Corticosteroid use in anaphylaxis

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.

Using a nationwide dataset of private insurance claims, researchers identified patients aged 18–64 years who were enrolled from 2012–2014. The main outcomes included rates of short-term use of oral corticosteroids (defined as <30 days duration), rates of adverse events in corticosteroid users vs. non-users, and the rate ratios for adverse events within 30 day vs. 31–90 day risk periods after treatment initiation.   Related Articles

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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.

Corticosteroid use in anaphylaxis

corticosteroid use in anaphylaxis

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