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Khác biệt giữa bản sửa đổi của “Corticosteroid”

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'''Corticosteroids''' là nhóm chất bao gồm [[hormone steroid]] tự nhiên được sản xuất từ [[tuyến thượng thận]] của [động vật có xương sống]] và các tổng hợp hormone tương tự trong phòng thí nghiệm. Corticosteroids liên quan đến rất nhiều quá trình [[sinh lý]] bao gồm [[đáp ứng stress]], [[đáp ứng miễn dịch]], [[viêm]], [[chuyển hóa]] [[carbohydrate]], [[quá trình dị hóa]][[protein]], và hành vi.
 
* '''[[Glucocorticoid]]''' như là [[cortisol]] kiểm soát chuyển hóa carbohydrate, chất béo và protein, kháng viêm nhờ ngăn chặn phóng thích [[phospholipid]], giảm hoạt động của [[bạch cầu hạt ưa eozin]] và một số cơ chế khác.<ref>{{citechú bookthích sách|title=Coumarin Anticoagulant Research Progress|author=Joseph P. Edardes|chapter=Steroids and Warfarin Therapy|publisher=Nova Publishers, 2008|page=18}}</ref>
* '''[[Mineralocorticoid]]''' như là [[aldosterone]] kiểm soát lượng chất điện phân và nước, nhưng chủ yêu là tăng lưu trữ muối ở [[thận]].
 
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=== Cấu trúc phân tử===
Nói chung, corticosteroids chia thành bốn nhóm, dựa trên cấu trúc hóa học. Phản ứng dị ứng to one member of a class typically indicate an intolerance of all members of the class. This is known as the "Coopman classification",<ref name="isbn1-55009-378-9">{{citechú bookthích sách |author=Rietschel, Robert L. |title=Fisher's Contact Dermatitis, 6/e |publisher=BC Decker Inc |location=Hamilton, Ont |year=2007 |page=256 |isbn=1-55009-378-9 }}</ref> after S. Coopman, who defined this classification in 1989.<ref name="pmid2757954">{{cite journal |author=Coopman S, Degreef H, Dooms-Goossens A |title=Identification of cross-reaction patterns in allergic contact dermatitis from topical corticosteroids |journal=Br. J. Dermatol. |volume=121 |issue=1 |pages=27–34 |year=1989 |month=July |pmid=2757954 |doi= 10.1111/j.1365-2133.1989.tb01396.x}}</ref>
The highlighted steroids are often used in the screening of allergies to topical steroids.<ref>{{citechú bookthích sách |author=Wolverton, SE |title=Comprehensive Dermatologic Drug Therapy |publisher=WB Saunders |year=2001 |page=562 }}</ref>
 
====Nhóm A — loại Hydrocortisone ====
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==== Steroids xông hít ====
 
Sử dụng điều trị tại niêm mạc mũi, xoang mũi, phế quản, phổi.<ref>{{citechú thích web|url=http://www.webmd.com/asthma/guide/asthma_control_with_anti-inflammatory-drugs |title=Asthma Steroids: Inhaled Steroids, Side Effects, Benefits, and More |publisher=Webmd.com |date= |accessdate=2012-11-30}}</ref>
Nhóm này bao gồm:
 
* [[Flunisolide]]<ref name=nyc>{{citechú thích web |author=Frieden, Thomas R. |title=Inhaled Corticosteroids — Long-Term Control Asthma medicine |date=03/2004 |work=New York City Asthma Initiative |publisher= |url=http://www.nyc.gov/html/doh/downloads/pdf/asthma/inhaled.pdf}}</ref>
* [[Fluticasone propionate]]<ref name=nyc/>
* [[Triamcinolone acetonide]]<ref name=nyc/>
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====Oral forms====
Such as prednisone and prednisolone.<ref name="dermnetnz.org">{{citechú thích web|url=http://dermnetnz.org/treatments/systemic-steroids.html |title=Systemic steroids (corticosteroids). DermNet NZ |publisher=. DermNet NZ |date=2012-05-19 |accessdate=2012-11-30}}</ref>
 
====Systemic forms====
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Synthetic glucocorticoids are used in the treatment of joint pain or inflammation ([[arthritis]]), [[temporal arteritis]], [[dermatitis]], [[allergic]] reactions, [[asthma]], [[hepatitis]], [[systemic lupus erythematosus]], [[inflammatory bowel disease]] ([[ulcerative colitis]] and [[Crohn's disease]]), [[sarcoidosis]] and for glucocorticoid replacement in [[Addison's disease]] or other forms of [[adrenal insufficiency]].<ref>{{cite journal|author=Higashi AS, Zhu S, Stafford RS, Alexander GC|title=National trends in outpatient asthma treatment, 1997-2009|journal=Journal of General Internal Medicine|volume=26|pages=1465–1470|pmid=21769507|url=http://www.ncbi.nlm.nih.gov/pubmed/21769507}}</ref> Topical formulations are also available for the [[skin disease|skin]], eyes ([[uveitis]]), lungs ([[asthma]]), nose ([[rhinitis]]), and [[inflammatory bowel disease|bowels]]. Corticosteroids are also used supportively to prevent nausea, often in combination with 5-HT3 antagonists (''e.g.'' [[ondansetron]]).
 
Typical [[adverse drug reaction|undesired effects]] of glucocorticoids present quite uniformly as drug-induced [[Cushing's syndrome]]. Typical mineralocorticoid side-effects are [[arterial hypertension|hypertension]] (abnormally high blood pressure), [[hypokalemia]] (low potassium levels in the blood), [[hypernatremia]] (high sodium levels in the blood) without causing [[peripheral edema]], [[metabolic alkalosis]] and connective tissue weakness.<ref>{{citechú bookthích sách |author=Werner R |title=A massage therapist's guide to Pathology |publisher=Lippincott Williams & Wilkins |location=Pennsylvania |year=2005 |edition=3rd }}</ref> There may also be impaired wound healing or ulcer formation because of the immunosuppressive effects.
 
Clinical and experimental evidence indicates that corticosteroids can cause permanent eye damage by inducing [[central serous retinopathy]] (CSR, also known as central serous chorioretinopathy, CSC). A variety of steroid medications, from anti-allergy nasal sprays ([[Nasonex]], [[Flonase]]) to topical skin creams, to eye drops ([[Tobradex]]), to prednisone have been implicated in the development of CSR.<ref>{{cite journal|pmid=12359603|year=2002|last1=Carvalho-Recchia|first1=CA|last2=Yannuzzi|first2=LA|last3=Negrão|first3=S|last4=Spaide|first4=RF|last5=Freund|first5=KB|last6=Rodriguez-Coleman|first6=H|last7=Lenharo|first7=M|last8=Iida|first8=T|title=Corticosteroids and central serous chorioretinopathy|volume=109|issue=10|pages=1834–7|journal=Ophthalmology|doi=10.1016/S0161-6420(02)01117-X}}</ref><ref>{{citechú thích web|url=http://buteykola.com/2010/07/the-new-york-times-a-breathing-technique-offers-help-for-people-with-asthma |title=The New York Times :: A Breathing Technique Offers Help for People With Asthma |publisher=buteykola.com |date= |accessdate=2012-11-30}}</ref>
 
Corticosteroids have been widely used in treating people with traumatic brain injury.<ref>{{citechú bookthích sách|title=Corticosteroids for acute traumatic brain injury|author=Alderson P, Roberts I|publisher=The Cochrane Collaboration|chapter=Plain Language Summary|page=2}}</ref> A [[systematic review]] identified 20 randomised controlled trials and included 12,303 participants, then compared patients who received corticosteroids with patients who received no treatment. The authors recommended people with traumatic head injury should not be routinely treated with corticosteroids.<ref>{{cite doi|10.1002/14651858.CD000196.pub2}}</ref>
 
== Lịch sử ==
Biết đến đầu tiên vào năm 1944.<ref name=MerriamWebster>{{citechú thích web|last=Webster|title=First therapeutic use of Corticosteroid|url=http://www.merriam-webster.com/dictionary/corticosteroid|accessdate=30 July 2012}}</ref> [[Tadeusz Reichstein]] cộng tác với [[Edward Calvin Kendall]] và [[Philip Showalter Hench]] đã đạt [[giải Nobel]] cho lĩnh vực [[sinh lý học]] và [[y học]] năm 1950 nhờ tìm ra hormone ở [[tuyến thượng thận]], khi cô lập được [[cortisone]].<ref>http://nobelprize.org/nobel_prizes/medicine/laureates/1950/kendall-lecture.pdf</ref>
 
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]].<ref>Sarett, Lewis H. (1947). “Process of Treating Pregnene Compounds”, U. S. Patent 2,462,133</ref> 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]].<ref>{{cite journal |author=Marker, Russell E.; Wagner, R. B.; Ulshafer, Paul R.; Wittbecker, Emerson L.; Goldsmith, Dale P. J.; Ruof, Clarence H. |title=Steroidal Sapogenins |journal=J. Am. Chem. Soc. |volume=69 |issue=9 |year=1947 |doi=10.1021/ja01201a032 |pmid=20262743 |pages=2167–2230}}</ref> In 1952, D.H. Peterson and H.C. Murray of [[Upjohn]] developed a process that used [[Rhizopus]] mold to oxidize progesterone into a compound that was readily converted to cortisone.<ref>{{cite journal |author=Peterson D.H., Murray, H.C. |title=Microbiological Oxygenation of Steroids at Carbon 11 |journal=J. Am. Chem. Soc. |volume=74 |issue=7 |pages=1871–2 |year=1952 |doi=10.1021/ja01127a531 }}</ref> 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 $0.46 per gram by 1980. [[Percy Lavon Julian|Percy Julian's]] research also aided progress in the field.<ref>Julian, Percy L., Cole, John Wayne, Meyer, Edwin W., and Karpel, William J. (1956) “Preparation of Cortisone”. U. S. Patent 2,752,339</ref> 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 [[prostaglandin]]s and [[leukotriene]]s was fully understood in the early 1980s.
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Use of corticosteroids has numerous side-effects, some of which may be severe:
* Neuropsychiatric: [[steroid psychosis]],<ref name="Psychiatric Adverse Drug Reactions: Steroid Psychosis">{{citechú thích web|last=Hall|first=Richard|title=Psychiatric Adverse Drug Reactions: Steroid Psychosis|url=http://www.drrichardhall.com/steroid.htm|publisher=Director of Research Monarch Health Corporation Marblehead, Massachusetts}}</ref> and [[anxiety]],<ref name="">{{Cite journal |author=Korte SM |title=Corticosteroids in relation to fear, anxiety and psychopathology |journal=Neurosci Biobehav Rev |volume=25 |issue=2 |pages=117–42 |year=2001 |pmid=11323078 |doi= 10.1016/S0149-7634(01)00002-1}}</ref> [[depression (mood)|depression]]. Therapeutic doses may cause a feeling of inappropriate well-being ("steroid euphoria").<ref>C R Swinburn, J M Wakefield, S P Newman, and P W Jones Evidence of prednisolone induced mood change ('steroid euphoria') in patients with chronic obstructive airways disease. Br J Clin Pharmacol. 1988 December; 26(6): 709–713. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1386585/</ref> The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina.<ref>Benjamin H. Flores and Heather Kenna Gumina. The Neuropsychiatric Sequelae of Steroid Treatment. URL: http://www.dianafoundation.com/articles/df_04_article_01_steroids_pg01.html</ref>
*Cardiovascular: Corticosteroids can cause sodium retention through a direct action on the kidney, in a manner analogous to the mineralocorticoid [[aldosterone]]. This can result in fluid retention and [[hypertension]].
* Metabolic: Corticosteroids cause a movement of body fat to the face and torso, resulting respectively in "[[moon face]]" and "buffalo hump". and away from the limbs. Due to the diversion of amino-acids to glucose, they are considered anti-anabolic, and long term therapy can cause muscle wasting <ref>
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== Safety ==
Corticosteroids were voted [[Allergen of the Year]] in 2005 by the American Contact Dermatitis Society.<ref>{{citechú thích web|url=http://www.medscape.com/viewarticle/505245 |title=Contact Allergen of the Year: Corticosteroids: Introduction |publisher=Medscape.com |date=2005-06-13 |accessdate=2012-11-30}}</ref>
 
==See also==
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== References ==
{{Reflisttham khảo|2}}
 
{{Major Drug Groups}}
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