Kortikosteroidni preparati

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RESULTS: There is a significant difference between incidence rate of pneumonia for patients who used inhaled corticosteroids and incidence rate of pneumonia for patients who used only salbutamol (p = ). 52% of the patients who used inhaled corticosteroids had pneumonia or upper respiratory tract infection. Daily symptoms frequency (less than once per week) and night symptoms frequency (less than twice per month) had value of 47% for patients who used inhaled corticosteroids and value of 25% for patients who used only salbutamol. Number of patients who have these symptoms more than once per week, or for night symptoms more than twice per month is equal for both groups and has value of 30% patients of each group.

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.

Kortikosteroidni preparati

kortikosteroidni preparati


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