Corticosteroids immunosuppressive drugs

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We identified seven trials, with 895 evaluable participants for this review. All provided data suitable for the primary outcome meta-analysis. One of the trials was new since the last version of this Cochrane systematic review. Risk of bias in the older, smaller studies included some unclear- or high-risk assessments, whereas we deemed the larger studies at low risk of bias. Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation; significantly fewer than the 125/447 (28%) in the control group (risk ratio (RR) , 95% confidence interval (CI) to , seven trials, n = 895). The number of people who need to be treated with corticosteroids to avoid one incomplete recovery was 10 (95% CI 6 to 20). The reduction in the proportion of participants with cosmetically disabling sequelae six months after randomisation was very similar in the corticosteroid and placebo groups (RR , 95% CI to , two trials, n = 75, low-quality evidence). However, there was a significant reduction in motor synkinesis during follow-up in participants receiving corticosteroids (RR , 95% CI to , three trials, n = 485, moderate-quality evidence). Three studies explicitly recorded the absence of adverse effects attributable to corticosteroids. One trial reported that three participants receiving prednisolone had temporary sleep disturbances and two trials gave a detailed account of adverse effects occurring in 93 participants, all non-serious; the combined analysis of data from these three trials found no significant difference in adverse effect rates between people receiving corticosteroids and people receiving placebo (RR , 95% CI to , n = 715).

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.

Glucocorticoide erfüllen wichtige Aufgaben im Glucose-, Lipid- und Proteinstoffwechsel. Ein Mangel kann zu einer glucocorticoidinduzierten Osteoporose führen. Aus diesem Grund ist bei der Einnahme auf einen vermehrte Zufuhr mit Vitamin D , Vitamin C und K, sowie Magnesium und Zink zu achten. Vor allem der Bedarf an Vitamin D und C, wird durch die Gabe von Glucocorticoiden stark erhöht. Omega-3- Fettsäuren hingegen können den Bedarf an Glucocorticoiden senken. Dies sollte grundsätzlich in Verbindung mit einer speziell abgestimmten Ernährung erfolgen.

Corticosteroids immunosuppressive drugs

corticosteroids immunosuppressive drugs

Glucocorticoide erfüllen wichtige Aufgaben im Glucose-, Lipid- und Proteinstoffwechsel. Ein Mangel kann zu einer glucocorticoidinduzierten Osteoporose führen. Aus diesem Grund ist bei der Einnahme auf einen vermehrte Zufuhr mit Vitamin D , Vitamin C und K, sowie Magnesium und Zink zu achten. Vor allem der Bedarf an Vitamin D und C, wird durch die Gabe von Glucocorticoiden stark erhöht. Omega-3- Fettsäuren hingegen können den Bedarf an Glucocorticoiden senken. Dies sollte grundsätzlich in Verbindung mit einer speziell abgestimmten Ernährung erfolgen.

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