Corticosteroids disease, specific agents

The synthetic analogs of cortisol are useful in the treatment of a diverse group of diseases unrelated to any known disturbance of adrenal function (Table 39-2). The usefulness of corticosteroids in these disorders is a function of their ability to suppress inflammatory and immune responses, as described above. In disorders in which host response is the cause of the major manifestations of the disease, these agents are useful. In instances where the inflammatory or immune response is important in controlling the pathologic process, therapy with corticosteroids may be dangerous but justified to prevent irreparable damage from an inflammatory response—if used in conjunction with specific therapy for the disease process. 

More specific therapeutic measurements can include treatment with bronchodilators such as oral or aerosol Pg agonists or oral theophylline preparations. The mechanism of action of these drugs has been thoroughly described in the section of this chapter that deals with the treatment of asthma (Section 5.1). Even if there is not an initial reversal of airway obstruction with these agents, they may be helpful over the long term and should be continued if side effects are not evident. Corticosteroid treatment may also be helpful in patients with a reversible component to their disease and should be given a 3- to 4-week trial to determine potential usefulness. 

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