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Vicky 留話於:2005/4/23 |
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關於異位性皮膚炎用藥(九個月大嬰兒) |
醫生您好,
我的孩子從兩個月大就一直為異位性皮膚炎所困擾, 之前醫生都是要我們買1% Hydrocortison自己擦, 但是斷斷續續時好時壞, 到現在快八個月了, 不見改善反而更嚴重, 所有該注意的我們都已想盡辦法(如控制母奶媽媽我的飲食, 因為他對牛奶和黃豆過敏, 沒配方奶可餵, 室內放humidifier, 用lukewarm water 洗澡, 母子都穿純棉衣服, 純棉床單...), 今天再去看醫生他開了5% Aclovate (alclometasone dipropionate), 我仔細讀了precaution發現是劑量蠻重的類固醇, 上台灣國家藥典網路查不到, 不知道台灣是否有人用過, 用在小嬰兒上會不會有問題, 因為它上面寫孕婦使用會生畸形兒, 母奶媽媽也不能用, 那怎麼可以用在小嬰兒????
不好意思麻煩您, 本來我們應該直接聽從醫生的prescription, 但是真的很擔心, 一個已經擦掉快兩條Hydrocortison的小小孩, 若再繼續用更重的類固醇, 會不會在他身上留下難以挽回的副作用?
另外醫生也開了Elidel讓寶寶在狀況好轉後使用, 但是前些時候看到美國FDA發出警告說可能致癌, 我就暫時把藥停了.
另外有越南朋友推薦用Cortibion(含 dexamethasone acetate 和 Chloramphenicol), 幾乎每一種藥都是擦兩天就好, 沒兩天又發, 已經用類固醇這麼久, 到底該怎麼用藥才不會有問題?
感謝您的解答...
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張裕豐 回應於:2005/4/24 |
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Re: 關於異位性皮膚炎用藥 |
看了您的描述, 可以想見您的困擾.
類固醇藥膏仍是目前治療異位性皮膚炎最有效的藥物. 中低強度的類固醇藥膏安全性很高, 只需依醫囑使用, 基本上不會有問題. 異位性皮膚炎的疹子本來就會復發, 所以父母的毅力耐心相當重要. 至於高強度的類固醇只要在皮膚科醫師的指導下使用, 出現副作用的機會就會大幅降低
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Vicky 回應於:2005/4/25 |
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dexamethasone acetate 強度? |
謝謝醫生的回答, 再請教, Cortibion 含的dexmaethasone acetate 約 0.625% 比 Aclovate 含的alclometasone dipropionate 0.5%, 哪一種類固醇藥效比較強?
若是臉上比四肢嚴重, 可以臉上擦一種, 四肢擦另一種嗎?
若是要從類固醇轉Elidel, 中間是否須停藥幾天?
還有就是用藥順序, 是先擦抗生素(醫囑一天三到四次)還是先擦類固醇(醫囑一天二到三次), 同一位置是否須錯開使用? 若是需間隔多久?
麻煩您了...謝謝您耐心詳細解答! |
小小 回應於:2005/5/2 |
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可以試試 "普特皮" |
我有朋友用了普特皮 , 效果滿好的,健保也有給付
它不是類固醇的藥物, 效果比醫立妥好一些, 可以問問看你的醫師, 希望對你有幫助 |
張裕豐 回應於:2005/5/3 |
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Re: 關於異位性皮膚炎用藥 |
alclometasone dipropionate 0.5% 為中低強度類固醇, 使用上大致上安全; 臉上擦的類固醇, 倘若強度太強, 則臉皮容易變薄 !!!故不能因為臉上比四肢嚴重, 就在臉上使用更強效的類固醇 !
Cortibion 似乎只有越南有在用, 同成分產品台灣只有口服及針劑, "沒有藥膏", 用之前考慮考慮 !
抗生素 and 類固醇請間隔擦, 隔多久到沒一定標準, 可以間隔1-2小時使用
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