During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.
These eye drops and ointments contain a combination of a steroid and one or more types of antibiotic for treatment of infection and inflammation of the eye. The steroid reduces inflammation while the antibiotic treats or prevents infection which may be the cause of the infection. Examples of steroids that are used in these eye drops are hydrocortisone, loteprednol, prednisolone, and dexamethasone . Examples of antibiotics used in these formulations include tobramycin, neomycin, bacitracin, polymixin B, and gentamycin. These antibiotics have different mechanisms of action and two or three may be combined in one formulation.