Corticosteroids


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Related to Corticosteroids: prednisone, Topical corticosteroids

Corticosteroids

 

biologically active tetracyclic compounds manufactured by the adrenal cortex.

More than 40 compounds have been isolated from the adrenals. Eight of these are active, that is, they can reproduce the effect of adrenocortical extract, known as cortine naturelle (first obtained in 1927). Chemically, the active corticosteroids are pregnane derivatives containing the Δ4-3-keto- and 20-keto-21 hydroxy groups and with oxygen substitutes at the 11C, 17C, or 18C atom. True adrenal hormones include the mineralocorticoid aldosterone, which mostly regulates the metabolism of K+ and Na+ ions; the glucocorticoid hydrocortisone, or cortisol, which regulates carbohydrate metabolism; and corticosterone (17-deoxyhydrocortisone), which performs both of these functions. Cortexone (11-deoxycorticosterone) is a mineralocorticoid. Cortisone is a glucocorticoid. The corticosteroids also participate in the regulation of protein metabolism and fat metabolism. A corticosteroid deficiency results in Addison’s disease. The symptoms of the Itsenko-Cushing syndrome appear when the same hormones are in excess.

The formation, metabolism, and mode of excretion of corticosteroids are species-specific. In the human body, 15–25 mg of hydrocortisone, 1–5 mg of corticosterone, and 0.1–0.2 mg of aldosterone are manufactured daily. In some animals (for example, monkeys, sheep, and guinea pigs) the adrenal cortex produces mainly hydrocortisone. In others (rabbits and rats) it produces mostly corticosterone. Cholesterol is a precursor in the biosynthesis of the corticosteroids. The secretion of corticosteroids is regulated by adrenocorticotropic hormone, which is produced by the pituitary. Some of the corticosteroids in the blood are bound to plasma proteins. They are inactivated in the liver by partial reduction and binding by glucuronic and sulfuric acids. The corticosteroids and their metabolic products are rapidly excreted from the body, mainly with urine.

The corticosteroids are used in substitution therapy and as anti-inflammatory and antiallergic agents in the treatment of many diseases. Synthetic dehydro, hydroxy, halogen, and methyl derivatives of the corticosteroids (prednisone, dexamethazone, triamcinolone, Synalar) have also found practical application, since they are much more active biologically and produce fewer side effects.

REFERENCES

Iudaev, N. A. Biokhimiia steroidnykh gormonov kory nadpochechnikov. Moscow, 1956.
Komissarenko, V. P. Gormony kory nadpochechnikov i ikh roV vfiziologicheskikh i patologicheskikh protsessakh organizma. Kiev, 1956.
Fieser, L., and M. Fieser. Steroidy. Moscow, 1964. (Translated from English.)

M. A. KREKHOVA

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Yes [] No ORAL CORTICOSTEROID USE Within the past 2 years, have you administered a short-term course of oral corticosteroids for musculoskeletal injuries to the High School or College Athlete?
Alternatively, a short course of systemic corticosteroids can be used to gain control of symptoms followed by a step-down in therapy.
Patients using corticosteroids should be warned of the complication of ONFH, especially those with underlying diseases as mentioned above, and should be more alerted when close family members are affected.
Infants born already 3 hours after corticosteroid administration to the mother had significantly lower mortality than those not exposed to the treatment, and corticosteroid administration 6 to 12 hours before birth was associated with halved risks of infant death.
A sixty-year-old right hand dominant woman with a history of right small finger stenosing tenosynovitis and left thumb carpometacarpal joint arthritis presented for corticosteroid injections of both hands.
Previously operated individuals with same disease or individuals who had any contraindication to corticosteroids like hypertension, diabetes mellitus, diabetes insipidus and glaucoma were excluded.
They classified the timing of antenatal corticosteroids into four categories: no injections (662 infants, or 14.
A single course of betamethasone is recommended for pregnant women between 34 0/7 and 36 6/7 weeks of gestation at risk of preterm birth within 7 days, and who have not received a previous course of antenatal corticosteroids.
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Patients with skin diseases who were on topical corticosteroids were included.
In summary, this manuscript highlights the facts that the use of corticosteroids in IPH management is a heavily debated topic that needs further in- vestigation to clarify the existing conflicts.
Key clinical point: Pimecrolimus cream is a safe, effective alternative to topical corticosteroids for atopic dermatitis beginning in infancy.

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