Corticosteroids interaction

Corticosteroids interact with barbiturates, carbamazepine, phenytoin, primidone, frusemide, thiazide, NSAIDs, antidiabetics, and antihypertensive drugs. Benzquinamide hydrochloride is incompatible with chlordiazepoxide, diazepam, and some barbiturates. Care should be exercised when handling bisacodyl to avoid contact with skin and mucosal membranes. 

GENERAL MECHANISMS EOR CORTICOSTEROID EFFECTS Corticosteroids interact with specific receptor proteins in target tissues to regulate the expression of corticosteroid-responsive... 

Johnson M (2004) Interactions between corticosteroids and beta2-agonists in asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc 1 200-6... 

Corticosteroids may be given in high doses for some arthritic disorders. Many adverse reactions are associated with high-dose and long-term corticosteroid therapy. Chapter 50 discusses some of the adverse reactions associated with corticosteroid therapy. A comprehensive list of adverse reactions is provided in Display 50-2. Contraindications, precautions, and interactions of the corticosteroids are discussed in Chapter 50. 

Theophylline is also considered an alternative to inhaled corticosteroids for the treatment of mild persistent asthma however, limited efficacy compared to inhaled corticosteroids, a narrow therapeutic index with life-threatening toxicity, and multiple clinically important drug interactions have severely limited its use. Theophylline causes bronchodilation through inhibition of phosphodiesterase and antagonism of adenosine and appears to have anti-inflammatory and immunomodulatory properties as well.36... 

For patients receiving corticosteroids, monitor for adverse effects and drug interactions. Does the patient need Gl prophylaxis for long-term treatment Slowly taper once symptoms improve and/or radiation is completed. 

Evaluate the patient for drug interactions, allergies, and adverse effects with chemotherapy and/or corticosteroid therapy. 

Ligand-bound corticosteroid receptors have been shown to interact to form heterodimers with other transcription factors, such as the jun protein. Such interactions are responsible for transactivation of the ds-regulatory sites known as AP-1 sites and for the glucocorticoid-mediated suppression of transcription, such as that seen in the pro-opiomelanocortin gene. A number of such specific protein interactions have been reported these interactions and their locations relative to other transcription factors transform a ubiquitous steroid hormone signal into a tissue-specific, graded cellular response. 

The interaction between the adrenal cortex of the foetus and the placenta in production of steroid hormones is complex. In outline, the placenta produces progesterone from cholesterol (which is available from the maternal blood) whereas the foetal adrenal cortex produces corticosteroids and androgens from the progesterone produced in the placenta. The placenta then converts some of these androgens into oestrogens. The interplay between the placenta and the foetal adrenal cortex is acknowledged by the use of the term foeto-placental unit to describe steroido-... 

The a- and /8-globulins of the plasma also form an important group of binding proteins and a number of them have been isolated and found to have a high affinity, but relatively low capacity, for a variety of endogenous and chemically related synthetic compounds. Westphal (W7) has reviewed the extensive literature on the interaction of corticosteroids... 

Drug/Lab test interactions Trans ent elevations of plasma 11-hydroxy-corticosteroid levels (Glenn-Nelson technique) may occur when IV calcium is administered, but levels return to control values after 1 hour. In addition, IV calcium gluconate can produce false-negative values for serum and urinary magnesium. 

Drug/Lab test interactions Plasma corticosteroid levels may be increased. Urinary steroid determinations may be altered by amphetamines. 

Drugs that may interact with rifabutin include the following Anticoagulants, azole antifungal agents, benzodiazepines, beta blockers, buspirone, corticosteroids, cyclosporine, delavirdine, doxycycline, hydantoins, indinavir, rifamycins, losartan, macrolide antibiotics, methadone, morphine, nelfinavir, quinine, quinidine, theophylline, aminophylline, tricyclic antidepressants, and zolpidem. 

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