Glucocorticoids drugs

IV.a.1.11. Mineralocorticoid side effects. These are common problems, causing sodium and water retention, hypokalaemia and hypertension. They are often marked with hydrocortisone, but may be seen with high doses of all of the therapeutic glucocorticoid drugs. 

Duanmu, Z., Kocarek, T. A., and Runge-Morris, M. (2001) Transcriptional regulation of rat hepatic aryl sulfotransferase (SULT1A1) gene expression by glucocorticoids. Drug Metab. Dispos. 29, 1130-1135. 

Glucocorticoid therapy is used in trauma, surgery, infections, emotional upsets, and anxiety. Most glucocorticoid drugs are synthetically produced and are administered orally, IM, IV, topically (see Chapter 20), intranasally (see Chapter 14), and as aerosol inhalers (see Chapter 14). 

Although devil s claw has been studied for anti-inflammatory activity, notably in patients with arthritis, studies have indicated that devil s claw does not affect the biosynthesis of prostanoids, and thus is not expected to produce the adverse effects associated with nonsteroidal anti-inflammatory and glucocorticoid drugs (ESCOP 2003 Loew et al. 1996 Moussard et al. 1992 Whitehouse et al. 1983). 

Fluticasone is a glucocorticoid drug that has been used to treat asthma. In the synthesis of fluticasone, the following transformation is used that involves a limiting amount of sodium iodide. Analyze the structure using the chemistry you learned in this chapter and draw the product of the reaction. 

Tolrestat (28) is a long-acang aldose reductase inhibitor useful in the prophylaxis of diabetic neuropathy, retinopathy, and cataracts [24 25] Lastly, the intro-ducuon of fluorine into steroids probably ushered in the modem era of fluonnated drugs Many commercial products were introduced [2] Typical of the products are the anti inflammatory glucocorticoids dexamethasone (29 X = F, Y = H), para-methasone (29, X = H, Y = F), and flumethasone (29, X = H, Y = F)... 

Amongst the —> immunosuppressive agents besides the —> glucocorticoids the modern nontoxic drugs have become drugs of choice including ciclosporin, tacrolimus or ascomycin. 

Corticotropin is used for diagnostic testing of adrenocortical function. This drug may also be used for the management of acute exacerbations of multiple sclerosis, nonsuppurative thyroiditis, and hypercalcemia associated with cancer. It is also used as an anti-inflammatory and immunosuppressant drug when conventional glucocorticoid therapy lias not been effective (see Display 50-1). 

---