1.Short-acting (nisone): cortisone, hydrocortisone (the former is converted into the latter in the liver before it takes effect)
2, medium-acting (nisone class): nisone prednisone, hydrogenated prednisone (prednisolone) (the former is converted into the latter in the liver before taking effect).
3.Long-acting (Mizzone-type): dexamethasone, betamethasone.
4. Topical (fludrocortisone): fludrocortisone, skin relaxation.
Glucocorticoids summary (memory method, eight four).
1, there are four conformational relationships: the basic structure of the steroid nucleus
(1) C3 ketone group, C20 carbonyl and C4-5 double bond is necessary to maintain physiological function;
(2) C17 with -OH; C11 with =O or -OH;
(3) The double bond of C1-2 and the introduction of -CH3 to C6 increase the anti-inflammatory effect and decrease the water-salt metabolism;
(4) C9 introduced -F, C16 introduced -CH3 or -OH is stronger anti-inflammatory effect, water and salt metabolism is weaker.
2.Four major physiological effects: glycemic, egg solving, lipid sharing and sodium preservation.
(1)Glycemic: promote glycogen isogenesis; inhibit sugar uptake and oxidative utilization;
(2) egg solving: synthesis of ¯, accelerated decomposition) r (negative nitrogen balance;
(3) Lipid partitioning: fat synthesis¯, catabolism; fat redistribution;
(4) Sodium retention: water and sodium retention;
3, divided into four categories: short-acting (of pine class), medium-acting (nisone class), long-acting (mizone class), topical (flusone class)
4, four major anti-inflammatory effects (supraphysiological dose): anti-inflammatory, anti-toxic, anti-allergic, anti-shock
5, the role of the blood and hematopoietic system, four more and one less: red blood cells, hemoglobin, platelets, fibrinogen increase, lymphocyte reduction
6, adverse reactions.
Four one: one in, one out, one slow, one against.
(1) one into: the class of hyperadrenocorticism (Cushing’s syndrome).
(2) One retreat: adrenal cortical atrophy and hypersecretion.
(3) A retardation: delayed wound healing. (3) One regression: rebound phenomenon of drug discontinuation.
IV triggering.
(1) Induced or aggravated infection.
(2) Induced or aggravated diabetes mellitus, hypertension.
(3) Induced or aggravated ulcer disease.
(4) Induced or aggravated psychosis.
7. Quadruple use.
(1) Small amount of substitution: hyperalgesia, etc .
(2) Large amount of surprise: severe infection or shock.
(3)Positive amount for a long time: autoimmune diseases, post-inflammatory diseases, etc.
(4)Two-day total amount once for morning use.
Description:For certain chronic diseases that have been controlled with corticosteroids, alternate day dosing can be used instead, i.e., the 48-hour dose is taken once in the morning at 8:00 a.m. The efficacy is the same as daily dosing, while the hypothalamus-pituitary, adrenal cortex is less inhibited and the adverse effects are less. Prednisone, prednisolone is better when given every other day. 20mg prednisone is equivalent to 0.75mg dexamethasone .