A patient comes to the clinic for a follow-up appointment after using a glucocorticoid ointment for eczema for 3 weeks

Question

Because the patient is pleased with the results, she states that she would like to continue treatment with an oral glucocorticoid. What response from the nurse is most appropriate?
a. "Oral glucocorticoids are only indicated if topical glucocorticoids have been ineffective."
b. "Oral glucocorticoids will have fewer side effects, so your suggestion is good."
c. "You make an excellent point! Topical glucocorticoids can cause skin atrophy, whereas oral agents don't have the same effect."
d. "Oral glucocorticoids are more convenient to use, so I agree with your suggestion."

Answer 1

ANS: A
The nurse should tell the patient that there is no basis for administration of oral glucocorticoids, because the topical agent has been effective.
Oral glucocorticoids have more serious side effects (e.g., adrenal suppression), and there is no basis for their use.
Whether applied topically or taken orally, glucocorticoids can still lead to skin atrophy.
Convenience is not an adequate reason for switching to oral agents when the topical agents have been effective.