Drugs

How might Glucocorticoids be grouped in terms of biologic activity? Glucocorticoids may be divided into three main groups according to their duration of biologic activity. The categories are presented in the below table Glucocorticoids Grouped in Terms of Biologic Activity Short-Acting(Half-life 12 hours) Intermediate-Acting(Half-life 12–36 hours) Long-Acting(Half-life 48 hours) Hydrocortisone Prednisone Paramethasone Cortisone Prednisolone Betamethasone …

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In the treatment of rheumatic disease, what is considered to be low-dose, medium-dose, and high-dose daily prednisone therapy? Low dose ≤7.5 mg/day Medium dose 7.5 mg/day to <40 mg/day High dose ≥40 mg/day to 100 mg/day (2 mg/kg per day in children) Very high dose >100 mg/day

Timing of the daily dose of Glucocorticoids medication to minimize the risk of HPA axis suppression The body makes 10 to 12 mg/day of cortisol (equivalent to 2.5–3 mg/day prednisone). Because natural cortisol secretion in humans has a circadian rhythm with the peak level in the morning, taking the GC at that time will have …

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How may a general clinical baseline be established for potential complications before instituting Glucocorticoids therapy? • Some chronic infections, that is, opportunistic, may not be immediately apparent on the initial physical examination and may progress rapidly when corticosteroid therapy is implemented. For a baseline, obtain a chest x-ray, tuberculin skin test (or interferon gamma-release assay), and screen for hepatitis B and …

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How is prednisone metabolized? Prednisone is metabolized in the liver to the active form, prednisolone. This conversion is impaired in patients with significant liver disease, which is present if the patient has an elevated international normalized ratio (INR) that cannot be normalized with supplemental vitamin K. In those patients, prednisolone and not prednisone should be …

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What are the effects of Glucocorticoids on the innate and adaptive immune systems? • Innate immune system. GCs upregulate enzymes that degrade bradykinin resulting in vasoconstriction. This causes less swelling and pain. GCs suppress production of prostaglandins by inducing synthesis of lipocortin-1, which inhibits phospholipase A2-mediated liberation of arachidonic acid from cell membranes. GCs inhibit NF-κB …

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general indications for implementation of GlucoCorticoids therapy in rheumatology GCs are potent medications discovered in 1949 (Drs. Hench and Kendall won Nobel Prize in 1950) and used since then for various medical indications. In the management of rheumatic disorders, there are two primary indications for their use: • Suppression of the inflammatory cascade. • Modification of the …

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