Glucocorticoids

 

glucocorticoids-01

Classification:

1.Natural Cortisol(t½:1-1.5hr)

Hydrocortisone

2.Synthetic [A]Short acting

(8-12 hours)

Prednisolone

Prednisone

Methyl-prednisolone

[B]Intermediate acting

(12-36 hours)

Flu-prednisolone

Paramethasone

Triamcinolone

[C]Long acting

(36-72 hours)

Dexamethasone

Betamethasone

Beclomethasone

Mechanism of action/ Prednisolone/Dexamethasone/Glucocorticoids::

Glucocorticoids

Enter into the cell

Bind with specific protein in the cytoplasm

Steroid receptor complex

The complex enters into the nucleus

Binds with (GRE)glucocorticoid receptor element of specific gene

Transcription reaction

mRNA in the cytoplasm

Synthesis of new protein

New protein is responsible for various effects of steriod.

Adverse effect /Prednisolone/Dexamethasone/ Glucocorticoids:

1)      Cushing’s syndrome.

2)      Avascular necrosis of bone.

3)      Insomnia.

4)      Diabetic mellitus.

5)      Glucoma.

6)      Increased intra-cranial pressure.

7)      Fever.

8)      Nausea,dizzines,weight.

Indications/Prednisolone/Dexamethasone/Glucocorticoids:         

1)      Allergic reaction:

  • Asthma.
  • Allergic rhinitis.
  • Urticaria.
  • Anphylactic shock.

2)      Bone and joint disease:

  • Arthritis.
  • Bursitis.
  • Sinuvitis.

3)      Collagen vascular disease:

  • SLE.
  • Rheumatoid arthritis.

4)      Dermatological diseases:

  • Atopic dermatitis.
  • Contact dermatitis.
  • Seborrheic dermatitis.

5)      Eye disease:

  • Acute uveitis.
  • Choroiditis.
  • Optic neuritis.

6)      Joint disease.

7)      Kidney disease:nephrotic syndrome.

8)      Lung disease:

  • Bronchial asthma.
  • Infant respiratory distress.
  • Aspiraton pneumonia.

9)      Neurological disorders:

  • Cerebral oedema.
  • Multiple sclerosis.

10)  Sub-acute thyroiditis.

Contraindication:

1)      Cushing syndrome(absolute contraindication)

2)      Peptic ulcer.

3)      DM.

4)      Infection.

5)      Osteoporosis.

6)      HTN.

7)      CCF.

8)      Children(because glucocorticoids cause growth reterdation).

9)      Psychosis.

10)  Glaucoma.

11)  Epilepsy.

12)  TB.

13)  Renal dysfunction.

14)  Thrombo-embolism.

Difference between Prednisolone & Ketoprofen:

Trait Prednisolone Ketoprofen
1.Type Steroidal anti-inflammatory Non-steroidal anti-inflammatory
2.M/A Inhibit phospholipase A2→No arachidonic acid synthesis from member phospholipids→ so no PG,LT→ anti-  inflammatory action Inhibit cycloxygenase→No PG synthesis from arachidonic acid→So no mediators of inflammation→Anti-inflammatory action
3.Adverse effects Cushing syndrome,

Insomnia,DM,Avascular necrosis of bone.

PUD,Headache,Dizziness, Neutropenia.

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