Asthma treatment

  Therapeutic use [Edit]
Glucocorticoid drugs, such as cortisone, have anti-inflammatory effect. They are used for therapy, for example, allergic rhinitis or bronchial asthma used. Highly effective alternatives are in acute emergencies (anaphylaxis, sepsis, shock) are used. Other preparations can be applied topically (locally) can be used, for example on the skin or in the nose. Today there are numerous topical Glucocorticoids available, such as budesonide or Fluticasonpropionat.

Effects: On the Bronchialschleimhaut decongestant inflammation and inhibition – the Hyperreaktivität the Bronchialschleimhaut is reduced – and in the solution Bronchialmuskulatur convulsions. Both effects occur earlier than 30 minutes after the injection of the medicine.

  Side effects [Edit]
Depending on the strength of class and localization can be applied to the skin (topical) corticosteroids for long-term application (weeks to months) or systemic (ie not local) application of side effects: water retention in the tissues (edema) and weight gain, weakening of the immune system, promoting the formation of gastric ulcers, promoting the formation and strengthening of an existing diabetes mellitus, promotion and strengthening of an existing bone loss (osteoporosis), for inhaled administration hoarseness. Glucocorticoids inhibit the conversion of vitamin D3 in the active ligands Calcitriol. Therefore, it is during a systemic Corticoidtherapie if vitamin D used to be necessary, vitamin D into active form as Alphacalcidol (current medications in Germany: “One Alpha”, “Bondiol”, “Doss”), to be used. The kurzdauernde Stoßtherapie in acute diseases is virtually free of side effects.

Generic Name Trade Name Biological half-life equivalent dose
Cortisone very short 25
Cortisol very short 20
Cloprednol Synthestan ®? 2,5-5
Prednisone short Decortin ® 5
Prednisolone Decortin ® H 5 briefly
Methylprednisolone Urbason ® short 4
Deflazacort Calcort ®? 7-9
Fluocortolon Ultralan ® medium 5
Triamcinolone Volon ® medium 4
Dexamethasone ® Fortecortin long 0,75-1
Betamethasone Celestan ® solubile long 0.75

  Topical application [Edit]
Glucocorticoids are not systemic, but only at certain points, mostly on the skin, (ie, topically) applied, so each show has different active ingredients as the relative efficacy for parenteral application. Possible desirability of a strong anti-inflammatory / antiproliferative effects to various skin manifestations, such as eczema, can disappear without the skin to move too far to atrophy (reduce). Moreover, it may be in strong agents, prolonged use and application of large area or greatly reduced barrier function of the skin lead to significant systemic (usually undesirable) effects of the corticoids come.

In order to improve dermal Wirkprofil, intelligent steroids developed, which are metabolized more quickly. Their main effect is only superficial coverage to come by in deeper layers or in the circulation rapidly dismantled. This rapid metabolism by specific adducts on Corticoidmolekül achieved: examples are Prednicarbat, Mometasonfuroat, Hydrocortsonbutyrat, aceponat, Methylprednosolonaceponat. Such adducts can also use the biological effectiveness, both topically and systemically, modify.

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