Glucocorticoids bronchial asthma

Glucocorticoids Immunosuppressive Agents Bronchial Asthma Allergy... 

A 37-year-old woman who was pregnant developed Churg-Strauss syndrome after withdrawal of her usual high-dose inhaled glucocorticoid therapy (drug not stated) that she had used for 3 years for bronchial asthma (148). 

All of these hormones produce their effects after a characteristic lag period of 30 minutes to several hours—the time required for the synthesis of new proteins. This means that the gene-active hormones cannot be expected to alter a pathologic state within minutes (eg, glucocorticoids will not immediately relieve the symptoms of acute bronchial asthma). 

The adrenal cortex synthesizes corticosteroids (glucocorticoids and mineralocor-ticoids), which differ in activities. In humans, cortisol is the main glucocorticoid, and aldosterone is a main mineralocorticoid. Steroid therapy causes severe potential side effects, hence a careful consideration is always exercised before starting therapy. These are used in variety of disorders such as rheumatic disorder, renal disease, allergic manifestation, bronchial asthma, skin diseases, infectious diseases, malignancy, and hepatic diseases. 

Bone mineral density, bone turnover markers, and adrenal glucocorticoid hormones have been measured in 53 patients (34 women, 19 men) with chronic bronchial asthma who took either inhaled beclomethasone or budesonide in doses of at least 1500 micrograms/day for at... 

Lane SJ, Arm JP, Staynov DZ, et al Chemical mutational analysis of the human glucocorticoid receptor cDNA in glucocorticoid-resistant bronchial asthma. Am J Respir Cell Mol Biol 1994 11 42-48. (NC)... 

Nedocromil, a well-tolerated drug (2 inhalations 4 times a day at regular intervals to provide 14 mg/day), is indicated for maintenance therapy in the management of patients with mild to moderate bronchial asthma. Nedocromil has no intrinsic bronchodilating, glucocorticoid, or antihistaminic properties. Therefore, it should not be used in stams asth-maticus (see also Figure 94). 

Steroids are administered therapeutically in chronic and acute adrenal insufficiency. In addition, glucocorticoids are often administered for their anti-inflammatory effect to treat rheumatoid and osteoarthritis, bronchial asthma, and certain skin diseases or malignancies. 

Vachier I, Chiappara G, Vignola AM, Gagliardo R, Altieri E, Terouanne B, Bous-quet J, Godard P, Chanez P. Glucocorticoid receptors in bronchial epithelial cells in asthma. Am J Respir Crit Care Med 1998 158 963-970. 

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