Steroid, preparation

There are hundreds of topical steroid preparations that are available for the treatment of skin diseases. In addition to their aforementioned antiinflammatory effects, topical steroids also exert their effects by vasoconstriction of the capillaries in the superficial dermis and by reduction of cellular mitosis and cell proliferation especially in the basal cell layer of the skin. In addition to the aforementioned systemic side effects, topical steroids can have adverse local effects. Chronic treatment with topical corticosteroids may increase the risk of bacterial and fungal infections. A combination steroid and antibacterial agent can be used to combat this problem. Additional local side effects that can be caused by extended use of topical steroids are epidermal atrophy, acne, glaucoma and cataracts (thus the weakest concentrations should be used in and around the eyes), pigmentation problems, hypertrichosis, allergic contact dermatitis, perioral dermatitis, and granuloma gluteale infantum (251). 

V. Steroid preparations (used topically as antiinflammatory agents)... 

Precursor of other steroids prepares uterus for implantation of an egg prevents ovulation during pregnancy... 

Inflammations of the posterior segment, optic nerve, or orbit usually require systemic administration of steroids. Selection of the particular steroid preparation and the dosage remains largely an individual choice, but the tendency is to use compoimds with minimal mineralocor-ticoid activity. Table 12-2 compares various systemic steroids to hydrocortisone in terms of equivalent dose (20 mg) and relative anti-inflammatory and sodium-retaining activities when giving a value of 1.0 for hydrocortisone. Prednisone is a popular agent of choice for oral administration. For intravenous administration, methylprednisolone sodiiun succinate has proven useful. 

The use of periocular steroids circumvents many of the side effects associated with systemic steroids however, complications may still arise. lOP response is a particular concern, because depot medications cannot be removed easily, as compared with tapering or discontinuing an oral preparation. Cataractogenesis may occur with any steroid preparation with intravitreal corticosteroid implants, the incidence of cataract formation requiring surgery over 2 years is nearly 90%. 

Other treatment for meningitis involves decreasing inflammation (with steroid preparations) and paying careful attention to the balance of fluids, glucose, sodium, potassium, oxygen, and carbon dioxide in the patient s system. Patients who develop seizures will require medications to halt the seizures and prevent their return. 

Alcohol and some drugs can also affect calcium levels in the body, thus producing osteoporosis. Some of these drugs include thyroid medications, steroid preparations, anti-seizure medications, and certain chemotherapy (anti-cancer) agents. 

Williamson IJ, Matusiewicz SP, Brovm PH, Greening AP, Crompton GK. Frequency of voice problems and cough in patients using pressurized aerosol inhaled steroid preparations. Eur Respir J 1995 8(4) 590-2. 

An additional risk is as.sociatcd with self-injection of long-lasting anabolic steroid preparations. The risk of conttacliog hepatitis A. hepatitis C. and human immunodeficienc) vini> (HIV) is increa.scd if needles used for injecting steroids are shared.""... 

Dilute steroid preparations (hydrocortisone lotion) may be of symptomatic value in reducing irritation and itching. More powerful steroid preparations (beclomethasone dipropionate, i.e. Propaderm cream) have also been used. Considerable symptomatic improvement was produced by the use of this preparation. Steroids have been said to delay healing and to enhance the likelihood of infection. No such ill-effects were observed in the Iranian casualties. 

A small set of steroids prepared from androstanes feature a spirobutyrolactone at C17. These agents act as antagonists of aldosterone, the highly oxygenated steroid that controls serum electrolytes and blood volume. The antagonist action of the spirolactones is manifested as diuretic and antihypertensive activity. 

The ability to make unnatural cephalostatins will greatly aid our understanding of the biological potency of these compounds. For example, one half could be kept identical to a natural product, while varying the other with synthetic steroids prepared from commercially available materials. In this sense, the cephalostatins provide a unique opportunity for such experiments, as the steroid skeleton is a readily accessible and well understood scaffold in which the effects of particular substituents can be determined. The situation here is in stark contrast to certain other potent biologically active compounds such as taxol (which promotes microtubule assembly) and bryostatin (a protein kinase C inhibitor). In the latter cases, construction of the skeletal framework is a formidable enterprise, hindering further dissection of the biological activity. 

Neomycin is mostly used in a wide variety of local infection such as burns, ulcers, wounds, impetigo, infected dermatoses, furunculosis, conjunctivitis, etc. It is also employed as an adjuvant in topical steroid preparations to control secondary infections in the case of inflammatory disorders. 

For dermatitis, a topical steroid preparation (eg, triamcinolone acetonide, fluocinolone acetonide, flurandrenolone, or betamethasone-17-valerate) is the principal therapeutic agent. Oozing lesions should be treated with wet dressings (moistened with fluids such as 1 40 Burow s solution). Appropriate antibiotics should be given for secondary infection, and oral antihistamines for itching.13 Vesicating lesions have been successfully treated with compresses of a cold silver nitrate solution (1 1,000)... 

The soup method is of course not suitable for drug suspensions, such as the steroid preparations for use with nebulizers, since the drug may not be uniformly distributed in either the suspension or the droplets generated by the nebulizer. However, radioactive particles whose characteristics are similar to the drug particle may be useful surrogates for suspension aerosols inhaled from nebulizers (67). 

The sterilization of pharmaceutical preparations has been extensively studied. Here again, there is the possibility of chemical change being induced by the radiation, and, in general, it is difficult to predict what effect radiation will have on a particular pharmaceutical preparation. Most pharmaceutical compounds are more resistant in the dry form than in solution or suspension. Steroid preparations appear to be relatively radiation-resistant for example, it has been shown that powdered cortisone. 

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