Directory → Hormones and their antagonists → Adrenal → Glukokortikoida
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The groupGlukokortikoida affect carbohydrate and protein exchange, but less so in relation to the water and salt exchange. They contribute to the accumulation of glycogen in the liver, the increase of glucose in the blood, increasing the nitrogen in the urine.
With the organism (as a drug) glukokortikoida have antiinflammatory, and desencibilizirutee protiwallergicescoe effect. They have also protivosokovmi and antitoxic properties.
A characteristic feature of glucocorticoids is immunodepressus activity. Unlike drugs immune properties of glucocorticoids do with mitostaticski action.
The state-of-the-art, corticosteroids slow release Cytokines (interleukin 1 and 2 and gamma-interferon) from the cells and macrophages, drove up eozinofilami inflammation mediators, reduce metabolism arahidonova acid. Stimulating receptors societies, they inducyruut special education class protein-lipokortinov with protivootecna and противовоспалительно й activity.
A relatively high doses glukokortikoida factor limfoidna and connective tissues, including retikuloendotelia; Reduce the number of fat cells a place of hyaluronic acid suppress activity gialuronidasy and reduce permeability of the capillaries. Under the influence of glucocorticoids delayed fusion and accelerated the disintegration of proteins.
A napochecnica hormones is controlled by the central nervous system, and in close relation to the pituitary function. Adrenakortikotropony pituitary hormone (ACTG, kortikotropin) is a physiological stimulus napochechnikov crust. Kortikotropin enhances education and the provision of glucocorticoids. The latter, in turn, affect the Gray, oppressing a kortikotropina and thus reducing further stirring napochechnikov (feedback). Prolonged Administration of glucocorticoids (eye and its analogues) could lead to oppression and atrophy napochechnikov crust, and the oppression of education is not only ACTG but gonadotroponah tireotroponogo and pituitary hormones.
Practical use as medicines, in addition to eye and hydrocortisone found many of their synthetic substitutes : pred, prednisolone, metilprednizolon, dexamethasone, triamcinolon, flumetazon, betamethasone, etc. These compounds tend to be more active than natural glukokortikoida operate at lower doses; some of them more toxic, as a local (skin atrophy), and systemic (oppression napochechnikov crust) side effects.
The testimony to the use of glucocorticoids are kollagenozy, arthritis, rheumatoid arthritis, bronchial asthma, acute lymphoblastic and myeloblastic leukemia, infectious mononucleosis, neirodermita, eczema and other skin diseases, various allergies. Glukokortikoida applied with the hemolytic anemia glomerulonefrite, acute pankreatite, virusnom Hepatitis and other diseases. With regard to the effect protivosokovm glukokortikoida designated for the prevention and treatment of shock (trauma, operating, toxic, anaphylacticski, burns, cardiogennogo etc.).
Immunodepressivne of glucocorticoids enable them to be used for the transplantation of organs and tissues to suppress rejection reactions, as well as various "autoimmune diseases". "
Glukokortikoida are, in many cases, very valuable therapeutic means. It should, however, bear in mind that they may give rise to a number of side effects, including simptomokomplex Itsenko - Kushinga (delay of sodium and water in the body of possible trauma, the loss of potassium, the AD), giperglikemia until diabetes mellitus (steroidnyi diabetes), increased the calcium and osteoporosis, the slow regeneration of tissues, worsening ulcers stomach and duodenal ulcers, izgyazwlenia digestive tract CPMSR nerspoznanna canker haemorrhagic pancreatitis, low resistance to infection, giperkoagulyatia the risk of thrombosis, a bass, lunoobraznogo person obesity menstrual irregularities, etc. can also nervous and mental health disorders : insomnia, excitation (with the development of some cases of psychoses) epileptiformnye convulsions, euphoria.
With long-term use glucocorticoids should take into account the likely oppression of the crust napochechnikov (not quite impossible) to the suppression of the biosynthesis of hormones. Introduction kortikotropina while glukokortikoidami prevents bone napochechnikov.
Sudden removal of glucocorticoids could exacerbate the process. Treatment should end the gradual decrease in dose.
The frequency and strength of side effects caused by glukokortikoidami, can be expressed in different ways. When selecting dose to be taken, the continuing monitoring of treatment side effects are available.
With regard to side effects glukokortikoida apply only when there are clear testimony and carefully medical supervision. Protivopokazana them in heavy forms hypertensive disease Itsenko-kushinga disease, pregnancy, circulatory failure III stage acute endocardite, psihozah, nephrite, osteoporosis, ulcers stomach and duodenal ulcers, after recent surgery, and AIDS, and the active form of tuberculosis (in the absence of a specific treatment), diabetes, allergies to glukokortikoida (including in history). Products containing glukokortikoida (ointments, drops) should not be applied to viral diseases, eye and skin because the oppression of regeneration might be common salt (in the eye until corneal perforation). The fungal and parasitic skin lesions should not apply ointments containing corticosteroids, if they are not added or fungicidal protivoparazitarnae funds.