Corticosteroid drugs

Fig. 18. Partial synthesis of corticosteroid drugs 9a- uoro-16a-hydroxyhydrocortisone [337-02-0] (129), triamcinolone [124-94-7] (130), prednisolone...

Adverse reactions to sulfites appear to occur mainly among a small percentage of asthmatics, but it is possible for individuals without asthma to be sulfite sensitive. It is typically more of a problem in individuals with severe asthma who are also taking corticosteroid drugs to control their disease. Among these individuals, the prevalence of sulfite sensitivity is about 8%, while it is about 1% in asthmatics who are not dependent on steroids (Taylor and Bush, 1986). 

Keywords Anticholinergics asthma p-agonist corticosteroids drug response genetic association leukotriene polymorphisms. 

Corticosteroids are produced by the adrenal glands, and display two main types of biological activity. Glucocorticoids are concerned with the synthesis of carbohydrate from protein and the deposition of glycogen in the liver. They also play an important role in inflammatory processes. Mineralocorticoids are concerned with the control of electrolyte balance, promoting the retention of Na+ and CC, and the excretion of K+. Synthetic and semi-synthetic corticosteroid drugs are widely used in medicine. Glncocorticoids are primarily nsed for their antirhenmatic and anti-inflammatory activities, and mineralocorticoids are nsed to maintain electrolyte balance where there is adrenal insufficiency. 

Isaksson M. Skin reactions to inhaled corticosteroids. Drug Saf 2001 24(5) 369-73. 

CORTICOSTEROIDS DRUG DEPENDENCE THERAPIES-BUPROPION t risk of seizures. This risk is marked in elderly people, in patients with a history of seizures, with addiction to opiates/cocaine/ stimulants, and in diabetics treated with oral hypoglycaemics or insulin Bupropion is associated with a dose-related risk of seizures. These drugs, which lower seizure threshold, are individually epileptogenic. Additive effects occur when combined Extreme caution. The dose of bupropion should not exceed 450 mg/day (or 150 mg/day in patients with severe hepatic cirrhosis)... 

Candida albicans) after they received high doses of cytotoxic, immunosuppressive, or corticosteroid drugs. By monitoring the D/L arabinitol ratio, fungal infections can be diagnosed early enough to permit effective—in some cases, life-saving—treatment. The separation of trifluoroacetylated arabinitol is depicted in Fig. 14,... 

Edsbacker S. Pharmacological factors that influence the choice of inhaled corticosteroids. Drugs 1999 58(suppl 4) 7 16. 

Apart from classic analgesic nephropathy, this chapter will also handle the possible nephrotoxic role of 5-aminosalicylic acid (5-ASA) used in patients with chronic inflammatory bowel disease (IBD). During the last decade, 5-ASA replaced sulfasalazine as first-line therapy for mildly to moderately active IBD. For decades, sulphasalazine, an azo-compound derived from sulphapyridine and 5-aminosalicylic acid (5-ASA), has been the only valuable non-corticosteroid drug in the treatment of inflammatory bowel disease. Azad Kahn et al. [25] showed that the pharmacologically active moiety in sulphasalazine for the treatment of these diseases was 5-ASA. Consequently, this resulted in a number of new 5-ASA formulations (mesalazine, olsalazine, balsalazine) for topical and oral use. Since the metabolite sulphapyridine was largely responsible for the side effects of sulfasalazine, the primary advantage of the newer 5-ASA agents is their improved adverse effect profile. 

Once skeletal maiurily has been attained, it is the magnitude of the subsequent bone loss which may lead to osteoporosis. Tlie use of corticosteroid drugs should be minimized. Stopping smoking is impttrtant. At the menopause, hormone replacement iherapy is of benefit, not only for the relief of menopausal symptoms but also to prevent rapid bone loss. Indeed, cardiovascular protection also follows as an incidental benefit of such therapy. 

Formation of charge transfer complexes UV spectral measurements of tranquilizers and antidepressants like chloropromazine, promethazine, promazine, thioridazone, progesterone, imprimane, and amitriptyline, hydrazines, pyrazolones, and corticosteroid drugs resulted in their determination at trace levels via formation of charge transfer complexes. 

Kendall, Edward Calvin (1886-1972) U.S. biochemist who studied the hormones produced by the outer zone (cortex) of the adrenal gland and, from his findings, synthesized cortisone. This led to the valuable range of corticosteroid drugs. In 1950, Kendall and his colleague, Philip Hench, were awarded the Nobel Prize in physiology or medicine. 

Table 12.1 Skin test concentrations for some commonly used corticosteroid drugs...

The skin lesion improved after the discontinuation of the ATDs and treatment with oral antihistamine and topical corticosteroid drugs. Streptomycin, Emb and ofloxacin were administered as second-line ATT during the patient s hospitalisation. No adverse reactions were observed. 

---