Dermovate
clobetasol
(kloe-bay-ta-sol) clobetasol,Clobex
(trade name),Dermovate
(trade name),Temovate
(trade name),Temovate E
(trade name)Classification
Therapeutic: anti inflammatories steroidalPharmacologic: corticosteroids
Indications
Action
Therapeutic effects
Pharmacokinetics
Time/action profile (response depends on condition being treated)
ROUTE | ONSET | PEAK | DURATION |
Topical | min–hrs | hrs–days | hrs–days |
Contraindications/Precautions
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
Availability (generic available)
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. Solution, spray, and shampoo are useful in hairy areas.
- Topical: Apply ointment, creams, gel, or lotion sparingly as a thin film to clean skin. Wash hands immediately after application. Apply occlusive dressing only if specified by health care professional.
- Apply solution and shampoo to hair by parting hair and applying a small amount to affected area. Rub in gently. With solution, protect area from washing, clothing, or rubbing until medication has dried. Hair may be washed as usual but not right after applying medication. With shampoo, wash hair as usual 15 minutes after application.
- Apply spray sparingly as a thin film to clean, dry skin. Wash hands immediately after application.
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.
- 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.
- Advise patient to consult health care professional before using medicine for condition other than indicated.
- 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.