Corticosteroids immunosuppressive action

Corticosteroids (e.g., beclomethazone, flunisolide, triamcinolone) have anti-inflammatory and immunosuppressant actions. These drugs are used prophylactically to prevent the occurrence of asthma in patients with frequent attacks. Because they are not useful during an acute attack, corticosteroids are prescribed along with maintenance bronchodilators. These drugs are also administered by inhalation. Cromolyn is another anti-inflammatory agent used prophylactically to prevent an asthmatic attack. The exact mechanism of action of cromolyn is not fully understood however, it is likely to involve the stabilization of mast cells. This prevents the release of the inflammatory mast cell mediators involved in inducing an asthmatic attack. Cromolyn has proven effective in patients with exercise-induced asthma. 

Pneumococcal Vaccine, Polyvalent (Pneumovox-23) [Vaccine/ Inactive Bacteria] Uses Immunization against pneumococcal Infxns in pts at high risk (eg, all = 65 y of age) Action Active immunization Dose 0.5 mL EM. Caution [C, ] Contra Do not vaccinate during immunosuppressive thCTapy Disp Inj SE Fever, inj site Rxn, hemolytic anemia, thromboc5rtopenia, anaphylaxis Interactions Effects W/ corticosteroids, immunosuppressants EMS None OD ... 

Hepatitis A (Inactivated) Hepatitis B (Recombinant) Vaccine (Twinrix) [Vaccine/lnactivated] Uses Active immunization against Hep A/B Action Active immunity Dose 1 mT, IM at 0, 1, 6 mo Caution [C, +] Contra Component sensitivity Disp Single-dose vials, syringes SE Fever, fatigue, pain at site, HA Interactions X- Immune response w/ corticosteroids, immunosuppressants EMS None OD Unlikely... 

Hepatitis B Vaccine (Engerix-B, Recombivax HB) [Vaccine/ Inactivated] Uses Prevent Hep B Action Active immunization recombinant DNA Dose Adults. 3 EM doses 1 mL each 1st 2 doses 1 mo apart the 3rd 6 mo after the 1st Peds. 0.5 mL EM adult schedule Caution [C, +] 1 effect w/ immunosuppressives Contra Yeast allergy Disp Engerix-B Inj 20mcg/mL peds inj 10 mcg/0.5 mL Recombivax HB Inj 10 40 mcg/mL peds inj 5 mcg/0.5 mL SE Fever, inj site pain Interactions i Immune response W/ corticosteroids, immunosuppressants EMS None OD Unlikely... 

The interrelationship between the antiinflammatory and immunosuppressive actions of corticosteroids on the one hand and, on the other, the body s allergic responses to the drugs. 

Echinacea (Echinacea purpurea) Uses immune system stimulant prevention/Rx of colds, flu as supportive th apy for colds chronic infxns of the resp tract lower urinary tract Action Stimulates phagocytosis cytokine production T resp cellular activity topically exerts anesthetic, antimicrobial, anti-inflammatory effects Efficacy Not established may X severity duration of URI Available forms Caps w/ powdered herb equivalent to 300-500 mg, PO, tid pressed juice 6-9 mL, PO, once/d tine 2-4 mL, PO, tid (1 5 dilution) tea 2 tsp (4 g) of powdered herb in 1 cup of boiling water Noles/SE Fever, taste p -version, urticaria, angioedema Contra w/ autoimmune Dz, collagen Dz, progressive systemic Dz (TB, MS, collagen-vascular disorders), HIV, leukemia, may interfere w/ immunosuppressive therapy Interactions t Risk of disulfiram-like reaction W/ disulfiram, metronidazole T risk of exacerbation of HIV or AIDS W/ chinacea amprenavir, other protease inhibitors X effects OF azathioprine, basiliximab, corticosteroids, cyclosporine, daclizumab, econazole vag cream, muromonab-CD3, mycophenolate, prednisone, tacrolimus EMS Possible immunosuppression... 

CONTENTS Introduction to the Series An Editor s Foreword, Albert Padwa. Preface, Bruce E. Maryanoff and Cynthia A. Maryanoff. Computer Assisted Molecular Design Related to the Protein Kinase C Receptor, Paul A. Wenderand Cynthia M. Cribbs. Chemistry and Biology of the Immunosuppressant (-)-FK-506, Ichiro Shinkai and Nolan H. Sigal. The Development of Ketorolac Impact on Pyrrole Chemistry and on Pain Therapy, Joseph M. Muchowski. Application of Silicon Chemistry in the Corticosteroid Field, Douglas A. Livingston. Hu-perzine A-A Possible Lead Structure in the Treatment of Alzheimers Disease, Alan P. Kozikowski, X.C, Tang and Israel Hanin. Mechanism-Based-Dual-Action Cephalosporins, Harry A. Albrecht and James G. Christenson. Some Thoughts on Enzyme Inhibitors and the Quiescent Affinity Label Concept, Mien Krantz Index. 

The main drugs used in the treatment of ulcerative colitis and Crohn s disease are the aminosalicylates and corticosteroids. Their mode of action is obscure. Other immunosuppressives also have a role and recent studies into the mechanisms of inflammation are leading to the introduction of novel therapies to inhibit the inflammatory process. 

The glucocorticoids are immunosuppressants both by virtue of their antiinflammatory properties and their actions against the immune responses. The basis of these is discussed under other headings see antiinflammatory agents corticosteroids glucocorticoids. 

The corticosteroid prednisone is used extensively as an immunosuppressant in autoimmune diseases and organ transplantation. Glucocorticoids have multiple actions, including those described. The answer is (E). 

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