Glucocorticoids immunosuppressants

Glucocorticoids Osteoporosis occurs in Cushing s disease and in patients treated with glucocorticoids for immunosuppression. Glucocorticoids are used in the treatment of hypercalcemia. Decrease intestinal Ca + absorption may antagonize 1,25-(0H)2D or PTH may directly stimulate parathyroids may have direct effects on intestine and bone independent of PTH and 1,25-(0H)2D. 

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

Glucocorticoids Immunosuppressive Agents Bronchial Asthma Allergy... 

Glucocorticoids belong to the oldest immunosuppressive agents given to transplant recipients and are... 

In the pathogenesis of many chronic inflammatory diseases (e.g., rheumatoid arthritis, glomerulonephritis, colitis ulcerosa, Morbus Crohn, atopic dermatitis, psoriasis) autoimmune processes play an important role, too. Although first of all nonsteroidal antiinflammatory agents or glucocorticoids should be applied, immunosuppressive agents may also be indicated. 

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). 

Of the following mechanisms of anti-inflammatory and immunosuppressive effects of glucocorticoids, which one is uniformly observed ... 

Treatment of IBD centers on agents used to relieve the inflammatory process. Salicylates, glucocorticoids, antimicrobials, and immunosuppressive agents are commonly used to treat active disease and, for some agents, to lengthen the time of disease remission. 

The major types of drug therapy used in IBD include aminosalicylates, glucocorticoids, immunosuppressive agents (azathioprine, mercaptopu-rine, cyclosporine, and methotrexate), antimicrobials (metronidazole and ciprofloxacin), and agents to inhibit tumor necrosis factor-a (TNF-a) (anti-TNF-a antibodies). 

De Bosscher, K., Vanden Berghe, W., and Haegeman G., Mechanisms of anti-inflammatory action and of immunosuppression by glucocorticoids Negative interference of activated glucocorticoid receptor with transcription factors, J. Neuroimmunol., 109, 16, 2000. 

Orally administered glucocorticoids have substantial adverse effects, including immunosuppression, suppression of the synthesis of endogenous glucocorticoids themselves (that can be a problem when glucocorticoid therapy is stopped), resorption of bone, and retention of water. Nonetheless, they are important drugs for control of inflammation. They also augment resistance to stress. 

Desired effects. As anti-allergies, immunosuppressants, or anti-inflammatory drugs, glucocorticoids display excellent efficacy against undesired inflammatory reactions. 

Cortisol, the most important g/ucocorticoid, is synthesized by the adrenal cortex, it is involved in regulating protein and carbohydrate metabolism by promoting protein degradation and the conversion of amino acids into glucose. As a result, the blood glucose level rises (see p. 152). Synthetic glucocorticoids (e.g., dexamethasone) are used in drugs due to their anti-inflammatory and immunosuppressant effects. 

Betamethasone Synthetic corticosteroid, displays glucocorticoid activity, lacks mineralocorticoid activity Use mainly as anti-inflammatory and immunosuppressive effect... 

Methylprednisolone Synthetic glucocorticoid Used as an anti-inflammatory agent and as an immunosuppressant... 

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