Corticosteroid use in asthma

Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

There were 1455 preterm deliveries included in the present study; 527 (%) occurred before 34 weeks of pregnancy and prenatal corticosteroids were used in 285 (%) of these pregnancies. Among neonates delivered at 32–33 +6  weeks, prenatal corticosteroid use was associated with lower pneumonia ( P= ) and mortality ( P= ) rates. Among neonates delivered at 34–36 +6  weeks, prenatal corticosteroid use was associated with longer neonatal hospital admission ( P< ), and an increased incidence of 5-minute Apgar scores below 7 ( P= ), endotracheal intubation ( P= ), surfactant use ( P= ), neonatal morbidities ( P= ), respiratory distress ( P= ), and intraventricular hemorrhage ( P= ).

Dexamethasone is given systemically to decrease inflammatory and immune responses. It is used in high doses in emergencies for anaphylactic reactions, spinal cord trauma or shock. It is used in lower doses to treat allergic reactions such as Chronic Obstructive Pulmonary Disease (COPD), hives, itching, inflammatory diseases including arthritis and to manage and treat immune mediated hemolytic anemia and thrombocytopenia. It sometimes is used systemically as a "performance-enhancing” drug because corticosteroids decrease inflammation, possibly enhance glucose metabolism (there is some debate about this) and may have some mood elevating properties. Other corticosteroids are preferred for intra articular use.

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

Corticosteroid use in asthma

corticosteroid use in asthma

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

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