Acting Glucocorticoids

Administration of a short-acting glucocorticoid on alternate days and before 9 AM, when glucocorticoid plasma levels are still relatively high, does not affect the release of ACTH later in the day, yet it gives the patient the benefit of exogenous glucocorticoid therapy. 

Administer glucocorticoid treatment every other day (calculate the total 48-hour dose and give as a single dose of intermediate-acting glucocorticoid in the morning).4... 

Mechanism of Action A long-acting glucocorticoid that inhibits accumulation of inflammatory cells at inflammation sites, phagocytosis, lysosomal enzyme release and synthesis, and releaseof mediators of inflammation. Therapeutic Effect Prevents and suppresses cell and tissue immune reactions and inflammatory process. Pharmacohinetics Rapidly, completely absorbed from the G1 tract after oral administration. Widely distributed. Protein binding High. Metabolized in the liver. Primarily excreted in urine. Minimally removed by hemodialysis. Half-life 3-4.5 hr. 

It is a selective and very potent long acting glucocorticoid. It causes suppression of pituitary adrenal axis. Used in shock due to trauma, allergic emergencies, rheumatoid arthritis, asthma, nephrotic syndrome and suppression of inflammation in eye and skin disorders. 

Long-acting agents, such as salmeterol and formoterol, have superseded short-duration bronchodilators such as albuterol and fenoterol. In addition, more potent, site-specific, rapid-onset, and long-acting glucocorticoids, such as fluticasone and budesonide, have superseded the delayed onset of action of less specific molecules such as beclomethasone. 

Methylprednisolone is an intermediate-acting glucocorticoid with no mineralocorticoid properties (see also Tables 11 and 14). Glucocorticoids are used in ... 

Betamethasone is an extremely potent long-acting glucocorticoid having a 20-30 folds enhanced activity in comparison to cortisol. It has been duly observed that it veiy rarely causes induction of sodium and water retention, and potassium depletion viz., co-treatment with cortisone and several other adrenal corticoids. 

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