on 17.3.09 with 0 comments

  • Pharmacology

    • oral or IV

    • binds extensively to serum albumin, so increased bioavailability with low serum albumin

  • Mechanisms of action

    • binds glucocorticoid receptor and regulates transcription of a multitude of genes for the initiation, implementation of immune responses

    • glucocorticoids enhance IκB expression (i.e., decrease NF-κB); impairs expression of a number of cytokines (decreases IL-1, 2, 3, 6, TNFα, IFN-γ)

    • lympholytic; causes redistribution of lymphocytes into nodes; decreases activation of cytotoxic T lymphocytes (CTLs)

  • Common side effects, which generally are associated with high doses of systemic glucocorticoids and not inhaled agents

    • hypertension

    • glucose intolerance

    • dyslipidemia

    • osteoporosis; avascular necrosis of femoral head

    • decreased wound healing

    • cataracts

    • enhanced risk of infection; decreased signs of infection. “patients smile all the way to the morgue”

  • we use it early, at the time of transplantation; it is a mainstay of treatment for autoimmune diseases and a variety of inflammatory diseases

Category: Medical Subject Notes , Pathology Notes



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