeks. Sensitivity and intensity depend on the person.
Adult maximum daily dose: 60 mg/day. Pediatric patients with Bell palsy may experience spontaneous recovery, even without treatment; potential benefit of. This randomized, controlled trial examined the efficacy and side effects of a 5-day regimen of 40 mg oral prednisone daily (short course). Adult maximum daily dose: 60 mg/day. Pediatric patients with Bell palsy may experience spontaneous recovery, even without treatment; potential benefit of. Children—Dose is based on body weight and must be determined by your doctor. The dose is usually to 2 mg per kilogram (kg) of body weight. Topical steroids will reduce itchiness and inflammation. OTC 1% hydrocortisone cream applied in a thin layer over the rash up to 4 times per day can help. You. Concurrent administration of immunosuppressives with the leukapheresis procedure that occurs prior to sipuleucel-T infusion has not been studied. For the treatment of corticosteroid-responsive respiratory disorders including aspiration or hypersensitivity pneumonitis, berylliosis, Loeffler's syndrome, idiopathic eosinophilic pneumonia, or idiopathic pulmonary fibrosis.What can you do to help patients prevent the problem and to ease their discomfort when they do fall prey? In addition to relieving the discomfort, you can help patients and their parents learn how to recognize the plants and protect themselves so they can enjoy the outdoors without paying for the consequences.
Poison ivy, oak, and sumac are all members of the family Anacardiaceae, genus Toxicodendron. These related plants look different, although they share some general features see Table 1. And poison oak indigenous to the East Coast is very different from poison oak out West. Therefore, unless a specific plant is intended, this article uses the shorthand "poison ivy" to refer to poison ivy, oak, and sumac. Although not all the children exposed to these plants will break out in a rash, many have the capacity to develop a sensitivity.
The discrepancy lies in the opportunity for exposure and concentration of the allergen. Children who are immunodeficient, such as those with leukemia or AIDS, may actually be less susceptible because allergic contact dermatitis is a cell-mediated immune reaction. The prevalence of poison ivy dermatitis also seems to be reduced in those who have asthma, hay fever, and other types of allergies. This may be because they have diminished immune function or because they are less likely to engage in outdoor activities that expose them to the plants.
The "poison" in these plants is the chemical urushiol, which is found in the sap. An intact plant is not capable of triggering an allergic reaction. Pulling weeds or cutting the plant when mowing can release toxic material. A gust of wind may be enough to crack a leaf and allow the sap to leak. The brush of a hiker's leg, a child's lost ball, or a gardener's tool can break a stem and allow urushiol to seep out.
When exposed to air, the yellowish- to-clear urushiol will turn black. Black spots on a plant are a good indication that it is poison ivy or one of its cousins. These are seen where there is trail damage or where insects damage a leaf.
Sensitive persons should avoid touching any plant with black spots, whether or not it looks like the poison ivy, oak, or sumac common in your area. Urushiol is a haptene and rapidly penetrates the skin to combine with skin proteins. A person who is aware of making contact with poison ivy may be able to prevent an eruption by taking quick action soon after contact. The impact of urushiol can be lessened by washing with plain water.
Adding soap or using an organic solvent or oxidizing agent, such as hydrogen peroxide, is even better. Many rashes are the result not of direct contact with a plant but of transfer of urushiol from the hand to another part of the body.
For example, someone who has touched poison ivy wipes a sweaty brow, and later the forehead is bumpy and itchy. Urushiol trapped under the fingernails will land on skin idly scratched, so it is important to scrub under the nails after touching poison ivy.
Because urushiol is an oil, it penetrates the skin easily. Animals can carry the oil on their fur and leave it on furniture or on the skin of an affectionate human companion.
An unsuspecting athlete might end up with dermatitis after retrieving a ball that rolled into a poison ivy patch weeks earlier. Someone who gathers clothes for the laundry could break out after picking up urushiol-soaked attire.
The allergic reaction may begin as early as six hours after exposure, with a linear group of itchy, red spots at the point of contact with urushiol. More typically, the onset of symptoms is 24 to 72 hours after exposure. Pruritus and erythema are accompanied by edema, and urticarial plaques and bullae may develop Figure 1. Linear vesicles or papulovesicles strongly suggest that a rash is caused by poison ivy. Several days or even as long as two weeks after the initial eruption, the rash may appear on other areas of the body.
This has led to the mistaken notion that poison ivy dermatitis is spread by the blister fluid. Actually, there are two reasons why the outbreak may occur in stages. First, the skin that erupts at a later time may have been exposed to less urushiol. The more likely explanation, however, is believed to be a difference in the rate of absorption and differences in skin reactivity at various anatomic sites.
The thin skin around the eyes will absorb urushiol much faster than the thicker skin on the arms. Although the hands probably make contact with these noxious plants more often than any other part of the body, rashes are uncommon on the hands because the skin is much thicker. While not likely to break out itself, the hand often is the transfer agent for urushiol. Many times, a rash that develops on the face or arm may resemble a handprint, and linear lesions may trace the marks of scratching fingers.
Severe edema on the delicate skin of the face and genitalia may be the only symptom of an encounter with a poisonous plant.
The genital and perianal areas usually become affected when someone defecates in the woods and either accidentally brushes against poison ivy or selects a urushiol-tainted leaf as toilet paper. In addition, poison ivy dermatitis has been acquired in intimate moments of skin contact by people whose sexual partners failed to wash off urushiol.
Before gathering around the fireplace or campfire, people should inspect the logs for clinging vines, brown rootlets, and black spots of urushiol. Smoke from burning plants that carries particles of the sap can cause a diffuse dermatitis. If inhaled, urushiol may cause bronchitis or pneumonitis. Nearly one third of forestry workers and firefighters in the Pacific Northwest develop rashes or lung irritations from contact with poison oak.
The diagnosis of poison ivy dermatitis is usually obvious, and the source generally can be determined even in atypical presentations. However, you may have to put on your Sherlock Holmes cap to get to the source of the problem if a patient keeps returning with dermatitis or if the lesions fail to heal in a few weeks. Recurrent or persistent dermatitis indicates repeated contamination with urushiol.
The patient may be coming in contact with fomites such as pets, clothing, or tools. Washing every possible source of contamination should eliminate the problem. The contact dermatitis from poison ivy is a self-limiting condition. Without any treatment, a mild case will often resolve in about two weeks. But the discomfort is too much for most of the afflicted to ignore.
The treatments discussed here do not cure the condition; they simply ease the suffering. Patients will find relief by using cool compresses with astringents like aluminum acetate solution or soaks with colloidal oatmeal.
Calamine lotion is soothing, but products that contain a topical antihistamine, such as diphenhydramine, should be used only with the understanding that sensitization can occur. Fortunately, sensitization is uncommon. For children with mild reactions to poison ivy, simple compresses, soaks, and lotions will probably be adequate, and the lesions will then heal spontaneously.
Many experts feel that oral corticosteroid therapy is not the best way to approach the routine treatment of a limited condition like poison ivy.
Corticosteroids should be reserved for more serious cases, especially those in which the rash is severe and accompanied by swelling. For some patients, the discomfort may be so distressing that a short course of corticosteroids would be beneficial. In any case, oral systemic corticosteroids can be quickly tapered and discontinued; dosages should be kept relatively small and tailored to the individual patient. Injected corticosteroids are warranted in the unusual cases in which urushiol has been inhaled or swallowed.
An injection of fast-acting corticosteroids will quickly stop the reaction. Patients in extreme discomfort also may experience quicker relief from injection of medications such as betamethasone sodium phosphate. The earlier the injection is given, the better the relief from symptoms.
Topical corticosteroids such as clobetasol propionate have some usefulness; they may be helpful in treating acute lesions that are not blistering. The full-blown reaction may be avoided if the earliest itchy, red lesions are treated with a potent topical corticosteroid such as mometasone furoate Elocon Cream 0.
However, patients rarely come for treatment so quickly. By the time you see most of those afflicted, they already have blisters, and at this point topical corticosteroids will do little good.
The corticosteroids in OTC preparations are too weak to be effective. In rare cases when systemic corticosteroid therapy is contraindicated and the dermatitis is confined to a limited area, topical treatment may be an option.
A midpotency corticosteroid can be used with an occlusive dressing applied for 24 hours. The treatment is repeated the next day. The occlusive dressing increases the efficacy of the drug.
The principal reason to use antihistamines to treat a poison ivy reaction is that the patient is too miserable to sleep as a result of intense itching. In that case, the sedating effect of antihistamines may be desired. Nonsedating antihistamines probably have no role in the treatment of poison ivy dermatitis. Over the centuries, many herbal treatments and folk remedies have been touted for poison ivy. Such natural therapies are bound to appeal to some parents who are outdoor enthusiasts.
Among the purported herbal treatments for poison ivy are plantain, feverfew, and jewelweed. Despite anecdotal reports that these plants ease discomfort, there is no scientific evidence using humans subjects to support the use of any herbal remedies. However, they may have a soothing effect similar to that of the compresses that have long been recommended by physicians for patients suffering from an itchy rash.
Poison ivy is one condition for which the best treatment is prevention. Everyone should learn to recognize the varieties of poison ivy, poison oak, and poison sumac that grow in the areas where they live or play. This is not as easy as it sounds.
The plants take many forms, and no single textbook, no matter how thorough, will picture every possible culprit. Quaternium bentonite is available to prevent poison ivy dermatitis. The active ingredient is an organoclay that has been used for years in cosmetics and has a good safety record. A multicenter trial demonstrated that quaternium bentonite lotion prevented or diminished poison ivy and poison oak dermatitis in susceptible volunteers.
Stoko Gard Outdoor Cream, another product that forms a barrier on the skin and may help to prevent poison ivy dermatitis, is available from industrial suppliers. Although people who know they are about to enter an area thick with poison ivy might arm themselves with a barrier lotion, most contacts with the plants are not anticipated. Therefore, other precautions become necessary.
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