This document summarizes corticosteroids, including their biosynthesis, regulation, classification, mechanisms of action, effects, and therapeutic uses. Corticosteroids are synthesized from cholesterol in the adrenal cortex under ACTH control. They are classified as mineralocorticoids and glucocorticoids. Glucocorticoids such as cortisol regulate carbohydrate and protein metabolism and have anti-inflammatory effects. Prolonged corticosteroid use can cause HPA axis suppression and metabolic side effects like hyperglycemia. Therapeutic uses include replacing cortisol in adrenal insufficiency and treating inflammatory/autoimmune conditions.
This seminar presentation discusses the uses of dapsone, colchicine, and thalidomide in dermatology. For dapsone, it provides a detailed history, mechanisms of action, indications, dosing, administration, and adverse effects. It is commonly used to treat dermatitis herpetiformis, leprosy, and other chronic inflammatory dermatoses. For colchicine, it discusses the mechanisms of action, pharmacokinetics, and various dermatological uses including papulosquamous dermatoses, recurrent aphthous stomatitis, Behcet's syndrome, bullous diseases, vasculitis, and others. Adverse effects include gastrointestinal issues and bone marrow
This document discusses anti-leprotic drugs used to treat leprosy, which is caused by Mycobacterium leprae. It outlines the classification, mechanisms of action, adverse effects, and resistance issues of main drugs used including dapsone, clofazimine, rifampin, ofloxacin and minocycline. It also describes multidrug therapy regimens introduced by WHO using combinations of these drugs to shorten treatment duration and prevent resistance. Alternative regimens are discussed for cases of rifampin resistance. Reactions during leprosy treatment like lepra reaction are also summarized.
This document discusses immunosuppressant drugs, which inhibit immune responses and are used in organ transplantation and autoimmune diseases. It classifies major immunosuppressant classes including calcineurin inhibitors like cyclosporine and tacrolimus, mTOR inhibitors like sirolimus and everolimus, antiproliferative agents like azathioprine and methotrexate, glucocorticoids, and biological agents. For each drug class and examples, it explains mechanisms of action, therapeutic uses, and common adverse effects. The document provides detailed information on commonly used immunosuppressants to treat transplant rejection and autoimmune conditions.
an overall overview in corticosteroids and its application in oral and maxillofacial diagnostic medicine and pathology drawing to the conclusions of the limitations and drawbacks of these medicines. i have also included the precautions to be taken in dental therapeutic procedures fo
This document provides information on antileprotic drugs used to treat leprosy. It begins with an introduction to leprosy and classification systems. It then discusses individual drugs like dapsone, clofazimine, rifampin and ethionamide, covering their mechanisms of action, pharmacokinetics, adverse drug reactions and uses. Multidrug therapy is the standard recommended treatment, using combinations of drugs over 6-12 months depending on the type of leprosy. Reactions like type 1 and type 2 are described along with treatments for these reactions.
This document discusses various classes of antibiotics - polyenes and polypeptides. It provides details about Amphotericin B, Nystatin, Hamycin in the polyene class and Bacitracin, Polymyxin-B, Colistin/Polymyxin-E, and Dactinomycin/Actinomycin-D in the polypeptide class. It describes their origins, mechanisms of action, therapeutic uses, dosages and adverse effects.
This seminar presentation discusses the uses of dapsone, colchicine, and thalidomide in dermatology. For dapsone, it provides a detailed history, mechanisms of action, indications, dosing, administration, and adverse effects. It is commonly used to treat dermatitis herpetiformis, leprosy, and other chronic inflammatory dermatoses. For colchicine, it discusses the mechanisms of action, pharmacokinetics, and various dermatological uses including papulosquamous dermatoses, recurrent aphthous stomatitis, Behcet's syndrome, bullous diseases, vasculitis, and others. Adverse effects include gastrointestinal issues and bone marrow
This document discusses anti-leprotic drugs used to treat leprosy, which is caused by Mycobacterium leprae. It outlines the classification, mechanisms of action, adverse effects, and resistance issues of main drugs used including dapsone, clofazimine, rifampin, ofloxacin and minocycline. It also describes multidrug therapy regimens introduced by WHO using combinations of these drugs to shorten treatment duration and prevent resistance. Alternative regimens are discussed for cases of rifampin resistance. Reactions during leprosy treatment like lepra reaction are also summarized.
This document discusses immunosuppressant drugs, which inhibit immune responses and are used in organ transplantation and autoimmune diseases. It classifies major immunosuppressant classes including calcineurin inhibitors like cyclosporine and tacrolimus, mTOR inhibitors like sirolimus and everolimus, antiproliferative agents like azathioprine and methotrexate, glucocorticoids, and biological agents. For each drug class and examples, it explains mechanisms of action, therapeutic uses, and common adverse effects. The document provides detailed information on commonly used immunosuppressants to treat transplant rejection and autoimmune conditions.
an overall overview in corticosteroids and its application in oral and maxillofacial diagnostic medicine and pathology drawing to the conclusions of the limitations and drawbacks of these medicines. i have also included the precautions to be taken in dental therapeutic procedures fo
This document provides information on antileprotic drugs used to treat leprosy. It begins with an introduction to leprosy and classification systems. It then discusses individual drugs like dapsone, clofazimine, rifampin and ethionamide, covering their mechanisms of action, pharmacokinetics, adverse drug reactions and uses. Multidrug therapy is the standard recommended treatment, using combinations of drugs over 6-12 months depending on the type of leprosy. Reactions like type 1 and type 2 are described along with treatments for these reactions.
This document discusses various classes of antibiotics - polyenes and polypeptides. It provides details about Amphotericin B, Nystatin, Hamycin in the polyene class and Bacitracin, Polymyxin-B, Colistin/Polymyxin-E, and Dactinomycin/Actinomycin-D in the polypeptide class. It describes their origins, mechanisms of action, therapeutic uses, dosages and adverse effects.
1. Corticosteroids are a class of steroid hormones produced in the adrenal cortex that are involved in various physiologic systems such as stress response, immune response, metabolism, and electrolyte balance.
2. There are two main types of corticosteroids - glucocorticoids such as cortisol which control metabolism and have anti-inflammatory effects, and mineralocorticoids such as aldosterone which control electrolyte and water levels.
3. Corticosteroids have various uses including replacement therapy for adrenal insufficiency, treatment of inflammatory and autoimmune conditions, and organ transplantation. However, long term use can also cause adverse effects like Cushing's syndrome, infections, oste
Tetracycline and chloramphenicol are broad spectrum antibiotics discovered in the 1940s-1950s. Tetracycline is obtained from soil actinomycetes and is orally effective against a wide range of gram-positive and gram-negative bacteria. It works by inhibiting bacterial protein synthesis. Chloramphenicol is produced by Streptomyces venezuelae and also inhibits bacterial protein synthesis. Both antibiotics have fallen out of favor due to increasing resistance and potential adverse effects like bone marrow suppression and aplastic anemia. They were once used to treat serious infections but are now reserved as drugs of last resort.
Sex hormones and oral contraceptive [autosaved]Sujit Karpe
This document discusses female and male sex hormones as well as oral contraceptives. It describes the natural and synthetic forms of estrogen, progesterone, and testosterone, their functions, therapeutic uses, and preparations. It then explains how oral contraceptives work by inhibiting ovulation and changes in the reproductive system. Different types of oral contraceptives are classified and their administration, uses, side effects, contraindications, and drug interactions are outlined.
Gout is caused by high levels of uric acid in the blood, which can deposit as crystals in tissues and joints. Treatment involves lowering uric acid levels using drugs that inhibit uric acid synthesis or increase uric acid excretion. For acute gout attacks, medications like colchicine and NSAIDs are used. Chronic gout is treated long-term with uricosuric drugs like probenecid or allopurinol, a xanthine oxidase inhibitor that reduces uric acid production. These long-term therapies can prevent future gout attacks and kidney damage if uric acid levels are maintained below saturation point.
This document discusses drugs used to treat rheumatoid arthritis (RA). The goals of drug therapy for RA are to reduce pain, swelling, joint damage, and preserve joint function. Nonsteroidal anti-inflammatory drugs (NSAIDs) provide symptomatic relief but do not stop disease progression. Disease-modifying antirheumatic drugs (DMARDs) like methotrexate are usually added soon after diagnosis to slow the disease. Biological agents that target cytokines like tumor necrosis factor alpha (TNFα) can provide quicker relief than nonbiological DMARDs. Corticosteroids also provide potent anti-inflammatory effects but do not alter disease progression long-term. Newer targeted DMARDs inhibit Janus kin
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones
1) Rheumatoid arthritis is an autoimmune disorder characterized by joint inflammation and cartilage destruction, causing pain, swelling, and loss of function. It affects around 1-2% of the population and is more common in women over age 55.
2) Disease-modifying antirheumatic drugs (DMARDs) like methotrexate, sulfasalazine, and hydroxychloroquine are used to suppress the rheumatoid process and bring remission, in addition to nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief. Biologic response modifiers targeting tumor necrosis factor alpha are also used.
3) Methotrexate is one of the most effective and commonly used
Seretonin (5HT) and Its Antagonists PharmacologyPranatiChavan
Serotonin is a chemical that has a wide variety of functions in the human body. It is sometimes called the happy chemical, because it contributes to wellbeing and happiness.
The scientific name for serotonin is 5-hydroxytryptamine, or 5-HT. It is mainly found in the brain, bowels, and blood platelets.
Serotonin is used to transmit messages between nerve cells, it is thought to be active in constricting smooth muscles, and it contributes to wellbeing and happiness, among other things. As the precursor for melatonin, it helps regulate the body’s sleep-wake cycles and the internal clock.
It is thought to play a role in appetite, the emotions, and motor, cognitive, and autonomic functions. However, it is not known exactly if serotonin affects these directly, or if it has an overall role in co-ordinating the nervous system.
This document summarizes antirheumatoid and antigout drugs. It discusses various drugs used to treat rheumatoid arthritis including disease-modifying antirheumatic drugs like methotrexate, sulfasalazine, hydroxychloroquine, leflunomide, tofacitinib, and biological drugs like etanercept, infliximab, adalimumab, anakinra, and rituximab. It also discusses corticosteroids and classification, mechanisms of action, and uses of various antigout drugs including NSAIDs, colchicine, corticosteroids, probenecid, allopurinol, and febuxostat.
Introduction.
Biosynthesis
Types of Thyroid diseases
Thyroid Drugs
Antithyroid Drugs
Mechanism of action
Structure
Adverse Drug Reactions and Uses.
Reference
Antileprosy drugs have been described with their pharmacology also this topic covers Multidrug treatment for leprosy including paucibacillary and multibacillary leprosy and lepra reactions
This document discusses aminoglycoside antibiotics. It begins by listing the key learning objectives which include explaining the mechanisms of action and resistance of aminoglycosides, describing different dosing regimens, monitoring therapy to avoid toxicity, and the unique features of individual drugs. It then covers the common structural features and characteristics of aminoglycosides, their mechanisms of action, and causes of resistance. The advantages and disadvantages of different dosing regimens are outlined. Signs of ototoxicity and nephrotoxicity are described along with monitoring therapy. Individual drugs like gentamicin, streptomycin, and amikacin are discussed in terms of their uses, doses, and spectra of activity.
Dapsone is a sulfone antibiotic synthesized in 1908 that is used to treat leprosy and other conditions. It works by inhibiting the biosynthesis of folate. Dapsone began being used to treat leprosy in 1945 and is included on the WHO's list of essential medicines. It is commonly used in combination with other drugs in multiple drug therapy (MDT) for leprosy. Dapsone is absorbed and distributed throughout the body, metabolized in the liver, and eliminated through urine and feces. Common side effects include mild anemia, rashes, and nausea. Recent developments include a topical gel formulation for acne.
The document discusses calcium regulation and drugs that affect calcium balance such as parathyroid hormone, calcitonin, vitamin D, and bisphosphonates. It describes the actions and uses of these drugs to treat conditions like hypocalcemia, hypercalcemia, osteoporosis, and rickets. The management of hypercalcemia, osteoporosis, and side effects of drugs affecting calcium balance is also reviewed.
This document provides information on the pharmacology of diuretics. It begins by explaining that diuretics cause a net loss of sodium and water in urine but sodium balance is restored through homeostatic mechanisms. It then classifies diuretics and describes various classes in detail, including their mechanisms and sites of action, uses, and adverse effects. The classes discussed include high efficacy loop diuretics like furosemide, medium efficacy thiazides, weak carbonic anhydrase inhibitors, potassium sparing aldosterone antagonists, and renal sodium channel inhibitors.
This document discusses biguanides and thiazolidinediones as oral hypoglycemic drugs. It describes metformin as the main biguanide currently used, noting its mechanism of action involves suppressing glucose production in the liver and enhancing glucose disposal in muscles. Pioglitazone is the only available thiazolidinedione, which works by enhancing insulin sensitivity. Potential side effects and appropriate uses are provided for both classes. Acarbose is also summarized as an alpha-glucosidase inhibitor that reduces glucose absorption from the gut. Clinical uses of glucagon for treating hypoglycemia are briefly mentioned.
1. Corticosteroids are steroid hormones produced by the adrenal cortex that have important physiological effects and are used therapeutically.
2. They are synthesized from cholesterol through a series of enzymatic reactions and regulated by the hypothalamic-pituitary-adrenal axis.
3. Glucocorticoids like cortisol have effects on carbohydrate, lipid and protein metabolism while mineralocorticoids like aldosterone regulate sodium and fluid balance.
4. Therapeutic uses of corticosteroids include replacement in adrenal insufficiency and treatment of inflammatory and autoimmune conditions due to their potent anti-inflammatory effects.
Corticosteroids are steroid hormones produced in the adrenal cortex that lower inflammation and reduce immune system activity. Cortisone is a corticosteroid hormone released by the adrenal gland that binds to cytosolic receptors and regulates target gene expression. Hydrocortisone is a topical corticosteroid used to treat skin conditions by binding glucocorticoid receptors and inhibiting inflammatory processes. Prednisolone is an oral corticosteroid used to treat allergies, blood disorders, infections, and prevent organ rejection by decreasing inflammation. Betamethasone is a corticosteroid used for rheumatoid arthritis and skin diseases that binds intracellular receptors and modifies gene expression to inhibit inflammation. Dexamethasone
- The document discusses the adrenal cortex and the steroid hormones it produces, including mineralocorticoids like aldosterone and glucocorticoids like cortisol.
- It explains that these hormones aid in regulating processes like sodium balance, glucose metabolism, immune function, and stress response. They are synthesized and regulated through the HPA axis in response to ACTH.
- The effects, uses, and side effects of corticosteroid therapies are summarized for conditions like arthritis, asthma, skin diseases, and cancers. Long-term use can suppress the HPA axis and cause adverse effects like osteoporosis, infections, and metabolic disturbances.
This document provides an overview of corticosteroids, including their history, biosynthesis, classification, mechanisms of action, therapeutic uses, and adverse effects. Corticosteroids are steroid hormones produced in the adrenal cortex from cholesterol. They have important roles in carbohydrate, protein, and fat metabolism, electrolyte balance, and anti-inflammatory responses. Common therapeutic uses include replacement therapy for adrenal insufficiency, and treatment of conditions like arthritis, asthma, skin diseases, and organ transplantation. Adverse effects can include fluid retention, altered electrolyte levels, infections, delayed wound healing, and osteoporosis. Inhaled corticosteroids are commonly used as first-line therapy for chronic asthma.
1. Corticosteroids are a class of steroid hormones produced in the adrenal cortex that are involved in various physiologic systems such as stress response, immune response, metabolism, and electrolyte balance.
2. There are two main types of corticosteroids - glucocorticoids such as cortisol which control metabolism and have anti-inflammatory effects, and mineralocorticoids such as aldosterone which control electrolyte and water levels.
3. Corticosteroids have various uses including replacement therapy for adrenal insufficiency, treatment of inflammatory and autoimmune conditions, and organ transplantation. However, long term use can also cause adverse effects like Cushing's syndrome, infections, oste
Tetracycline and chloramphenicol are broad spectrum antibiotics discovered in the 1940s-1950s. Tetracycline is obtained from soil actinomycetes and is orally effective against a wide range of gram-positive and gram-negative bacteria. It works by inhibiting bacterial protein synthesis. Chloramphenicol is produced by Streptomyces venezuelae and also inhibits bacterial protein synthesis. Both antibiotics have fallen out of favor due to increasing resistance and potential adverse effects like bone marrow suppression and aplastic anemia. They were once used to treat serious infections but are now reserved as drugs of last resort.
Sex hormones and oral contraceptive [autosaved]Sujit Karpe
This document discusses female and male sex hormones as well as oral contraceptives. It describes the natural and synthetic forms of estrogen, progesterone, and testosterone, their functions, therapeutic uses, and preparations. It then explains how oral contraceptives work by inhibiting ovulation and changes in the reproductive system. Different types of oral contraceptives are classified and their administration, uses, side effects, contraindications, and drug interactions are outlined.
Gout is caused by high levels of uric acid in the blood, which can deposit as crystals in tissues and joints. Treatment involves lowering uric acid levels using drugs that inhibit uric acid synthesis or increase uric acid excretion. For acute gout attacks, medications like colchicine and NSAIDs are used. Chronic gout is treated long-term with uricosuric drugs like probenecid or allopurinol, a xanthine oxidase inhibitor that reduces uric acid production. These long-term therapies can prevent future gout attacks and kidney damage if uric acid levels are maintained below saturation point.
This document discusses drugs used to treat rheumatoid arthritis (RA). The goals of drug therapy for RA are to reduce pain, swelling, joint damage, and preserve joint function. Nonsteroidal anti-inflammatory drugs (NSAIDs) provide symptomatic relief but do not stop disease progression. Disease-modifying antirheumatic drugs (DMARDs) like methotrexate are usually added soon after diagnosis to slow the disease. Biological agents that target cytokines like tumor necrosis factor alpha (TNFα) can provide quicker relief than nonbiological DMARDs. Corticosteroids also provide potent anti-inflammatory effects but do not alter disease progression long-term. Newer targeted DMARDs inhibit Janus kin
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones
1) Rheumatoid arthritis is an autoimmune disorder characterized by joint inflammation and cartilage destruction, causing pain, swelling, and loss of function. It affects around 1-2% of the population and is more common in women over age 55.
2) Disease-modifying antirheumatic drugs (DMARDs) like methotrexate, sulfasalazine, and hydroxychloroquine are used to suppress the rheumatoid process and bring remission, in addition to nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief. Biologic response modifiers targeting tumor necrosis factor alpha are also used.
3) Methotrexate is one of the most effective and commonly used
Seretonin (5HT) and Its Antagonists PharmacologyPranatiChavan
Serotonin is a chemical that has a wide variety of functions in the human body. It is sometimes called the happy chemical, because it contributes to wellbeing and happiness.
The scientific name for serotonin is 5-hydroxytryptamine, or 5-HT. It is mainly found in the brain, bowels, and blood platelets.
Serotonin is used to transmit messages between nerve cells, it is thought to be active in constricting smooth muscles, and it contributes to wellbeing and happiness, among other things. As the precursor for melatonin, it helps regulate the body’s sleep-wake cycles and the internal clock.
It is thought to play a role in appetite, the emotions, and motor, cognitive, and autonomic functions. However, it is not known exactly if serotonin affects these directly, or if it has an overall role in co-ordinating the nervous system.
This document summarizes antirheumatoid and antigout drugs. It discusses various drugs used to treat rheumatoid arthritis including disease-modifying antirheumatic drugs like methotrexate, sulfasalazine, hydroxychloroquine, leflunomide, tofacitinib, and biological drugs like etanercept, infliximab, adalimumab, anakinra, and rituximab. It also discusses corticosteroids and classification, mechanisms of action, and uses of various antigout drugs including NSAIDs, colchicine, corticosteroids, probenecid, allopurinol, and febuxostat.
Introduction.
Biosynthesis
Types of Thyroid diseases
Thyroid Drugs
Antithyroid Drugs
Mechanism of action
Structure
Adverse Drug Reactions and Uses.
Reference
Antileprosy drugs have been described with their pharmacology also this topic covers Multidrug treatment for leprosy including paucibacillary and multibacillary leprosy and lepra reactions
This document discusses aminoglycoside antibiotics. It begins by listing the key learning objectives which include explaining the mechanisms of action and resistance of aminoglycosides, describing different dosing regimens, monitoring therapy to avoid toxicity, and the unique features of individual drugs. It then covers the common structural features and characteristics of aminoglycosides, their mechanisms of action, and causes of resistance. The advantages and disadvantages of different dosing regimens are outlined. Signs of ototoxicity and nephrotoxicity are described along with monitoring therapy. Individual drugs like gentamicin, streptomycin, and amikacin are discussed in terms of their uses, doses, and spectra of activity.
Dapsone is a sulfone antibiotic synthesized in 1908 that is used to treat leprosy and other conditions. It works by inhibiting the biosynthesis of folate. Dapsone began being used to treat leprosy in 1945 and is included on the WHO's list of essential medicines. It is commonly used in combination with other drugs in multiple drug therapy (MDT) for leprosy. Dapsone is absorbed and distributed throughout the body, metabolized in the liver, and eliminated through urine and feces. Common side effects include mild anemia, rashes, and nausea. Recent developments include a topical gel formulation for acne.
The document discusses calcium regulation and drugs that affect calcium balance such as parathyroid hormone, calcitonin, vitamin D, and bisphosphonates. It describes the actions and uses of these drugs to treat conditions like hypocalcemia, hypercalcemia, osteoporosis, and rickets. The management of hypercalcemia, osteoporosis, and side effects of drugs affecting calcium balance is also reviewed.
This document provides information on the pharmacology of diuretics. It begins by explaining that diuretics cause a net loss of sodium and water in urine but sodium balance is restored through homeostatic mechanisms. It then classifies diuretics and describes various classes in detail, including their mechanisms and sites of action, uses, and adverse effects. The classes discussed include high efficacy loop diuretics like furosemide, medium efficacy thiazides, weak carbonic anhydrase inhibitors, potassium sparing aldosterone antagonists, and renal sodium channel inhibitors.
This document discusses biguanides and thiazolidinediones as oral hypoglycemic drugs. It describes metformin as the main biguanide currently used, noting its mechanism of action involves suppressing glucose production in the liver and enhancing glucose disposal in muscles. Pioglitazone is the only available thiazolidinedione, which works by enhancing insulin sensitivity. Potential side effects and appropriate uses are provided for both classes. Acarbose is also summarized as an alpha-glucosidase inhibitor that reduces glucose absorption from the gut. Clinical uses of glucagon for treating hypoglycemia are briefly mentioned.
1. Corticosteroids are steroid hormones produced by the adrenal cortex that have important physiological effects and are used therapeutically.
2. They are synthesized from cholesterol through a series of enzymatic reactions and regulated by the hypothalamic-pituitary-adrenal axis.
3. Glucocorticoids like cortisol have effects on carbohydrate, lipid and protein metabolism while mineralocorticoids like aldosterone regulate sodium and fluid balance.
4. Therapeutic uses of corticosteroids include replacement in adrenal insufficiency and treatment of inflammatory and autoimmune conditions due to their potent anti-inflammatory effects.
Corticosteroids are steroid hormones produced in the adrenal cortex that lower inflammation and reduce immune system activity. Cortisone is a corticosteroid hormone released by the adrenal gland that binds to cytosolic receptors and regulates target gene expression. Hydrocortisone is a topical corticosteroid used to treat skin conditions by binding glucocorticoid receptors and inhibiting inflammatory processes. Prednisolone is an oral corticosteroid used to treat allergies, blood disorders, infections, and prevent organ rejection by decreasing inflammation. Betamethasone is a corticosteroid used for rheumatoid arthritis and skin diseases that binds intracellular receptors and modifies gene expression to inhibit inflammation. Dexamethasone
- The document discusses the adrenal cortex and the steroid hormones it produces, including mineralocorticoids like aldosterone and glucocorticoids like cortisol.
- It explains that these hormones aid in regulating processes like sodium balance, glucose metabolism, immune function, and stress response. They are synthesized and regulated through the HPA axis in response to ACTH.
- The effects, uses, and side effects of corticosteroid therapies are summarized for conditions like arthritis, asthma, skin diseases, and cancers. Long-term use can suppress the HPA axis and cause adverse effects like osteoporosis, infections, and metabolic disturbances.
This document provides an overview of corticosteroids, including their history, biosynthesis, classification, mechanisms of action, therapeutic uses, and adverse effects. Corticosteroids are steroid hormones produced in the adrenal cortex from cholesterol. They have important roles in carbohydrate, protein, and fat metabolism, electrolyte balance, and anti-inflammatory responses. Common therapeutic uses include replacement therapy for adrenal insufficiency, and treatment of conditions like arthritis, asthma, skin diseases, and organ transplantation. Adverse effects can include fluid retention, altered electrolyte levels, infections, delayed wound healing, and osteoporosis. Inhaled corticosteroids are commonly used as first-line therapy for chronic asthma.
The ppt is made for undergraduate students to have a basic understanding on Corticosteroids and its role in all feilds of medicine. This is also useful to Postgraduate students
ACTH is a polypeptide hormone released by the anterior pituitary gland that controls secretions of the adrenal cortex. CRH from the hypothalamus stimulates production and release of ACTH. The adrenal cortex is divided into three zones that synthesize and secrete different types of steroids: mineralocorticoids in the outer zone, glucocorticoids in the middle zone, and adrenal androgens in the inner zone. Glucocorticoids such as cortisol are involved in metabolism and stress response and have anti-inflammatory and immunosuppressive effects.
Steroids in omfs
This document discusses the use of corticosteroids (steroids) in oral and maxillofacial surgery. It begins with the history and development of steroid therapy. It describes the biosynthesis, transport, metabolism and excretion of corticosteroids. It discusses the regulation of glucocorticoids and measures to minimize suppression of the HPA axis. It details the pharmacological actions, therapeutic uses, and adverse effects of steroids. It provides guidelines for replacement therapy in adrenal insufficiency, tapering steroids, and contraindications for steroid use.
The document summarizes corticosteroids and antagonists. It discusses how corticosteroids are produced in the adrenal cortex and controlled by the HPA axis. It describes their therapeutic uses, mechanisms of action, effects, and important drugs. It also discusses corticosteroid antagonists that inhibit corticosteroid synthesis or receptors to treat conditions like Cushing's syndrome.
Corticosteroids are steroid hormones produced in the adrenal cortex. There are two main types: glucocorticoids which help regulate metabolism and mineralocorticoids which regulate salt and water balance. In 1949, cortisone was discovered to help treat rheumatoid arthritis, leading researchers like Hench, Kendall, and Reichstein to win the Nobel Prize for their work on corticosteroid hormones. Since then, many synthetic corticosteroids have been developed with varying durations of action and potencies. Corticosteroids have wide-ranging anti-inflammatory and immunosuppressive effects useful for treating many conditions.
Corticosteroids are steroid hormones synthesized from cholesterol in the adrenal cortex. They have broad anti-inflammatory and immunosuppressive actions. As glucocorticoids, they regulate carbohydrate, protein, and fat metabolism. As mineralocorticoids, they regulate sodium and fluid balance. Corticosteroids are used to treat conditions such as adrenal insufficiency, inflammatory disorders like rheumatoid arthritis, allergic reactions, autoimmune diseases, lung diseases including asthma, eye diseases, skin diseases, intestinal diseases, and cancers. Their use can cause adverse effects like cushingoid features, hyperglycemia, muscle weakness, susceptibility to infection, osteoporosis, and psychiatric issues.
Corticosteroids have both mineralocorticoid and glucocorticoid actions. Mineralocorticoid action increases sodium reabsorption leading to fluid retention and hypokalemia. Glucocorticoid actions include increased blood glucose through gluconeogenesis and breakdown of proteins and fats. Short acting corticosteroids include hydrocortisone and prednisolone while dexamethasone and betamethasone are long acting. Adverse effects include fluid retention, skin thinning, infections, and bone loss. Corticosteroids are used to treat inflammation, autoimmune diseases, and cancers. Contraindications include peptic ulcer and infections. In dentistry, corticosteroids can treat oral
The document discusses corticosteroids, including their history, physiology, regulation, classification, mechanisms of action, pharmacokinetics, therapeutic uses, interactions, adverse reactions and contraindications. Corticosteroids are steroid hormones produced by the adrenal cortex that regulate a wide range of physiologic systems such as carbohydrate metabolism, immune function and electrolyte balance. They have many therapeutic uses including replacement therapy for adrenal insufficiency, treatment of inflammatory and autoimmune conditions.
Corticosteroids are hormones secreted by the adrenal cortex. There are three main types: mineralocorticoids, glucocorticoids, and sex hormones. Glucocorticoids like cortisol have various metabolic effects such as increasing blood glucose, mobilizing fat, and suppressing inflammation. They are used to treat conditions like arthritis, asthma, skin diseases, and organ transplantation. Adverse effects include fluid retention, high blood pressure, osteoporosis, and susceptibility to infections. Corticosteroids are administered orally, intravenously, intramuscularly, and topically. In dentistry they are used to treat oral ulcers and conditions like TMJ disorders and postoperative pain.
This document discusses corticosteroids, including their production in the adrenal cortex, classification, mechanisms of action, and uses. It notes that corticosteroids are produced from cholesterol and have important roles in metabolic control and stress response regulation. They are classified based on their chemical structure and can have glucocorticoid, mineralocorticoid, or androgenic effects. Corticosteroids have a wide range of therapeutic uses due to their potent anti-inflammatory and immunosuppressive properties.
This lecture talk about the disturbance of adrenal gland hormones and how it affect health. it also discuss in brief how to manage such condition in your dental clinic
Dr. Yugal kishor discusses corticosteroids in his document. He begins with an introduction to corticosteroids and the three main types produced by the adrenal cortex: glucocorticoids, mineralocorticoids, and sex hormones. He then covers the functional anatomy and classes of corticosteroids. Applications in dentistry are also reviewed such as supplementing patients with adrenal insufficiency during dental procedures to prevent adrenal crisis. Topical corticosteroids are discussed for treating various oral conditions like recurrent aphthous stomatitis.
Systemic corticosteroids are synthetic derivatives of cortisol that can be taken orally or via injection. They are used to treat various autoimmune and inflammatory conditions. Common side effects include increased risk of infection, skin thinning, acne, osteoporosis, diabetes, and psychiatric issues. Risks are higher with longer term or high dose use. Monitoring of blood pressure, weight, and blood sugar is recommended during treatment. Measures like calcium/vitamin D supplementation and bone density scans can help prevent side effects like osteoporosis. Some conditions like active tuberculosis or severe psychiatric disease are contraindications for steroid use due to risk of worsening.
Similar to Corticosteroids & Anabolic Steroids (20)
This document summarizes common fungal infections and the antifungal drugs used to treat them. It discusses both superficial and systemic mycoses caused by fungi like Candida, Dermatophytes, Aspergillus, and Cryptococcus. The main classes of antifungal drugs covered are polyenes like amphotericin B and nystatin, azoles including imidazoles and triazoles, antimetabolites like flucytosine, and allylamines such as terbinafine. Specific drugs discussed in detail include amphotericin B, griseofulvin, ketoconazole, fluconazole, itraconazole, voriconaz
This document summarizes antiprotozoal drugs used to treat amoebiasis and giardiasis. It describes the life cycles and treatment of Entamoeba histolytica and Giardia lamblia. Nitroimidazoles like metronidazole are first-line to treat intestinal infections while tissue amoebicides like emetine are used for extra-intestinal amoebiasis. Metronidazole is also used to treat giardiasis. Other drugs discussed include luminal amoebicides, nitazoxanide, paromomycin, and 8-hydroxyquinolines. Adverse effects and mechanisms of action are provided for major antiproto
Anthelminthic drugs are used to treat helminthic parasite infections. The main types of helminths that infect humans are nematodes (roundworms and hookworms), trematodes (flukes), and cestodes (tapeworms). Common anthelminthic drugs include mebendazole, albendazole, pyrantel pamoate, praziquantel, ivermectin, diethylcarbamazine, niclosamide, and piperazine. These drugs work by paralyzing or killing the parasites and helping expel them from the intestinal tract or tissues. The ideal anthelminthic is broad spectrum, achieves high cure rates with
This document summarizes various classes of antimicrobials including lincosamide antibiotics, glycopeptide antibiotics, oxazolidinones, polypeptide antibiotics, and urinary antiseptics. It describes the mechanism of action, antimicrobial spectrum, pharmacokinetics, uses, and adverse effects of lincomycin, clindamycin, vancomycin, teicoplanin, linezolid, polymyxin B, colistin, bacitracin, nitrofurantoin, and methenamine. It also discusses the treatment of lower urinary tract infections with these urinary antiseptics and other antimicrobials like cotrimoxazole, quinolones
Aminoglycosides are a class of bactericidal antibiotics that inhibit protein synthesis in gram-negative aerobic bacteria. They are highly polar compounds that are poorly absorbed from the GI tract and must be administered parenterally. They are effective against aerobic gram-negative bacilli but not anaerobes. Common side effects include ototoxicity and nephrotoxicity. Resistance can develop through bacterial enzyme inactivation of the drug, decreased drug entry into cells, or decreased drug affinity for ribosomes.
Macrolides are a class of antibiotics that contain a large lactone ring to which deoxy-sugar derivatives are attached. They work by binding to the 50S ribosomal subunit of bacteria and inhibiting protein synthesis. The main macrolides are erythromycin, clarithromycin, azithromycin, and roxithromycin. They are used to treat respiratory infections, sexually transmitted diseases, skin and soft tissue infections, and others. Common side effects include nausea and diarrhea. Some macrolides can interact with other drugs by inhibiting the CYP3A4 enzyme or increasing their effects. Newer macrolides like azithromycin have fewer drug interactions than older ones like erythromycin
This document discusses different classes of diuretic drugs, including their mechanisms of action, sites of action in the kidney, therapeutic uses, and side effects. It covers loop diuretics, thiazide diuretics, potassium-sparing diuretics, and osmotic diuretics. Loop diuretics act in the thick ascending limb of the loop of Henle and have the highest efficacy for increasing sodium excretion. Thiazide diuretics act in the early distal convoluted tubule and have medium efficacy. Potassium-sparing diuretics and osmotic diuretics have various mechanisms of action and are used to treat conditions like hypertension, heart failure, and edema. All diure
Haematinics such as iron, vitamin B12, and folic acid are used to treat various types of anemia by increasing the formation of red blood cells. Coagulants and anti-coagulants like heparin affect blood clotting, while fibrinolytics dissolve clots that have already formed. Antiplatelet drugs inhibit platelet aggregation to prevent excessive clotting. These drugs work by targeting different parts of the blood formation and clotting process.
Pharmacodynamics is the study of how drugs act on the body. Drugs can act through various mechanisms including stimulation, depression, irritation, replacement, and cytotoxic effects. The main mechanisms of drug action are receptor-mediated and non-receptor mediated effects. Receptor-mediated effects occur through ligand-gated ion channels, G-protein coupled receptors, enzyme-linked receptors, and nuclear receptors. Non-receptor effects include physical, chemical, and enzymatic actions. The dose-response relationship determines a drug's potency and efficacy. Drug interactions can result in additive, synergistic, or antagonistic effects.
Pharmacokinetics deals with the absorption, distribution, metabolism, and excretion of drugs in the body. Drug absorption involves movement of a drug from its site of administration into systemic circulation by crossing biological membranes. Distribution refers to the reversible transfer of a drug between blood and tissues. Key factors affecting distribution include a drug's physicochemical properties, binding to plasma proteins, and barriers to tissue permeability. Highly protein-bound drugs are restricted to the vascular compartment and have a prolonged duration of action.
This document discusses various antiviral agents used to treat different viral infections. It describes drugs used against herpes viruses like acyclovir, valacyclovir and famciclovir. It also discusses antiretroviral agents used to treat HIV infection, including nucleoside reverse transcriptase inhibitors like zidovudine, non-nucleoside reverse transcriptase inhibitors like nevirapine, and protease inhibitors like saquinavir. It also mentions anti-influenza agents amantadine and oseltamivir, as well as other antiviral drugs like interferons and ribavirin.
This document summarizes anti-tubercular drugs used to treat tuberculosis and other mycobacterial diseases. It discusses first-line drugs like isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin which are effective, less toxic options routinely used to treat tuberculosis. Second-line drugs discussed include fluoroquinolones, macrolides, rifapentine, and rifabutin which are used for multidrug-resistant tuberculosis or atypical mycobacterial infections. World Health Organization recommended treatment regimens including the directly observed treatment short course protocol are mentioned. Mechanisms of action, pharmacokinetics, uses, and side effects of various anti
β-Lactam antibiotics such as penicillin, cephalosporins, monobactams, and carbapenems contain a β-lactam ring. Penicillin was the first antibiotic discovered and is effective against streptococcal infections, syphilis, and diphtheria. It works by inhibiting bacterial cell wall synthesis. Resistance can arise via β-lactamase production or altered penicillin binding proteins. Semisynthetic penicillins like ampicillin and amoxicillin are acid stable and have a broader spectrum of activity against gram-negative bacteria. They are used to treat a variety of infections affecting the respiratory tract, skin, and urinary tract.
This document discusses sulfonamides, including their history, mechanism of action, uses, and adverse effects. It notes that sulfonamides were the first synthetic antibacterial agents and are bacteriostatic, inhibiting bacterial synthesis of folic acid. Co-trimoxazole is a fixed dose combination of sulfamethoxazole and trimethoprim that has a synergistic effect. The combination is widely used to treat urinary tract infections, pneumonia, and travelers' diarrhea. Common adverse effects include rashes, nausea, and hematologic issues.
Milan J. Anadkat, MD, and Dale V. Reisner discuss generalized pustular psoriasis in this CME activity titled "Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communications Strategies to Improve Shared Decision-Making." For the full presentation, please visit us at www.peervoice.com/HUM870.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Corticosteroids & Anabolic Steroids
1.
2. Corticosteroids:-
Adrenal Gland
Outer (Adrenal Cortex)
(3 layers)
Inner (Adrenal Medulla)
Secretes on sympathetic stimulation
Epinephrine
(Predominantly)
Norepinephrine
Zona glomerulosa
(Mineralocorticoids)
e.g.-Aldosterone
F(x)- Na+ & H20 retention
K+ & H+ excretion
Zona Fasciculata
Zona Reticularis
(Glucocorticoids)
e.g.- cortisol,
Corticosteroids
F(X)- Regulate
carbohydrate & protein
metabolism
Androgens
Hypersecretion-
Primary
hyperaldosteronism
(Conn’s syndrome)
Hypersecretion-
Cushing’s syndrome
Hyposecretion- of all the hormone leading
to Addison’s Disease
3.
4. • Biosynthesis:-
• Corticoids (gluco + Mineralo)-21-carbon compounds having a
cyclopentanoperhydro-phenanthrene (steroid) nucleus.
• synthesized in the adrenal cortical cells from cholesterol under the control of
ACTH
Regulation of
synthesis and
secretion of
corticosteroids
5. Mineralocorticoids
Synthesize from → Zona glomerulosa(Adrenal cortex)
Most important Mineralocorticoids →Aldosterone
Site of Action→ Kidney (DCT & Collecting duct)
Function-Na+ retention by ↑Na+ reabsorption
MOA:- Aldosterone
↓↓
Bind to mineralocorticoids receptor
↓↓
stimulate synthesis of aldosterone induce protein(AIP)
↓
Stimulation of Na+/K+ exchanger in the apical membrane
↓↓
Responsible for action
6. Aldosterone effects
Deficiency state:-
↓Na+ reabsorption →Hyperkalemia & acidosis
Excess:-
Retention of Na+ & water-hypertension & oedema
Hypokalemia
Alkalosis
Synthesize from → Zona Fasciculata (Adrenal cortex)
MOA:-
Glucocorticoids
7.
8. Pharmacological Action:-
CNS:- Mild euphoria
Higher dose→↓seizure threshold (precipitate seizure in epileptic pt.)
CVS:- Glucocorticoids
Hypertension (permissive action)
GIT:- Inhibit-PG’s→↑GA & pepsin secretion→ aggravate Peptic ulcer
Hematopoietic system:-
Destruction of Malignant-T & B cells but little effect on normal cells
↑RBC, platelet & neutrophils
↓ lymphocytes, eosinophils, basophiles
Promote Na+ & water retention
(except synthetic glucocorticoids )
Potentiate effect of catecholamine &
angiotensin-II on smooth muscle
week mineralocorticoid action
9. • Metabolism:-
Carbohydrate metabolism- : through
↓utilization of glucose by peripheral tissues
Stimulate gluconeogenesis from amino acids
Protein metabolism:- (breakdown-protein)
Displace amino acids from protein synthesis(catabolic action)→muscle wasting
Fat metabolism:-
Redistribution of fat from peripheral tissue → central such as
Back of neck & shoulder (buffalo hump)
Abdomen & face (moon face)
Anti-insulin effects (insulin
resistance)→Hyperglycaemia
Centripetal obesity
10. • Anti-inflammatory action:-
Stimulation
Inhibit IL-1,2,6 & TNF-α
Stabilize lysosomal membrane
↓leucocyte migrate to site of injury
Potent
Anti-
inflammatory
action
Immunity:- suppress cell mediated(T-cell) immunity more than humoral
immunity (B-cells)-immunosuppressant
Favors spread of infection→ impaired capacity of defensive cells to kill micro-
organism
11. Interfere healing & scare formation
Inhibit chemotaxis of immune cells
Inhibit the release of IL-2→↓T-cell proliferation
↓Antibody production from β-cells
Calcium metabolism:-
Glucocorticoid
Inhibit calcium
absorption from the gut
↑renal excretion
of calcium
↓Blood Calciumlevel
Promote Osteoclastic action
(bone resorption action)
Inhibits Osteoblastic
action (bone forming
cells)
osteoporosis and pathological fracture of vertebral
bodies
12. • Skeletal muscles:-
Corticosteroids are required for the normal function of skeletal muscles.
Weakness occurs in both hypocorticism and hypercorticism
Prolonged use →muscle wasting and weakness (steroid myopathy)
14. • Individual drugs:-
1. Hydrocortisone (cortisol):- Rapid action + short duration of action
Glucocorticoids + Mineralocorticoids action
Uses:-
Acute adrenal insufficiency
Status asthmaticus
Anaphylactic shock (emergency uses)
ulcerative colitis-Topically and as suspension for enema
2. Prednisolone:-
It is 4 times more potent than hydrocortisone
Has intermediate duration of action
Also process→ mineralocorticoid Action(Na+ & water retention)-higher dose
Uses-used preparation for allergic, inflammatory, autoimmune disorders and in
malignancies.
It causes less HPA axis suppression if given once daily in the morning
15. 3.Prednisone:-
• It is a prodrug, gets converted to prednisolone in liver;
• less efficacious, hence rarely used
4.Methyl-prednisolone:-
• It is used for its anti-inflammatory and immunosuppressant effects; as high-dose pulse
therapy
• in renal transplant, pemphigus vulgaris, etc.
• Routes: Retention enema in ulcerative colitis
5.Triamcinolone:-
• More potent and relatively more toxic than prednisolone.
• It has no mineralocorticoid activity
6. Dexamethasone:-
Very potent and highly selective glucocorticoid.
It is also long-acting causes marked pituitary-adrenal suppression
USES:-inflammatory and allergic conditions like shock & cerebral edema
16. 6.Betamethasone:- Similar to dexamethasone
• USES:- cerebral edema and other states in which fluid retention must be
avoided
7. Beclomethasone:-
They have local action
It is used by inhalation in bronchial asthma, as nasal spray for allergic rhinitis;
as ointment for skin and mucous membrane lesions.
HPA-axis suppression is minimal
8. Budesonide:-more potent than beclomethasone
• 9. Fluticasone:-
• Uses:-
• Asthma & COPD-inhalational route
• Inflammatory bowel disease-orally
• skin and mucous membrane lesions- ointment
17. • Desoxy-corticosterone acetate (DOCA):-
• It has selective mineralocorticoid activity and is used in Addison’s disease as
replacement therapy
• Fludrocortisone:-
• Potent mineralocorticoid activity.
• USES:-
• Addison’s disease:- as a replacement therapy (fludrocortisone + hydrocortisone)
Side effects of corticosteroid therapy:-
• Depends on dosages + duration of therapy
• Less side effect-short period(<2 weeks)
• ↑risk→ prolong use+ ↑dosing
18. Hypothalamic–pituitary–adrenal (HPA) axis suppression:-
Not seen-<1 week therapy with mild-moderate & high doses
Required precautions-during long term therapy
1. Topical use of steroids is preferred
2. Short- or intermediate-acting steroids (e.g. hydrocortisone, prednisolone) should
be preferred
3. If daily dose is high-split the dosing
2/3-dose at Morning
1/3-dose at Evening
4. Try alternate-day steroid therapy in chronic conditions like bronchial asthma,
nephrotic syndrome, systemic lupus erythematosus (SLE), etc
5. Tapering of dose-Withdrawal of steroids after long-term (2 weeks) treatment
should be very slow to allow recovery of normal adrenocortical function.
Minimize the HPA axis suppression
19. • Abrupt stoppage- Glucocorticoid therapy following prolonged use leads to
Flaring up of the underlying disease being treated.
• Withdrawal symptoms- like fever, myalgia, arthralgia, malaise, etc.
Metabolic effects:- Hyperglycaemia, precipitation of diabetes mellitus (DM) or
aggravation of pre-existing diabetes.
Cushing’s habitus:- Abnormal fat distribution causes peculiar features with
moon face, buffalo hump and thin limbs
GIT:- Peptic ulceration sometimes with haemorrhage or perforation.
Salt and water retention: Mineralocorticoid effect may cause oedema,
hypertension and even precipitation of CCF, particularly in patients with primary
hyperaldosteronism.
Rx-minimized by using synthetic steroids like dexamethasone, betamethasone,
etc.
Muscle- hypokalemia leading to muscle weakness and fatiguability.
Long-term steroid therapy –cause steroid myopathy
20. Bone:-
Osteoporosis with pathological fractures of vertebral bodies is common. Ischemic necrosis
of the femoral head can also occur.
Growth retardation in children is more common with dexamethasone and
betamethasone.
Eye:- Glaucoma and cataract may occur on prolonged therapy.
CNS:- Behavioral disturbances like nervousness, insomnia, mood changes can occur
psychosis may be precipitated.
Long-term therapy- steroids leads to immunosuppression, which makes the patient
more vulnerable to various infections like fungal (candidiasis, cryptococcosis), viral
(herpes, viral hepatitis), bacterial (reactivation of latent tuberculosis), etc.
Inhalational steroids- can cause local irritation and fungal infection of upper
respiratory tract, which can be prevented by the use of spacer and by rinsing the mouth
after inhalation.
21. Therapeutic uses of glucocorticoids:-
Endocrinal uses:-
1. Acute adrenal insufficiency:- (Medical emergency)
Rx-
I.V. hydrocortisone and i.v. normal saline with 5% glucose to correct fluid and
electrolyte imbalance. Precipitating causes such as trauma, infection or
hemorrhage should be treated.
2. Chronic adrenal insufficiency:-(Addison’s disease)
Treated with oral hydrocortisone
2/3-moring dose +1/3-evening dose + adequate salt and water.
2. Chronic secondary adrenocortical deficiency
3. Congenital adrenal hyperplasia
4. Maintenance therapy in Cushing syndrome (after surgical removal of
pituitary/adrenal tumor)
22. Non-endocrinal uses:-
• Because of their dramatic symptomatic relief, they are often misused. Non-
endocrinal diseases require
1. In dentistry:-Topical or systemic glucocorticoids are used in:-
• Recurrent aphthous stomatitis
• Chronic ulcerative stomatitis
• Oral pemphigoid
• Erythema multiforme
• Temporomandibular joint pain:- Intra-articular triamcinolone is used.
2. Rheumatoid arthritis:-
Immediate symptomatic relief but no action on progression of the disease.
Intra-articular injection is preferred only if one or two joints are involved.
Use adjunct NSAIDs & DMARDs
23. 3.Osteoarthritis:- rarely used in OA. Intra-articular injection is recommended for
acute episodes.
4. Rheumatic fever:-
They produce more rapid symptomatic relief than aspirin
Prednisolone is given along with aspirin and should be continued until the
erythrocyte sedimentation rate (ESR) comes to normal and then the steroid is
tapered off gradually.
5. Allergic diseases:- such as
Hay fever, Reactions to drugs, Urticaria, serum sickness, Contact dermatitis,
Angioneurotic oedema
Anaphylaxis-(DOC-adrenaline) as corticosteroid are slow onset of action.
Adjuvant I.V.- hydrocortisone+ I.M. Adrenaline
6.Bronchial Asthma-
Moderate to severe asthma-inhaled or systemic glucocorticoids
I.V. hydrocortisone + nebulized β2-agonist and ipratropium bromide
24. • Advantage-
• ↓ mucosal oedema and bronchial hyperirritability
• ↓development of resistance to glucocorticoids
Status asthmatics:-inhalational preparations like beclomethasone, budesonide
or fluticasone because they cause minimal systemic adverse effects.
7.Immunosuppressive therapy:-
Collagen vascular disease- large dose glucocorticoids(steroid with negligible
salt and water retaining property is preferred )
Skin graft-To avoid rejection
Organ transplantation-Glucocorticoids prevent as well as treat graft rejections
Acute immune disease-thrombocytopenia
Renal disease- Glucocorticoids are the first-line drugs in nephrotic syndrome
Chronic demyelinating polyneuropathies- e.g. Guillian barre syndrome
25. Myasthenia gravis
8. Ocular diseases:- used to suppress inflammation in the eye thus they prevent
damage to vision.
Administered- topically, sub conjunctivally, systemically or by retrobulbar
injection, depending upon the condition.
Contraindicated in herpes simplex, keratitis and ocular injuries.
9. Skin diseases:-
They dramatically relieve itching, pain, and inflammation in allergic and other
dermatoses.
To minimize systemic effects, topical steroids are preferred.
Systemic steroid therapy is needed in severe conditions like exfoliative dermatitis,
dermatomyositis, pemphigus, etc. Psoriasis, keloids and hypertrophic scar are
sometimes treated by intralesional injection of steroids.
10.Lung maturation in the foetus- betamethasone is given to mother who is going
to delivered premature baby(12mg i.m. followed by 12mg i.m. next day)
↓incidence of respiratory distress syndrome in infant
26. 11.Cerebral oedema:- oedema is caused by brain tumors, metastatic lesions and
tubercular meningitis. A steroid without salt and water retaining activity (e.g.
dexamethasone) is preferred.
12.Intestinal diseases:- They are used in ulcerative colitis when the patient is not
responding to other forms of treatment. Methylprednisolone can be administered as
retention enema during acute episodes
13.Hypercalcemia:- Hypercalcemia of sarcoidosis, and vitamin D intoxication responds
to prednisolone
Others:-
HIV related disorders e.g. pneumocystis carinii pneumonia, MAC
Lepra reaction & septic shock
Contraindication:-
Hypertension Epilepsy
Diabetes mellitus Psychosis
Peptic ulcer Congestive cardiac failure
Tuberculosis Renal failure
Herpes simplex keratitis Glaucoma
Osteoporosis
27.
28. • Anabolic Steroids are drug derived from synthetic testosterone, a
natural male hormone that are used to enhance performance
• They are synthetic androgens with greater anabolic(skeletal muscle) and
lesser androgenic activity
• On skeletal muscle testosterone →↑strength + muscle mass when used
with exercise for development of muscle & often misused
• Testosterone- potent anabolic effect, but it cannot be used because of
its strong androgenic effect
• Doping:- “Use of an expedient (substance or method) which is potentially harmful
to athletes’ health and/or capable of enhancing their performance, or the presence
in the athletes body of a prohibited substance or evidence of the use there of or
evidence of the use of a prohibited method”
30. Mechanism of Action :-
Anabolic steroid increase the body mass & increase the physical
performance by
1.Increasing the incorporation of amino acids into protein
2.Increasing the RNA polymerase activity in skeletal muscles.
3.Antagonizing protein catabolic effects of glucocorticoids
Antagonizing protein catabolic effect of glucocorticoids
Resulted-weight gain
31. 1. Catabolic states- In chronic illness they use to improve appetite &
feeling of wellbeing (as a protein anabolic agents)
2. During recovery from prolonged illness, surgery, burns, trauma or
chronic debilitating diseases.’
3. Short stature
– Athletic performance- misused by athletes. Their use by athletes is
prohibited. They can be detected in the urine by antidoping investigations.
– In postmenopausal and senile osteoporosis - ↓ca++ ion excretion (preferred
drug bisphosphonate)
32. Side effect:-
In Men:-
• Oligozoospermia,infertility – due to inhibition of LH,FSH(Negative feedback)
• Gynaecomastia- due to peripheral conversion of testosterone to estrogen
In women-
Virilization,
muscle hypertrophy ,
acne,
hirsutism,
frontal hair thinning,
deepening of voice ,
Anovulation
33. Teretogenic effect-
pseudomaphroditism (female uterus)
Children- Impairment of growth due to – premature closer of epiphyses
Toxicity in either sex-
Na+,H20 retention-oedema,
polycythaemia,
cirrhosis of liver.
Cholestatic jaundice-mainly with methyltestosterone
Abuse is sports- due to non-pharmacological use – serious side effect
Contraindication-
Pregnancy
Renal dysfunctions
Patients suffering from migraine, diabetes
Synthesized and released under influence of ACTH - Ant. Pituitary (HPA axis).
Central such as back of neck & shoulders
Stomatitis-A condition that causes painful swelling and sores inside the mouth
Pemphigoid-Auto-immun disease with patches
Erythema multiforme is a skin condition considered to be a hypersensitivity reaction to infections or drugs
Thrombocytopenia-low platelet count.
To achieve performance large dose of drug use leading to side effect-hepatic damage,tendon rupture,impotence,acne
Polycythaemia-an abnormally increased concentration of haemoglobin in the blood, either through reduction of plasma volume or increase in red cell numbers