Showing posts with label Corticosteroid (Glucocorticoid). Show all posts
Showing posts with label Corticosteroid (Glucocorticoid). Show all posts

Dexamethasone (Decadron)

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Name: Dexamethasone (Decadron)

Class: Corticosteroid (Glucocorticoid)

Mechanism: ­ PMNs in periph. blood, but decrease all other WBCs. Inhib. monocyte reactivity and secretion of IL-1 & TNF. Inhib. T cell activation, IgE-med. rxns, inducible cyclooxygenase II expression. Induces lipocortin ® inhibition of phospholipase A2.

Absorption: IV, IM, Oral, topical, intraarticular.

Dist.: Metabolism.: Excretion, : 36-72 hr.

Toxicity/S.E.s: Cataracts, hypertension, osteoporosis, myopathy, obesity, acne, hirsutism, hyperglycemia, muscle atrophy/myopathy, convulsions, mood changes, derm. changes, ¯ cellular immunity. Glucocorticoid admin > equiv. of 20 mg hydrocortisone/d ® suppression of HPA axis. Sudden stop of chronic therapy ® impaired physiologic homeostasis. Drug Interactions—phenytoin, barbiturates, & rifampin induce catabolic enzymes; antacids ® ¯ bioavailability of prednisone; salicylate levels reduced; increased doses required for insulin, hypoglycemic agents, antihypertensives, and glaucoma meds; if hypokalemia occurs, increased toxicity of digoxin.

Utility: Intraarticular injxn. to reduce inflamm. Immunosuppression, anti-inflammatory actions, cytostatic actions against some lymphocyte tumors, mgt. of allergic diseases.

Special Features: Rel. anti-inflamm. potency of 20-30. Synth. agents have potent anti-inflamm. activity w/little (if any) mineralocorticoid effect.

 

Triamcinolone acetonide (Azmacort)

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Name: Triamcinolone acetonide (Azmacort)

Class: Corticosteroid (Glucocorticoid)

Mechanism: ­ PMNs in periph. blood, but decrease all other WBCs. Inhib. monocyte reactivity and secretion of IL-1 & TNF. Inhib. T cell activation, IgE-med. rxns, inducible cyclooxygenase II expression. Induces lipocortin ® inhibition of phospholipase A2.

Absorption: IM, aerosol, oral, topical, intraarticular.

Dist.: Metabolism.: Excretion, : 12-36 hr.

Toxicity/S.E.s: Cataracts, hypertension, osteoporosis, myopathy, obesity, acne, hirsutism, hyperglycemia, muscle atrophy/myopathy, convulsions, mood changes, derm. changes, ¯ cellular immunity. Glucocorticoid admin > equiv. of 20 mg hydrocortisone/d ® suppression of HPA axis. Sudden stop of chronic therapy ® impaired physiologic homeostasis. Drug Interactions—phenytoin, barbiturates, & rifampin induce catabolic enzymes; antacids ® ¯ bioavailability of prednisone; salicylate levels reduced; increased doses required for insulin, hypoglycemic agents, antihypertensives, and glaucoma meds; if hypokalemia occurs, increased toxicity of digoxin. Aerosol—oral candidiasis, dysphonia.

Utility: Asthma. Intraarticular injxn. to reduce inflamm. Immunosuppression, anti-inflammatory actions, cytostatic actions against some lymphocyte tumors, mgt. of allergic diseases.

Special Features: Rel. anti-inflamm. potency of 5. Synth. agents have potent anti-inflamm. activity w/little (if any) mineralocorticoid effect.

 

Beclomethasone diproprionate (Beclovent)

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Name: Beclomethasone diproprionate (Beclovent)

Class: Corticosteroid (Glucocorticoid)

Mechanism: ­ PMNs in periph. blood, but decrease all other WBCs. Inhib. monocyte reactivity and secretion of IL-1 & TNF. Inhib. T cell activation, IgE-med. rxns, inducible cyclooxygenase II expression. Induces lipocortin ® inhibition of phospholipase A2.

Absorption: Aerosol, nasal pump spray, oral, topical.

Dist.: Metabolism.: Excretion, :

Toxicity/S.E.s: Cataracts, hypertension, osteoporosis, myopathy, obesity, acne, hirsutism, hyperglycemia, muscle atrophy/myopathy, convulsions, mood changes, derm. changes, ¯ cellular immunity. Glucocorticoid admin > equiv. of 20 mg hydrocortisone/d ® suppression of HPA axis. Sudden stop of chronic therapy ® impaired physiologic homeostasis. Drug Interactions—phenytoin, barbiturates, & rifampin induce catabolic enzymes; antacids ® ¯ bioavailability of prednisone; salicylate levels reduced; increased doses required for insulin, hypoglycemic agents, antihypertensives, and glaucoma meds; if hypokalemia occurs, increased toxicity of digoxin. Aerosol—oral candidiasis, dysphonia.

Utility: Asthma, allergic rhinitis. Immunosuppression, anti-inflammatory actions, cytostatic actions against some lymphocyte tumors, mgt. of allergic diseases.

Special Features: Synth. agents have potent anti-inflamm. activity w/little (if any) mineralocorticoid effect.


 

Hydrocortisone/Cortisol

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Name: Hydrocortisone/Cortisol

Class: Corticosteroid (Glucocorticoid)

Mechanism: ­ PMNs in periph. blood, but decrease all other WBCs. Inhib. monocyte reactivity and secretion of IL-1 & TNF. Inhib. T cell activation, IgE-med. rxns, inducible cyclooxygenase II expression. Induces lipocortin ® inhibition of phospholipase A2.

Absorption: IV, IM, oral, topical.

Dist.: Metabolism.: Excretion, : 8-12 hr.

Toxicity/S.E.s: Cataracts, hypertension, osteoporosis, myopathy, obesity, acne, hirsutism, hyperglycemia, muscle atrophy/myopathy, convulsions, mood changes, derm. changes, ¯ cellular immunity. Glucocorticoid admin > equiv. of 20 mg hydrocortisone/d ® suppression of HPA axis. Sudden stop of chronic therapy ® impaired physiologic homeostasis. Drug Interactions—phenytoin, barbiturates, & rifampin induce catabolic enzymes; antacids ® ¯ bioavailability of prednisone; salicylate levels reduced; increased doses required for insulin, hypoglycemic agents, antihypertensives, and glaucoma meds; if hypokalemia occurs, increased toxicity of digoxin.

Utility: IV/IM for asthma. Immunosuppression, anti-inflammatory actions, cytostatic actions against some lymphocyte tumors, mgt. of allergic diseases.

Special Features: Rel. anti-inflamm potency = 1. Synth. agents have potent anti-inflamm. activity w/little (if any) mineralocorticoid effect.


 

Prednisone

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Name: Prednisone

Class: Corticosteroid (Glucocorticoid)

Mechanism: ­ PMNs in periph. blood, but decrease all other WBCs. Inhib. monocyte reactivity and secretion of IL-1 & TNF. Inhib. T cell activation, IgE-med. rxns, inducible cyclooxygenase II expression. Induces lipocortin ® inhibition of phospholipase A2.

Absorption: IV, IM, oral.

Dist.:

Metabolism.:

Excretion, :

Toxicity/S.E.s: Cataracts, hypertension, osteoporosis, myopathy, obesity, acne, hirsutism, hyperglycemia, muscle atrophy/myopathy, convulsions, mood changes, derm. changes, ¯ cellular immunity. Glucocorticoid admin > equiv. of 20 mg hydrocortisone/d ® suppression of HPA axis. Sudden stop of chronic therapy ® impaired physiologic homeostasis. Drug Interactions—phenytoin, barbiturates, & rifampin induce catabolic enzymes; antacids ® ¯ bioavailability of prednisone; salicylate levels reduced; increased doses required for insulin, hypoglycemic agents, antihypertensives, and glaucoma meds; if hypokalemia occurs, increased toxicity of digoxin.

Utility: Oral for asthma. Immunosuppression, anti-inflammatory actions, cytostatic actions against some lymphocyte tumors, mgt. of allergic diseases.

Special Features: Synth. agents have potent anti-inflamm. activity w/little (if any) mineralocorticoid effect.