Oral corticosteroids

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.

Compared to the year before the procedure, at 1-year postadenotonsillectomy follow-up, there was a % reduction in acute asthma exacerbations and a % reduction in acute status asthmaticus ( P < for both). [ 68 , 69 ] In addition, asthma-related emergency department visits were reduced by % and asthma-related hospitalizations by %. Patients who underwent the procedure also had significantly fewer refills of several asthma medications. In contrast, no significant reductions were observed in any of these outcomes among children who did not undergo adenotonsillectomy. [ 68 , 69 ]

  • Prevent asthma symptoms from occurring
  • Can reduce and/or prevent:
    • Inflammation and scarring in the airways
    • Tightening of the muscle bands around the airways (bronchospasm)
  • Do not show immediate results, but work slowly over time
  • Should be taken daily, even when you are not having symptoms
  • Should NOT be used to relieve immediate asthma symptoms.

Back to top A Note about Long-Term Controller Medicines in Children According to the National Asthma Education and Prevention Program at the National Institutes of Health, long-term controller medicines should be considered when infants or young children have had three or more episodes of wheezing in the previous 12 months and who are at an increased risk of developing asthma because of their own or their parents' history of allergic diseases.

They also recommend long-term controller medicines for children who need short-acting bronchodilators (rescue medicines) more than twice a week or have had severe asthma symptoms less than six weeks apart. Without a controller medicine, the underlying inflammation will continue to cause more asthma symptoms.

Back to top
  • Site Map
© 2015 Palo Alto Medical Foundation. All rights reserved. Sutter Health is a registered trademark of Sutter Health®, Reg. Patent. & Trademark office.
Serving communities around Palo Alto, Mountain View, Fremont, San Jose, San Francisco, Oakland, Dublin, San Mateo & Santa Cruz.

Oral corticosteroids

oral corticosteroids

Media:

oral corticosteroidsoral corticosteroidsoral corticosteroidsoral corticosteroidsoral corticosteroids