\u010casto kladen\u00e9 dotazy<\/a><\/li>\n<\/ul>\n<\/div>\nCo je Tenovate Clobetasol kr\u00e9m?<\/h2>\n
Tenovate je indick\u00e1 zna\u010dka spole\u010dnosti GSK pro klobetasol propion\u00e1t 0,05 % w\/w<\/strong> jako kr\u00e9m k m\u00edstn\u00edmu pou\u017eit\u00ed dod\u00e1van\u00fd v 30g hlin\u00edkov\u00e9 tub\u011b. Klobetasol-propion\u00e1t je nej\u00fa\u010dinn\u011bj\u0161\u00ed molekula kortikosteroid\u016f b\u011b\u017en\u011b dostupn\u00e1 pro topick\u00e9 dermatologick\u00e9 pou\u017eit\u00ed \u2014 klasifikovan\u00e1 jako \u201cvelmi siln\u00fd\u201d (t\u0159\u00edda IV ve Velk\u00e9 Brit\u00e1nii a Evrop\u011b, t\u0159\u00edda I v USA)<\/strong>. Mezin\u00e1rodn\u011b identick\u00e9 p\u0159\u00edpravky jsou prod\u00e1v\u00e1ny jako Dermovate (UK\/EU), Temovate (US), Clobex (US \u0161ampon) a Olux (US p\u011bna).<\/p>\nTenovate je na MedsBase dod\u00e1v\u00e1n v balen\u00ed po 1, 2, 3 nebo 6 tub\u00e1ch (po 30 g)<\/strong>.<\/p>\nJeho m\u00edsto v \u017eeb\u0159\u00ed\u010dku \u00fa\u010dinnosti topick\u00fdch steroid\u016f<\/h2>\n
Topick\u00e9 kortikosteroidy jsou klasifikov\u00e1ny podle s\u00edly. Klobetasol je na vrcholu ka\u017ed\u00e9 stupnice \u00fa\u010dinnosti \u2014 p\u0159ibli\u017en\u011b 600kr\u00e1t siln\u011bj\u0161\u00ed ne\u017e 1% hydrokortizon<\/strong>:<\/p>\n\n\n\n| Britsk\u00e1 t\u0159\u00edda<\/th>\n | Americk\u00e1 t\u0159\u00edda<\/th>\n | Potence<\/th>\n | P\u0159\u00edklady<\/th>\n<\/tr>\n<\/thead>\n |
\n\n| I (m\u00edrn\u00fd)<\/td>\n | VII<\/td>\n | M\u00edrn\u00fd<\/td>\n | Hydrokortizon 0,5\u20131 %<\/td>\n<\/tr>\n |
\n| II<\/td>\n | VI\u2013V<\/td>\n | St\u0159edn\u00ed<\/td>\n | Klobetason butyr\u00e1t (Eumovate), betamethason valer\u00e1t 0,025 %<\/td>\n<\/tr>\n |
\n| III<\/td>\n | III\u2013II<\/td>\n | Siln\u00fd<\/td>\n | Betamethason valer\u00e1t 0,1 %, mometason furo\u00e1t 0,1 %, flutikason propion\u00e1t 0,05 %<\/td>\n<\/tr>\n |
\nIV<\/strong><\/td>\nI<\/strong><\/td>\nVelmi siln\u00fd<\/strong><\/td>\n| Klobetasol propion\u00e1t 0,05 % (Tenovate, Dermovate, Temovate)<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n Tato s\u00edla je d\u016fvodem, pro\u010d je klobetasol \u00fa\u010dinn\u00fd u dermat\u00f3z, kter\u00e9 nereagovaly na m\u00e9n\u011b siln\u00e9 steroidy \u2013 a z\u00e1rove\u0148 pro\u010d je nebezpe\u010dn\u00fd p\u0159i nespr\u00e1vn\u00e9m pou\u017eit\u00ed. Pou\u017e\u00edvejte nejni\u017e\u0161\u00ed \u00fa\u010dinnost, kter\u00e1 stav kontroluje; p\u0159ejd\u011bte na steroid st\u0159edn\u00ed s\u00edly, jakmile je vzplanut\u00ed pod kontrolou.<\/p>\n Jak klobetasol p\u016fsob\u00ed<\/h2>\nClobetasol propion\u00e1t se v\u00e1\u017ee na intracelul\u00e1rn\u00ed glukokortikoidn\u00ed receptory v keratinocytech, derm\u00e1ln\u00edch fibroblastech a z\u00e1n\u011btliv\u00fdch bu\u0148k\u00e1ch. Aktivovan\u00fd receptor se translokuje do j\u00e1dra, kde potla\u010duje transkripci proz\u00e1n\u011btliv\u00fdch cytokin\u016f (IL-1, IL-2, IL-6, TNF-\u03b1), inhibuje fosfolip\u00e1zu A2<\/sub> (sn\u00ed\u017een\u00edm synt\u00e9zy prostaglandin\u016f a leukotrien\u016f) a podporuje apopt\u00f3zu T-lymfocyt\u016f infiltruj\u00edc\u00edch z\u00e1n\u011btlivou k\u016f\u017ei. V\u00fdsledkem je rychl\u00e9 potla\u010den\u00ed z\u00e1n\u011btliv\u00e9 kask\u00e1dy zp\u016fsobuj\u00edc\u00ed stavy jako psori\u00e1za a t\u011b\u017ek\u00fd ekz\u00e9m.<\/p>\nN\u00e1stup klinick\u00e9ho \u00fa\u010dinku obvykle do 24-72 hodin; pln\u00e1 odpov\u011b\u010f v\u011bt\u0161inou do 1-2 t\u00fddn\u016f. Viditeln\u00e9 projevy mohou ustoupit rychleji ne\u017e podkladov\u00fd z\u00e1n\u011bt \u2014 proto je d\u016fle\u017eit\u00e9 dodr\u017eet cel\u00fd l\u00e9\u010debn\u00fd re\u017eim a pl\u00e1novan\u00e9 postupn\u00e9 vysazov\u00e1n\u00ed.<\/p>\n Schv\u00e1len\u00e9 pou\u017eit\u00ed<\/h2>\nKr\u00e9m Tenovate clobetasol je schv\u00e1len pro kr\u00e1tkodobou l\u00e9\u010dbu:<\/p>\n \n- Rezistentn\u00edho ekz\u00e9mu \/ atopick\u00e9 dermatitidy<\/strong> \u2014 pouze kdy\u017e m\u00e9n\u011b potentn\u00ed steroidy selhaly; nen\u00ed vhodn\u00fd jako prvn\u00ed volba<\/li>\n
- Psori\u00e1zy (omezen\u00e9 a stabiln\u00ed plakovit\u00e9 formy)<\/strong> \u2014 NE pro rozs\u00e1hlou plakovou psori\u00e1zu nebo generalizovanou pustul\u00f3zn\u00ed psori\u00e1zu (riziko rebound efektu a pustul\u00f3zn\u00edho vzplanut\u00ed); NE pro gut\u00e1tn\u00ed nebo erytrodermickou psori\u00e1zu<\/li>\n
- Lichen planus<\/strong> \u2014 v\u010detn\u011b hypertrofick\u00e9ho lichen planus na doln\u00edch kon\u010detin\u00e1ch<\/li>\n
- Lichen sclerosus et atrophicus<\/strong> \u2014 prvn\u00ed volba terapie pro genit\u00e1ln\u00ed a extragenit\u00e1ln\u00ed formy<\/li>\n
- Discoidn\u00ed lupus erythematosus<\/strong><\/li>\n
- Pretibi\u00e1ln\u00ed myxed\u00e9m<\/strong><\/li>\n
- Granuloma annulare, necrobiosis lipoidica<\/strong> (omezen\u00e9 d\u016fkazy; n\u011bkdy pou\u017e\u00edvan\u00e9)<\/li>\n
- T\u011b\u017ek\u00e9 reakce na hmyz\u00ed \u0161t\u00edpnut\u00ed, t\u011b\u017ek\u00e1 kontaktn\u00ed dermatitida<\/strong> \u2014 pouze kr\u00e1tkodob\u00e9 k\u00fary<\/li>\n
- Keloidn\u00ed a hypertrofick\u00e9 jizvy<\/strong> \u2014 n\u011bkdy se pou\u017e\u00edv\u00e1 pod okluz\u00ed nebo jako dopln\u011bk k intralesion\u00e1ln\u00ed injekci steroid\u016f<\/li>\n<\/ul>\n
Jak aplikovat Tenovate \u2014 pravidlo jednotky kone\u010dku prstu (FTU)<\/h2>\nD\u00e1vkov\u00e1n\u00ed topick\u00fdch steroid\u016f vyu\u017e\u00edv\u00e1 jednotku kone\u010dku prstu (FTU)<\/strong>: mno\u017estv\u00ed vytla\u010den\u00e9 ze standardn\u00ed tuby s 5 mm hrdlem pod\u00e9l d\u00e9lky dosp\u011bl\u00e9ho ukazov\u00e1\u010dku od \u0161pi\u010dky k prvn\u00edmu z\u00e1hybu. 1 FTU \u2248 0,5 g<\/strong> a o\u0161et\u0159\u00ed plochu p\u0159ibli\u017en\u011b velikosti dvou dosp\u011bl\u00fdch dlan\u00ed.<\/p>\nPostup aplikace:<\/strong><\/p>\n\n- Umyjte a osu\u0161te si ruce<\/li>\n
- Umyjte a jemn\u011b osu\u0161te posti\u017eenou oblast<\/li>\n
- Vytla\u010dte odpov\u00eddaj\u00edc\u00ed mno\u017estv\u00ed FTU pro o\u0161et\u0159ovanou \u010d\u00e1st t\u011bla<\/li>\n
- Naneste tenk\u00e1 vrstva<\/strong> \u2014 jemn\u011b vet\u0159ete, dokud se nevst\u0159eb\u00e1; NEpou\u017e\u00edvejte siln\u00e9 vrstvy (v\u011bt\u0161\u00ed mno\u017estv\u00ed kr\u00e9mu nen\u00ed \u00fa\u010dinn\u011bj\u0161\u00ed a v\u00fdrazn\u011b zvy\u0161uje syst\u00e9movou absorpci)<\/li>\n
- Po aplikaci si umyjte ruce, pokud neaplikujete na ruce<\/li>\n
- Nechte kr\u00e9m zcela vst\u0159ebat p\u0159ed nanesen\u00edm jak\u00e9hokoli emoliencia nebo hydrata\u010dn\u00edho p\u0159\u00edpravku; nechte minim\u00e1ln\u011b 30 minut mezi aplikacemi<\/li>\n
- Aplikujte jednou nebo dvakr\u00e1t denn\u011b<\/strong> podle pokyn\u016f l\u00e9ka\u0159e<\/li>\n
- NEzakr\u00fdvejte vzduchot\u011bsn\u00fdmi obvazy (okluz\u00ed), pokud nen\u00ed v\u00fdslovn\u011b doporu\u010deno \u2014 okluze m\u016f\u017ee zv\u00fd\u0161it syst\u00e9movou absorpci a\u017e desetin\u00e1sobn\u011b<\/li>\n<\/ol>\n
FTU na \u010d\u00e1st t\u011bla u dosp\u011bl\u00fdch:<\/strong><\/p>\n\n- Jedna ruka (p\u0159edn\u00ed a zadn\u00ed strana): 1 FTU<\/li>\n
- Jedna pa\u017ee: 3 FTU<\/li>\n
- Jedna noha (vrchn\u00ed a spodn\u00ed \u010d\u00e1st): 2 FTU<\/li>\n
- Jedna noha: 6 FTU<\/li>\n
- P\u0159edn\u00ed \u010d\u00e1st trupu: 7 FTU<\/li>\n
- Zadn\u00ed \u010d\u00e1st trupu a h\u00fd\u017ed\u011b: 7 FTU<\/li>\n<\/ul>\n
D\u00e1vkovac\u00ed limity a d\u00e9lka l\u00e9\u010dby<\/h2>\nP\u0159\u00edsn\u00e9 limity pro pou\u017eit\u00ed klobetasolu:<\/strong><\/p>\n\n- Maxim\u00e1ln\u011b 50 g t\u00fddn\u011b<\/strong> u dosp\u011bl\u00fdch (doporu\u010den\u00ed v\u00fdrobce \/ NICE)<\/li>\n
- Maxim\u00e1ln\u011b 2 t\u00fddny nep\u0159etr\u017eit\u00e9ho u\u017e\u00edv\u00e1n\u00ed<\/strong> bez l\u00e9ka\u0159sk\u00e9 kontroly<\/li>\n
- Pokud je pot\u0159eba del\u0161\u00ed l\u00e9\u010dba, v\u00e1\u0161 dermatolog napl\u00e1nuje postupnou redukci d\u00e1vkov\u00e1n\u00ed, p\u0159eru\u0161ovan\u00fd \u201cv\u00edkendov\u00fd\u201d re\u017eim nebo p\u0159echod na m\u00e9n\u011b potentn\u00ed steroid<\/li>\n
- Celkov\u00e9 kumulativn\u00ed u\u017e\u00edv\u00e1n\u00ed by nem\u011blo p\u0159ekro\u010dit 50 g t\u00fddn\u011b, i kdy\u017e l\u00e9\u010dbu p\u0159eru\u0161\u00edte a znovu za\u010dnete<\/li>\n
- D\u011bti<\/strong>Klobetasol se obecn\u011b NEPOU\u017d\u00cdV\u00c1 u d\u011bt\u00ed mlad\u0161\u00edch 12 let, krom\u011b p\u0159\u00edpad\u016f p\u0159\u00edm\u00e9ho dohledu dermatologa; d\u011btsk\u00e1 poko\u017eka je propustn\u011bj\u0161\u00ed a potla\u010den\u00ed HPA osy p\u0159edstavuje re\u00e1ln\u00e9 riziko<\/li>\n
- U star\u0161\u00edch pacient\u016f, pacient\u016f s tenkou k\u016f\u017e\u00ed (dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed prednisolonu, atrofick\u00e9 dermat\u00f3zy), pacient\u016f s ren\u00e1ln\u00edm\/jatern\u00edm posti\u017een\u00edm a t\u011bhotn\u00fdch pacient\u016f je nutn\u00e1 zv\u00fd\u0161en\u00e1 opatrnost<\/li>\n<\/ul>\n
Kam NEnan\u00e1\u0161et Tenovate<\/h2>\nPropustnost k\u016f\u017ee je v\u00fdrazn\u011b vy\u0161\u0161\u00ed v ur\u010dit\u00fdch oblastech, co\u017e zvy\u0161uje syst\u00e9movou absorpci (potla\u010den\u00ed HPA osy) a koncentruje lok\u00e1ln\u00ed \u00fa\u010dinek steroidu (atrofie, teleangiekt\u00e1zie, steroidn\u00ed r\u016f\u017eovka). Vyhn\u011bte se n\u00e1sleduj\u00edc\u00edm oblastem, pokud to dermatolog v\u00fdslovn\u011b nedoporu\u010d\u00ed:<\/strong><\/p>\n\n- Obli\u010dej<\/strong> \u2014 riziko perior\u00e1ln\u00ed dermatitidy, steroidn\u00ed r\u016f\u017eovky, teleangiekt\u00e1zi\u00ed, nevratn\u00e9 atrofie. M\u00edsto toho pou\u017eijte n\u00edzko\u00fa\u010dinn\u00fd steroid (hydrokortizon 1%) nebo topick\u00fd inhibitor kalcineurinu (takrolimus, pimekrolimus).<\/li>\n
- O\u010dn\u00ed v\u00ed\u010dka a okol\u00ed o\u010d\u00ed<\/strong> \u2014 absorpce je extr\u00e9mn\u011b vysok\u00e1 a existuje re\u00e1ln\u00e9 riziko vzniku glaukomu a zadn\u00ed subkapsul\u00e1rn\u00ed katarakty p\u0159i chronick\u00e9m u\u017e\u00edv\u00e1n\u00ed<\/li>\n
- Podpa\u017e\u00ed, t\u0159\u00edsla, genit\u00e1lie, perineum, intertrigin\u00f3zn\u00ed z\u00e1hyby<\/strong> \u2014 vysok\u00e1 absorpce, vysok\u00e9 riziko stri\u00ed, atrofie a zhor\u0161en\u00ed intertriga. V\u00fdjimkou je lichen sclerosus vulvy<\/strong>, kde je klobetasol l\u00e9kem prvn\u00ed volby pod odborn\u00fdm dohledem s definovan\u00fdm postupn\u00fdm sni\u017eov\u00e1n\u00edm d\u00e1vky.<\/li>\n
- Pod plenkami \/ okluzivn\u00edmi obvazy<\/strong> \u2014 okluze zvy\u0161uje absorpci desetin\u00e1sobn\u011b<\/li>\n
- Poru\u0161en\u00e1, infikovan\u00e1 nebo mokvaj\u00edc\u00ed k\u016f\u017ee<\/strong> \u2014 neaplikujte na nel\u00e9\u010denou bakteri\u00e1ln\u00ed, pl\u00eds\u0148ovou nebo virovou infekci (impetigo, tinea, herpes simplex). Nejprve infekci zal\u00e9\u010dte.<\/li>\n
- Akn\u00e9, perior\u00e1ln\u00ed dermatitida, r\u016f\u017eovka, perian\u00e1ln\u00ed ekz\u00e9m s infekc\u00ed<\/strong> \u2014 lok\u00e1ln\u00ed steroidy tyto stavy zhor\u0161uj\u00ed<\/li>\n<\/ul>\n
Vedlej\u0161\u00ed \u00fa\u010dinky & bezpe\u010dnost<\/h2>\nLok\u00e1ln\u00ed ko\u017en\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky (\u010dast\u011bj\u0161\u00ed p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed, okluzi nebo aplikaci na tenkou\/citlivou poko\u017eku):<\/strong><\/p>\n\n- Atrofie k\u016f\u017ee \u2014 zten\u010den\u00ed, pap\u00edrov\u011b k\u0159ehk\u00e1 poko\u017eka, snadn\u00e1 tvorba mod\u0159in<\/strong> (\u010dasto nevratn\u00e9)<\/li>\n
- Strie (jizvy po napnut\u00ed k\u016f\u017ee)<\/strong> \u2014 trval\u00e9<\/li>\n
- Teleangiekt\u00e1zie (viditeln\u00e9 drobn\u00e9 c\u00e9vky)<\/strong><\/li>\n
- Hypopigmentace (odbarven\u00e9 skvrny), zvl\u00e1\u0161t\u011b patrn\u00e9 u tmav\u0161\u00edch typ\u016f pleti<\/li>\n
- Perior\u00e1ln\u00ed dermatitida, steroidy vyvolan\u00e1 r\u016f\u017eovka, steroidn\u00ed akn\u00e9 (zejm\u00e9na na obli\u010deji)<\/li>\n
- Hypertrich\u00f3za (zv\u00fd\u0161en\u00fd r\u016fst ochlupen\u00ed v m\u00edst\u011b aplikace)<\/li>\n
- Tinea incognito \u2014 maskov\u00e1n\u00ed a zhor\u0161en\u00ed z\u00e1kladn\u00ed pl\u00eds\u0148ov\u00e9 infekce<\/li>\n
- Kontaktn\u00ed dermatitida na samotnou molekulu steroidu nebo na pomocn\u00e9 l\u00e1tky<\/li>\n
- P\u00e1len\u00ed, \u0161t\u00edp\u00e1n\u00ed nebo sv\u011bd\u011bn\u00ed v m\u00edst\u011b aplikace<\/li>\n
- Steroidn\u00ed rebound p\u0159i n\u00e1hl\u00e9m vysazen\u00ed \u2014 vzplanut\u00ed hor\u0161\u00ed ne\u017e p\u016fvodn\u00ed stav<\/li>\n<\/ul>\n
Syst\u00e9mov\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky (vz\u00e1cn\u00e9 p\u0159i kr\u00e1tkodob\u00e9m spr\u00e1vn\u00e9m u\u017eit\u00ed; re\u00e1ln\u00e9 riziko p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch, rozs\u00e1hl\u00e9 aplikaci, dlouhodob\u00e9m nebo okluzivn\u00edm pou\u017eit\u00ed):<\/strong><\/p>\n\n- Potla\u010den\u00ed osy HPA<\/strong> \u2014 sn\u00ed\u017een\u00e1 produkce kortizolu. Dokumentov\u00e1no p\u0159i d\u00e1vk\u00e1ch >50 g\/t\u00fdden nebo p\u0159i rozs\u00e1hl\u00e9m okluzivn\u00edm pou\u017eit\u00ed. Reverzibiln\u00ed p\u0159i v\u010dasn\u00e9m zachycen\u00ed.<\/li>\n
- Iatrogenn\u00ed Cushing\u016fv syndrom<\/strong> p\u0159i z\u00e1va\u017en\u00e9m nadu\u017e\u00edv\u00e1n\u00ed<\/li>\n
- Hyperglyk\u00e9mie\/glukosurie<\/li>\n
- Glaukom a zadn\u00ed subkapsul\u00e1rn\u00ed katarakta p\u0159i periokul\u00e1rn\u00ed aplikaci<\/li>\n
- Zpomalen\u00ed r\u016fstu u d\u011bt\u00ed<\/li>\n<\/ul>\n
Kontraindikace a varov\u00e1n\u00ed<\/h2>\nNepou\u017e\u00edvejte Tenovate, pokud m\u00e1te:<\/strong><\/p>\n\n- P\u0159ecitliv\u011blost na klobetasol propion\u00e1t nebo jakoukoli dal\u0161\u00ed slo\u017eku<\/li>\n
- Nel\u00e9\u010denou bakteri\u00e1ln\u00ed, pl\u00eds\u0148ovou nebo virovou ko\u017en\u00ed infekci<\/strong> \u2014 v\u010detn\u011b impetiga, tiney (opar, atletick\u00e1 noha, t\u0159\u00edsla), herpes simplex, herpes zoster, plan\u00e9 ne\u0161tovice, svrab, perian\u00e1ln\u00ed\/vulv\u00e1rn\u00ed kandid\u00f3za, prim\u00e1rn\u00ed syfilis<\/li>\n
- Akn\u00e9 vulgaris, r\u016f\u017eovka, perior\u00e1ln\u00ed dermatitida<\/li>\n
- Sv\u011bd\u011bn\u00ed bez prok\u00e1zan\u00e9ho z\u00e1n\u011btliv\u00e9ho dermat\u00f3zy<\/li>\n
- D\u011bti do 12 m\u011bs\u00edc\u016f (absolutn\u00ed kontraindikace v\u00fdrobce)<\/li>\n<\/ul>\n
T\u011bhotenstv\u00ed:<\/strong> vyhn\u011bte se rozs\u00e1hl\u00e9mu nebo dlouhodob\u00e9mu u\u017e\u00edv\u00e1n\u00ed b\u011bhem t\u011bhotenstv\u00ed. Pokud je klobetasol nezbytn\u00fd, pou\u017e\u00edvejte nejmen\u0161\u00ed \u00fa\u010dinn\u00e9 mno\u017estv\u00ed po nejkrat\u0161\u00ed mo\u017enou dobu a pokud mo\u017eno se vyhn\u011bte t\u0159et\u00edmu trimestru. Topick\u00e9 kortikosteroidy v t\u011bhotenstv\u00ed byly spojov\u00e1ny s n\u00edzkou porodn\u00ed hmotnost\u00ed p\u0159i vysok\u00e9 celkov\u00e9 kumulativn\u00ed expozici.<\/p>\nKojen\u00ed:<\/strong> pokud se aplikuje na oblast prsou, p\u0159ed ka\u017ed\u00fdm kojen\u00edm d\u016fkladn\u011b omyjte, aby nedo\u0161lo k po\u017eit\u00ed klobetasolu d\u00edt\u011btem.<\/p>\nJak vysadit \u2014 prevence rebound efektu<\/h2>\nN\u00e1hl\u00e9 vysazen\u00ed velmi siln\u00e9ho topick\u00e9ho steroidu po pravideln\u00e9m u\u017e\u00edv\u00e1n\u00ed d\u00e9le ne\u017e 2 t\u00fddny \u010dasto zp\u016fsobuje steroidn\u00ed rebound flare<\/strong> \u2014 p\u016fvodn\u00ed dermat\u00f3za se vrac\u00ed, \u010dasto z\u00e1va\u017en\u011bj\u0161\u00ed ne\u017e na za\u010d\u00e1tku, n\u011bkdy doprov\u00e1zen\u00e1 p\u00e1len\u00edm, zarudnut\u00edm a \u201csyndromem vysazen\u00ed topick\u00fdch steroid\u016f\u201d (TSWS\/RSS).<\/p>\nPokud jste Tenovate pou\u017e\u00edvali nep\u0159etr\u017eit\u011b d\u00e9le ne\u017e 2 t\u00fddny, v\u00e1\u0161 l\u00e9ka\u0159 nebo dermatolog obvykle napl\u00e1nuje jeden z n\u00e1sleduj\u00edc\u00edch postup\u016f:<\/p>\n \n- Postupn\u00e9 sn\u00ed\u017een\u00ed na steroid st\u0159edn\u00ed s\u00edly<\/strong> (nap\u0159. betamethason valer\u00e1t 0,1% nebo mometason 0,1%) po dobu 1-2 t\u00fddn\u016f, pot\u00e9 p\u0159echod na slab\u00fd steroid (hydrokortison 1%) p\u0159ed \u00fapln\u00fdm vysazen\u00edm<\/li>\n
- P\u0159eru\u0161ovan\u00e1 \u201cv\u00edkendov\u00e1 terapie\u201d<\/strong> \u2014 clobetasol aplikov\u00e1n pouze v sobotu a ned\u011bli, ve v\u0161edn\u00ed dny pou\u017e\u00edvejte m\u00edrn\u00fd steroid nebo emoliencium<\/li>\n
- P\u0159echod na l\u00e1tku \u0161et\u0159\u00edc\u00ed steroidy<\/strong> \u2014 topick\u00fd inhibitor kalcineurinu (tacrolimus 0,1%, pimecrolimus), topick\u00fd inhibitor PDE4 (crisaborole) nebo syst\u00e9mov\u00e1 terapie v t\u011b\u017ek\u00fdch p\u0159\u00edpadech<\/li>\n
- Trval\u00e9 pou\u017e\u00edv\u00e1n\u00ed emolienci\u00ed<\/strong> spolu s kter\u00fdmkoli z v\u00fd\u0161e uveden\u00fdch prost\u0159edk\u016f ke sn\u00ed\u017een\u00ed pot\u0159eby steroid\u016f<\/li>\n<\/ul>\n
Skladov\u00e1n\u00ed a trvanlivost<\/h2>\nUchov\u00e1vejte tubu p\u0159i teplot\u011b ni\u017e\u0161\u00ed ne\u017e 25\u00b0C v p\u016fvodn\u00edm obalu. Nezmrazujte. Po ka\u017ed\u00e9m pou\u017eit\u00ed pevn\u011b uzav\u0159ete v\u00ed\u010dko, aby nedo\u0161lo ke kontaminaci. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed. Po otev\u0159en\u00ed pou\u017eijte do lh\u016fty stanoven\u00e9 v\u00fdrobcem (obvykle 3-6 m\u011bs\u00edc\u016f) nebo do data expirace, podle toho, co nastane d\u0159\u00edve. Nepou\u017e\u00edvejte po datu expirace uveden\u00e9m na krabi\u010dce.<\/p>\n | | | |