In comparing the relative potencies of corticosteroids in terms of their anti-inflammatory (glucocorticoid) effects it should be borne in mind that high glucocorticoid activity in itself is of no advantage unless it is accompanied by relatively low mineralocorticoid activity.
The mineralocorticoid activity of fludrocortisone is so high that its anti-inflammatory activity is of no clinical relevance. The below shows equivalent anti-inflammatory doses.
Prednisolone 5 mg
= Betamethasone 750 micro-grams
= Deflazacort 6 mg
= Dexamethasone 750 micrograms
= Hdrocortisone 20 mg
= Methylprednisolone 4 mg
= Prednisone 5 mg
= Triamcinolone 4 mg
The relatively high minrelocoticoid activity of hydrocortisone, and the resulting fluid retention, makes it unsuitable for disease suppression on a long-term basis.
However, hydrocortisone can be used for adrenal replacement therapy. Hydrocortisone is used on short-term basis by intravenous injection for the emergency management of some conditions. The relatively moderate anti-infammatory potency of hydrocortisone also makes it a useful topical corticosteroid for the management of inlfammatory skin conditions because side-effects are less marked.
Prednisolone and prednisone have predominantly gucocorticoid activity. Prednisoone is the corticosteroid most commonly used by mouth for long-term disease suppresion.
Betamethasone and Dexamethasone have very high gucocorticoid activity in conjunction with insignificant mineralocorticoid activity. This makes them particularly suitable for high-dose therapy in conditions where fluid retention would be a disadvantage.
Betamethasone and Dexamethasone aslso have a long duration of action and this, couples with their lack of mineralocorticoid action makes them particularly suitable for conditions which require suppresion of corticotropin secretion. Spme esters of betamethasone and of beclomethasone exert a consoderaby more marked topical eefect than when given by mouth; use is made of this to obtain topical effects whist minimising systemic side-effects.
Deflazacort has a high glucocorticoid activity; it is derived from pednisolone.
The mineralocorticoid activity of fludrocortisone is so high that its anti-inflammatory activity is of no clinical relevance. The below shows equivalent anti-inflammatory doses.
Prednisolone 5 mg
= Betamethasone 750 micro-grams
= Deflazacort 6 mg
= Dexamethasone 750 micrograms
= Hdrocortisone 20 mg
= Methylprednisolone 4 mg
= Prednisone 5 mg
= Triamcinolone 4 mg
The relatively high minrelocoticoid activity of hydrocortisone, and the resulting fluid retention, makes it unsuitable for disease suppression on a long-term basis.
However, hydrocortisone can be used for adrenal replacement therapy. Hydrocortisone is used on short-term basis by intravenous injection for the emergency management of some conditions. The relatively moderate anti-infammatory potency of hydrocortisone also makes it a useful topical corticosteroid for the management of inlfammatory skin conditions because side-effects are less marked.
Prednisolone and prednisone have predominantly gucocorticoid activity. Prednisoone is the corticosteroid most commonly used by mouth for long-term disease suppresion.
Betamethasone and Dexamethasone have very high gucocorticoid activity in conjunction with insignificant mineralocorticoid activity. This makes them particularly suitable for high-dose therapy in conditions where fluid retention would be a disadvantage.
Betamethasone and Dexamethasone aslso have a long duration of action and this, couples with their lack of mineralocorticoid action makes them particularly suitable for conditions which require suppresion of corticotropin secretion. Spme esters of betamethasone and of beclomethasone exert a consoderaby more marked topical eefect than when given by mouth; use is made of this to obtain topical effects whist minimising systemic side-effects.
Deflazacort has a high glucocorticoid activity; it is derived from pednisolone.
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