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PubMed2000

Efficacy of intracochlear administration of betamethasone on peripheral vestibular disorder in the guinea pig.

We evaluated the effect of steroid hormone on vestibular function in a guinea pig of peripheral vestibular disorder. The right lateral semicircular canal was surgically damaged, and after surgery, animals were treated with 0.1 mg/ml of betamethasone in saline, 1 mg/ml of betamethasone in saline, or saline only, which was administrated directly into the scala tympani by osmotic pump. Rotation tests were performed, and the post-rotatory nystagmus (PRN) ratio (PRN number after counterclockwise rotation/PRN number after clockwise rotation) was calculated. The PRN ratio was recovered to normal at 5 days after treatment in the betamethasone administrated groups, but it did not recover to normal until 14 days after treatment in the saline administrated group. Results indicate that in the vestibular periphery steroid hormones may play an important role in recover of vestibular function.

Animals↗

PubMed2002

Analysis of betamethasone in rat plasma using automated solid-phase extraction coupled with liquid chromatography-tandem mass spectrometry. Determination of plasma concentrations in rat following oral and intravenous administration.

A method is described for the determination of betamethasone in rat plasma by liquid chromatography-tandem mass spectrometry (LC-MS-MS). The analyte was recovered from plasma by solid-phase extraction and subsequently analyzed by LC-MS-MS. A Packard Multiprobe II, an automated liquid handling system, was employed for the preparation and extraction of a 96-well plate containing unknown plasma samples, standards and quality control samples in an automated fashion. Prednisolone, a structurally related steroid, was used as an internal standard. Using the described approach, a limit of quantitation of 2 ng/ml was achieved with a 50 microl aliquot of rat plasma. The described level of sensitivity allowed the determination of betamethasone concentrations and subsequent measurement of kinetic parameters of betamethasone in rat. Combination of automated plasma extraction and the sensitivity and selectivity of LC-MS-MS offers a valuable alternative to the methodologies currently used for the quantitation of steroids in biological fluids.

Administration, Oral↗

PubMed1998

Determination of betamethasone and triamcinolone acetonide by GC-NCI-MS in excreta of treated animals and development of a fast oxidation procedure for derivatisation of corticosteroids.

The use of corticosteroids in combination with other hormonal substances has long been known to result in increased mass gain with bovines. Practice has demonstrated, however, that even the single use of a glucocorticoid may result in growth promoting effects. In addition to the popular dexamethasone, more recently other corticosteroids have also been misused for fattening purposes. The first part of this study deals with the detection of two of them, namely betamethasone and triamcinolone acetonide. Betamethasone was administered orally to a cow at a dose of 50 mg d-1 for 5 d, then later the same cow was injected intramuscularly with a dose of 50 mg of betamethasone dipropionate. Excretion in urine and faeces was followed with both HPLC-enzyme immunoassay and a previously described method based on negative chemical ionization mass spectrometry (NCI-MS) after oxidation. For the triamcinolone acetonide study a cow was treated with 50 mg d-1 of the drug during a 7 d period. Excretion in faeces was followed with GC-NCI-MS. As triamcinolone acetonide is resistant to the previously described oxidation procedure, however, a hydrolysis step had to be introduced prior to oxidation. In addition to this specific modification necessary for triamcinolone acetonide, in a subsequent part of this study the original oxidation procedure with pyridinium chlorochromate was re-investigated especially to shorten the procedure. With the introduction of potassium dichromate the reaction time could be decreased from 3 h to 10 min.

Animals↗

PubMed2003

Betamethasone associated changes in umbilical artery flow velocity waveforms in multiple pregnancies with umbilical artery absent end diastolic flow.

OBJECTIVES: It has been previously shown that glucocorticoids alter umbilical artery flow velocity waveforms in singleton pregnancies complicated by umbilical artery absent end diastolic flow. Whether similar effects are evident in multiple pregnancies where one fetus has umbilical artery absent end diastolic flow is not known. METHODS: Women with a twin or triplet pregnancy complicated by umbilical artery absent end diastolic flow in one fetus were admitted to hospital for intensive fetal surveillance including daily umbilical artery flow velocity waveform studies, as per hospital protocol. All women received prophylactic betamethasone (11.4 mg x 2, 24 h apart) in anticipation of preterm delivery. RESULTS: Between October 1996 and February 2002, 24 women with a multiple pregnancy complicated by umbilical artery absent end diastolic flow were cared for. Of these, six had a pregnancy with feto-fetal transfusion and excluded from further analysis. Of the remaining 18 women, eight had monochorionic diamniotic twins, eight had dichorionic twins, and two had trichorionic, triamniotic triplets. The median (range) gestation at diagnosis of umbilical artery absent end diastolic flow was 210.5 days (173-241). In nine (50%) of the 18 pregnancies the administration of betamethasone was associated with return of umbilical artery end diastolic flow for a median of 5 days. There was no association between this effect and chorionicity. The median (range) interval from diagnosis of umbilical artery absent end diastolic flow to delivery was 11 days (1-46). CONCLUSIONS: As previously reported in singleton pregnancies, the maternal administration of betamethasone in multiple pregnancies with umbilical artery absent end diastolic flow is associated with a transient return of end diastolic flow.

Betamethasone↗

PubMed1997

Betamethasone treatment and fetal lung perfusion evaluated with color Doppler energy imaging.

The aim of this study was semiquantitative evaluation of tissue blood flow in the fetal lung before and after administration of betamethasone. This was carried out by means of computer analysis of ultrasound Doppler signals obtained by the color Doppler energy (CDE) technique. CDE signals were recorded in 20 singleton pregnancies with appropriate growth and imminent preterm delivery between 26 and 33 weeks of gestation. The CDE signal recordings were made before and after intramuscular administration of betamethasone 8 mg/day for 3 days. Fixed preset CDE system control settings for the fetal right lung were used during the examinations. Images from CDE scans were recorded on S-VHS videotape and transmitted for computer analysis of 8-bit images at 256 gray-scale levels. The mean flow signal intensity was recorded for the fetal lung before and after betamethasone administration. Additionally, blood velocity waveforms were measured in the intrapulmonary arteries and veins in the peripheral part of the lung. CDE signals from the fetal lung indicated increased energy values after corticosteroid treatment in 16 cases. In three cases there was no change in CDE signal values, and in one case a fall of the signal value was noted. Blood velocity waveforms from the intrapulmonary arteries showed decreased resistance to flow in 15 cases, increased resistance to flow in four cases and no change in one case. No significant differences in venous blood flow velocities were found. In conclusion, the results suggest that there is an increase in fetal lung blood perfusion after maternal corticosteroid administration.

Betamethasone↗

PubMed1988

Serum free thyroid hormones are decreased by betamethasone treatment in Graves' disease.

38 patients with Graves' disease were treated at random with the glucocorticosteroid betamethasone or with placebo. The daily oral dose was 6.0 mg for the first 5 days, 4.5 mg for the following week, and then 3.0 mg. The serum free triiodothyronine (FT3) concentration decreased within 5 days, while the free thyroxine (FT4) level was reduced first after 3 weeks of betamethasone treatment. The suppressed serum thyrotropin concentration did not change. In the placebo group no significant constant alterations were found in any of the variables studied. The results corroborate that betamethasone decreases FT3 and to a less degree also FT4, which earlier has been indicated by indirect methods, although the mechanisms behind the changes remain to be clarified. Since FT3 is more readily available for the metabolic effects in tissues the rapid striking fall in its concentration is an argument for glucocorticoid treatment in selected patients with severe hyperthyroidism of Graves' disease.

Adult↗

PubMed1983

The effect of betamethasone on duodenal calcium absorption and 1,25-dihydroxy vitamin D3 production in the chick.

Duodenal absorption of calcium, renal 25-hydroxycholecalciferol-1-hydroxylase activity, percentage bone ash, growth rate and plasma levels of Ca and P were all measured in chicks which had been treated with the synthetic glucocorticoid, betamethasone, at the therapeutic dose level of 25 microgram/kg daily. It was found that treatment for 2-3 weeks resulted in a significant reduction in Ca absorption rate, renal 1-hydroxylase activity and growth rate but an increase in bone ash and plasma Ca. If betamethasone was administered for 10 days and then stopped 4-13 days before these parameters were measured, a compensatory increase was found in 1-hydroxylase activity while the Ca absorption rate attained control values in all but the 4 day group in which it was still significantly depressed. It was concluded that a therapeutic dose level of betamethasone depresses both duodenal Ca absorption and renal 1-hydroxylase activity although there may be no direct causal relationship between these two parameters. Recovery was complete in 5-7 days after cessation of treatment.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗

PubMed1983

The effects of betamethasone, low calcium and low phosphorus diets on growth in chicks.

The effects of oral betamethasone (25 micrograms/kg/d), low calcium (1 g/kg), and low phosphorus (2,5 g/kg) diets on weight gain were investigated in 513 growing chicks. The chicks were divided according to initial weight into a lower weight group (less than 100 g each) and a higher group (more than 100 g each). The increases in weight were recorded after periods of 7, 14 and 21 days. The increases in weight in the older chicks (high weight group) were less than in the younger chicks. There was a greater reduction in rate of growth in chicks fed the low phosphorus diet than in those fed the low calcium diet, particularly in the older birds. Betamethasone administration also reduced the rate of growth but this was not additive to the effect of a low calcium diet. In contrast, the greatest reduction in growth rate was observed in the chicks fed the low phosphorus diet and given betamethasone.

Aging↗

PubMed1981

[Comparison of betamethasone and clobetasone butyrate eye drops and their effect on intraocular pressure (author's transl)].

The effect of clobetasone butyrate eye drops on ocular pressure was tested in 15 steroid responders suffering from different types of conjunctivitis and compared with betamethasone eye drops. Elevated intraocular pressure following application of 0.1% betamethasone eye drops decreased significantly within 2 weeks under medication with 0.1% clobetasone butyrate 4 times daily, whereas fellow eyes kept under treatment with betamethasone suffered further increases in IOP. The therapeutic effect and subjective compatibility of the two steroids were found to be approximately equal.

Betamethasone↗

PubMed2000

Topical therapy for psoriasis with the use of augmented betamethasone and calcipotriene on alternate weeks.

BACKGROUND: Topical corticosteroids, commonly used for psoriasis, show diminished response on continuous use. OBJECTIVE: We tested efficacy of topical corticosteroid and calcipotriene used on alternate weeks versus daily corticosteroid in patients with psoriasis. METHODS: In a randomized, observer-blind design, the experimental group of 25 patients with stable plaque psoriasis received augmented betamethasone dipropionate 0.05% cream once daily in the first and third weeks and calcipotriene 0.005% ointment twice daily in the second and fourth weeks. The control group of 27 patients received augmented betamethasone once daily for 4 weeks. RESULTS: The experimental regimen was more effective than the control regimen as evidenced by (1) more patients with at least a 90% reduction in Psoriasis Area and Severity Index (PASI) score (difference 49.5%, 95% confidence interval [CI], 26.1%-72.9%, P <. 001), (2) lower PASI after 2 weeks (P < or =.04), and (3) greater percentage reduction in PASI after 2 and 4 weeks (difference 23.1% [CI, 11.1%-35.1%] and 46.4% [28.9%-63.8%], respectively; P <.001). The study had power of 93.7%. No patient had skin irritation. CONCLUSION: Use of augmented betamethasone and calcipotriene on alternate weeks is more effective than daily corticosteroid and represents a novel strategy for treating psoriasis.

Administration, Topical↗

PubMed2002

Effects of maternal betamethasone administration on fetal and maternal blood pressure and heart rate in the baboon at 0.7 of gestation.

OBJECTIVE: We sought to determine the effects of the intramuscular maternal administration of betamethasone to the pregnant baboon at 0.7 of gestation on fetal blood pressure and heart rate. STUDY DESIGN: We treated pregnant baboons at 0.7 of gestation with intramuscular betamethasone (n = 4), at a weight-adjusted dose equivalent to the daily dose administered to women in preterm labor or with saline solution (n = 5). Four injections were given at 12-hour intervals. Fetal and maternal blood pressure and heart rate were recorded continuously. Within-group differences and between-group differences were analyzed with repeated measures analysis of variance. RESULTS: Fetal blood pressure increased significantly after betamethasone treatment. Fetal heart rate, maternal blood pressure, and heart rate did not change. CONCLUSION: Exposure of the developing primate fetus to exogenous glucocorticoid at 0.7 of gestation elevates fetal blood pressure. These findings confirm and extend the observations in the fetal sheep. Further studies are needed to evaluate the mechanisms that are involved and possible long-term consequences of these cardiovascular effects of antenatal glucocorticoid exposure in the fetal primate.

Animals↗

PubMed2003

Gestation-related and betamethasone-induced changes in 11beta-hydroxysteroid dehydrogenase types 1 and 2 in the baboon placenta.

OBJECTIVE: We determined developmental and labor-related changes in 11beta-hydroxysteroid (HSD) 1 and 2 expression in baboon placentas during the final third of gestation and labor. We examined whether maternal glucocorticoid administration alters placental 11beta-HSD 2 expression. STUDY DESIGN: Maternal and fetal plasma cortisol concentrations were measured in five animals. Types 1 and 2 11beta-HSD messenger RNA (mRNA) and protein in placentas obtained at 121 to 185 days' gestation (dGA, term approximately 185 dGA, n = 16), during labor between 141 and 193 dGA (n = 8), and after maternal administration of four doses of 87.5 microg/kg betamethasone (n = 5) at 12-hour intervals at 121 to 135 dGA were analyzed by Northern and Western blot. RESULTS: Cortisol levels were higher in maternal plasma than fetal (4-fold, P <.mob031). Placental 11beta-HSD 2 mRNA and protein decreased after 0.9 gestation (P <.001). 11beta-HSD 1 mRNA remained unchanged. There was no effect of labor on placental 11beta-HSD 1 and 2 mRNA and protein levels. Maternal betamethasone administration dramatically increased (P <.05) 11beta-HSD 2 mRNA as well as protein without effect on 11beta-HSD 1 mRNA and protein expression. CONCLUSIONS: The late-gestation baboon maternal plasma cortisol concentration is four times the fetal plasma concentration. Decreased placental 11beta-HSD 2 may enhance maternal cortisol passage to the fetus at the end of gestation, thereby contributing to cortisol-mediated changes within the placenta and cortisol in fetal plasma at this stage of fetal development. The positive effect of betamethasone on placental 11beta-HSD 2 induction further suggests an ability of the placenta to regulate glucocorticoid transfer in the presence of elevated maternal glucocorticoid.

11-beta-Hydroxysteroid Dehydrogenase Type 2↗

PubMed2005

Combined orbital floor betamethasone and depot methylprednisolone in uveitis.

PURPOSE: To evaluate the outcome of orbital floor injection of betamethasone and methylprednisolone in the management of uveitis, with particular reference to its efficacy in avoiding increase in systemic immunosuppressive drugs. METHODS: A sample of all patients attending the Uveitis Service at Moorfields Eye Hospital was carried out over a three-month period. All patients who had received one or more orbital floor injections of betamethasone (4 mg) and methylprednisolone (Depo-Medrone; 40 mg) in the management of their uveitis were identified and the case notes reviewed. RESULTS: A total of 48 patients who had received 75 orbital floor injections were identified during the sample period. Most patients had either panuveitis (n = 24) or pars planitis (n = 14). One-month post-injection visual acuity (VA) had improved by at least one Snellen line after 33/75 injections (44%) and at least two lines after 11/75 (15%), was unchanged after 25 (33%), but had deteriorated in 14 (19%). VA was not recorded after 3/75 injections. The only complications recorded were periorbital haemorrhage (n = 1) and complaints of persistent pain after an injection (n = 1). Symptoms (pain and subjective vision) improved after 36/75 injections (47%), were unchanged after 24 (32%), and were reported as worse after five (7%). Additionally, three patients reported an improvement in symptoms which lasted less than one month. Signs other than VA were improved after 28/75 (37%), were unchanged after 38 (51%), and deteriorated after only one injection. Of the 31 patients given orbital floor injections to avoid systemic therapy, seven (23%) subsequently went on to require it, and the clinical course then improved in 45%. CONCLUSIONS: Combined orbital floor injection of betamethasone and methylprednisolone can result in improved visual acuity, symptoms, and signs of inflammation in uveitis, and may therefore avoid the necessity for increased systemic medication.

Adolescent↗

PubMed2006

The first 48 hours: Comparing 12-hour and 24-hour betamethasone dosing when preterm deliveries occur rapidly.

OBJECTIVE: To compare neonatal outcomes when dosing betamethasone every 12 hours compared to the standard 24-hour dosing regimen when premature deliveries occur within 48 hours of presentation. METHODS: A retrospective chart review was performed on preterm deliveries from January 1, 1996 to July 1, 2000. Deliveries that occurred less than 48 hours after initiation of antenatal steroids were analyzed for neonatal outcomes. RESULTS: Betamethasone was given to 562 women, of whom 166 delivered less than 48 hours after beginning therapy. There were no statistically significant differences in the rates of respiratory distress syndrome, surfactant use, chronic lung disease, intraventricular hemorrhage, neonatal death, or other outcomes between the two groups. The only statistically significant difference between the two groups was for venous cord blood pH (7.27 vs. 7.32, p = 0.01). Separating the results into delivery from 0-24 and 24-48 hour groups, there were no significant differences between the 12-hour and 24-hour dosing groups, although small sample size limited conclusions. CONCLUSION: Dosing betamethasone in 12-hour intervals may result in similar neonatal outcomes compared to the standard 24-hour regimen when delivery occurs within 48 hours of therapy initiation.

Adult↗

PubMed2004

Development of a new formulation combining calcipotriol and betamethasone dipropionate in an ointment vehicle.

Calcipotriol and betamethasone dipropionate are widely used effective treatments for psoriasis. Combined therapy is known to be superior to monotherapy, but current formulations do not permit simultaneous application as the drug substances will degrade when mixed. The purpose of the study was to develop a formulation which combines calcipotriol and betamethasone dipropionate in a single vehicle hereby achieving optimal delivery of both substances into the skin. As the two substances are incompatible in aqueous and alcoholic medias, different non-aqueous formulations were prepared. Skin permeation studies were investigated using Franz-type diffusion cells. Formulations based on isopropyl myristate were found to decrease the permeation rate (25-35%) as compared with marketed monotherapy products (set to 100%). Lanolin had no overall effect on skin permeability. However, polyoxypropylene-15 stearyl ether (PSE) had a marked effect. A 5% PSE formulation resulted in a permeation rate comparable to the marketed products. Thus, by using PSE as solvent, it was possible to combine calcipotriol and betamethasone dipropionate in a single formulation while optimal skin permeability was attained. Recently, the efficiency of this formulation (Daivobet) has been verified in clinical studies showing an improved efficacy in the treatment of psoriatic patients.

Administration, Topical↗

PubMed2005

In vitro evaluation of betamethasone-loaded nanoparticles.

The aim of the present work was to investigate the preparation of nanoparticles as a potential drug carrier in the treatment of various inflammatory diseases. A nanoprecipitation method was used to entrap betamethasone in a poly[epsilon-caprolactone] matrix. Process parameters such as the initial drug load, the surfactants (polyvinyl alcohol, PVA; sodium cholate, SC), and their concentration in the aqueous phase were analyzed for their influences on particle properties. Particle size changed with increasing surfactant concentrations (PVA: 250 to 400 nm; sodium cholate: 330 to 150 nm) due to changes in interface stability and viscosity of the aqueous phase. The zeta potential was around neutrality with PVA and between -28 and -42 mV with SC. Betamethasone encapsulation rates of about 75% and 90% slightly increased with higher surfactant concentration. Drug release profiles exhibited an initial burst release with both surfactants, PVA (8-18%) or SC (25-35%) followed by a sustained release delivering 15% to 40% of the entrapped drug within 48 hours. The present nanoparticulate formulations exhibit promising properties of a colloidal drug carrier for betamethasone. Although SC seems to be advantageous due to its biocompatibility, in terms of sustained drug release pattern, the use of PVA is favorable.

Betamethasone↗

PubMed1986

Effect of betamethasone in lungs of mice treated with lymphocytosis-promoting factor of Bordetella pertussis.

The role of betamethasone in the lungs of mice treated with lymphocytosis-promoting factor (LPF) was studied. Intravenous injection with 10 ng of LPF produced significant lymphocytosis and monocytosis five days later. Two groups were also treated with betamethasone: the first with daily administrations and the second at zero-time with LPF. Lymphocytosis was not as high as in the group treated only with LPF (P less than .05), and lymphocytosis was lower in the second group than in the first (P less than .05). In lungs of mice treated with LPF, lymphocytes accumulated relative to lymphoid organs such as the spleen, where a marked depletion was noted. Administration of betamethasone either with LPF or after one day did not cause accumulation of lymphocytes in lungs, whereas increased spleen cellularity was observed. These data were also supported by histological changes, i.e., diminished congestion and edema of the lung and reduction of mononuclear cells in parenchyma.

Animals↗

PubMed1998

Betamethasone reduces postoperative pain and nausea after ambulatory surgery.

UNLABELLED: The aims of this study were to evaluate the effects of a single-dose glucocorticoid on the incidence and severity of pain and nausea and vomiting (PONV) after ambulatory surgery. Seventy-eight ASA physical status I-III patients scheduled for hemorrhoidectomy or hallux valgus correction were studied using a randomized, double-blind, placebo-controlled protocol. One group received 12 mg of betamethasone i.m. 30 min before the start of surgery (Group B), whereas the placebo group (Group P) received saline. General anesthesia was induced with propofol and fentanyl and maintained with isoflurane in both groups. Pain (measured using a visual analog scale, verbal score, and analgesic requirements), PONV, and other side effects were evaluated postoperatively. Patients in Group B experienced significantly less postoperative pain, less PONV, and better patient satisfaction during the first 24 h after surgery. In conclusion, a single dose of betamethasone (12 mg) seemed to produce analgesic and antiemetic effects after day-case surgery. IMPLICATIONS: In a placebo-controlled study, the use of corticosteroid prophylaxis (betamethasone) produced a significant reduction in both postoperative pain and nausea in outpatients who received the corticosteroid injection before ambulatory foot or hemorrhoid operations.

Adult↗