Anti-inflammatory drug glucocorticoids

Desired effects. As anti-allergies, immunosuppressants, or anti-inflammatory drugs, glucocorticoids display excellent efficacy against undesired inflammatory reactions. 

Garcia Rodriguez LA, Hernandez-Diaz S. The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents. Arthritis Res 2001 3(2) 98-101. 

Anti-inflammatory Drugs that reduce inflammation, including the non-steroidal antiinflammatory drugs (NSAIDs) aspirin, ibuprofen and indomethacin and the glucocorticoids (e.g., dexamethasone and cortisol). 

A large amount of clinical data is available on some of the common anti-inflammatory drugs such as glucocorticoids and NSAIDs. Coupling of these drugs to drug carriers may favourably affect kinetics and metabolism, thereby improving effectiveness and safety. So,... 

The introduction of a 9a-fluoro substituent increases anti-inflammatory activity, but it increases mineralocor-ticoid activity even more (300x). Fludrocortisone acetate is of little value as an anti-inflammatory, but it is employed as a mineralocorticoid. On the other hand, additional modifications may be employed. Introduction of a 1,2-double bond increases glucocorticoid activity over mineralocorticoid activity, and a 16-methyl group reduces mineralocorticoid activity without affecting glucocorticoid activity. A combination of these three structural modifications gives valuable anti-inflammatory drugs, e.g. betamethasone, with hardly any mineralocorticoid activity. ... 

Nonsteroidal anti-inflammatory drugs, such as indomethacin and phenylbutazone, are also effective. In severe cases, glucocorticoids may be indicated. 

Pharmacotherapy. Acute relief of inflammatory symptoms can be achieved by prostaglandin synthase inhibitors nonsteroidal anti-inflammatory drugs, or NSAlDs, such as diclofenac, indomethacin, piroxicam, p. 200), and glucocorticoids (p. 248). The inevitably chronic use of NSAlDs is likely to cause adverse effects. Neither NSAlDs nor glucocorticoids can halt the progressive destruction of joints. 

All the glucocorticoids are absorbed from the skin, and are effectively are used as anti-inflammatory drugs. Following oral inhalation, glucocorticoids are absorbed from the gastrointestinal and respiratory tracts. 

Cryotherapy Cold/ice packs Ice massage Cold bath Vapocoolant sprays Decreased pain, edema, and inflammation Muscle relaxation and decreased spasticity Anti-inflammatory steroids (glucocorticoids) nonsteroidal anti-inflammatory analgesics (aspirin and similar NSAIDs) Skeletal muscle relaxants Peripheral vasodilators may exacerbate acute local edema Nonselective cholinergic agonists may stimulate the neuromuscular junction Some forms of cryotherapy may produce local vasoconstriction that temporarily impedes diffusion of drugs to the site of inflammation... 

The glucocorticoids also have powerful anti-inflammatory effects and when first introduced were considered to be the ultimate answer to the treatment of inflammatory arthritis. Unfortunately, the toxicity associated with chronic corticosteroid therapy limits their use except in the control of acute flare-ups of joint disease. Therefore, the nonsteroidal anti-inflammatory drugs have assumed a major role in the long-term treatment of arthritis. 

Step 2. If p2-mimetics have to be used more frequently than once a week, more severe disease is present. At this stage, management includes anti-inflammatory drugs, preferably an inhalable glucocorticoid... 

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