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Isnenia, Isnenia. "Penggunaan Non-Steroid Antiinflamatory Drug dan Potensi Interaksi Obatnya Pada Pasien Muskuloskeletal." Pharmaceutical Journal of Indonesia 6, no. 1 (December 1, 2020): 47–55. http://dx.doi.org/10.21776/ub.pji.2020.006.01.8.
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The main therapy on musculoskeletal patients is the use of non-steroidal anti-inflammatory drugs (NSAIDs) either as monotherapy or in combination with drugs of the same class or pain relievers from other groups. The use of more than one drugs have potentially caused drug-drug interactions that can affect to patient. This study was aimed to describe the patient's sociodemographic (sex, ages) and clinical (numbers of drugs, type of drugs and diagnose) characteristics, as well as to find the correlation between potential drug interactions with these variables. This research was a quantitative study with a cross sectional design. Data were taken from 100 medical records of patients who had diagnosed with top five musculoskeletal diseases. Data were analyzed descriptively for sex, ages, number of drugs, type of drugs, and potential drug interactions. Bivariate correlation with chi-square were conducted to find statistically significancy potential drug interactions with each variable consist of sex, ages, type of drugs and it’s diagnose. The result shows that the musculoskeletal patients were 44% male, 56% female. Most musculoskeletal patients were aged 18-65 years (78%). Patients who received drugs <5 were 68% and ≥ 5 were 32%. 54% of patients were taking the diclofenac and only 5% of patients were taking the two NSAIDs combination, diclofenac and ibuprofen. There was no significant correlation (p > 0,05) between potential drug interactions with age, sex, type of NSAID, and type of musculosceletal diseases.
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Denham, Bryan E. "Determinants of Anabolic-Androgenic Steroid Risk Perceptions in Youth Populations: A Multivariate Analysis." Journal of Health and Social Behavior 50, no. 3 (September 2009): 277–92. http://dx.doi.org/10.1177/002214650905000303.
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Grounded conceptually in social cognitive theory, this research examines how personal, behavioral, and environmental factors are associated with risk perceptions of anabolic-androgenic steroids. Ordinal logistic regression and logit log-linear models applied to data gathered from high-school seniors (N = 2,160) in the 2005 Monitoring the Future study showed significant explanatory effects for sex, race, exposure to drug spots, steroid availability, peer use of steroids, sensation-seeking, depression, and self-esteem. Females, African Americans, and those who had seen drug spots the most frequently estimated higher levels of risk associated with steroid use, while those who indicated ease in obtaining steroids and those with close friends who had used the drugs estimated lower risk. Also estimating lower levels of risk were sensation seekers, those who appeared depressed, and those with low levels of self-esteem. Analyses reveal how steroid risk determinants may differ from those related to methylenedioxymethamphetamine (i.e., MDMA, ecstasy) and marijuana use.
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Lykhonosov, Mykola P., and Alina Yu Babenko. "Prevalence of anabolic androgenic steroid use, its effect on the male pituitary-gonadal axis, and the possibility of reproductive rehabilitation." Problems of Endocrinology 65, no. 2 (June 30, 2019): 124–33. http://dx.doi.org/10.14341/probl9997.
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The purpose of this review is to assess the prevalence of AA steroid use, to identify the steroids that are used, and to present the negative effects of AA steroids on the human body while describing the mechanisms of their actions on the male reproductive system. The review highlights the diagnostic features of steroid-induced hypogonadism, and assesses the effectiveness of various drugs in the reproductive rehabilitation of patients who cease taking AA steroids. Emphasis is placed on the feasibility and effectiveness of various drug treatments in the context of post cycle therapy (PCT), which seeks to stabilize and restore normal hormonal function. All this data is necessary for the development of modern treatment algorithms for steroid-induced hypogonadism in men.
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Thanage, Ravi, Sanjay Chandnani, Vinay Zanwar, Shubham Jain, Samit Jain, Qais Contractor, and Pravin Rathi. "Unusual Case of Simultaneous Acute Hepatitis and Acute Pancreatitis in a Bodybuilder." Journal of Gastroenterology, Pancreatology & Liver Disorders 7, no. 1 (February 2, 2019): 1–3. http://dx.doi.org/10.15226/2374-815x/7/1/001137.
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The use of anabolic steroids is widespread, particularly among bodybuilders. Most athletes have only a crude pharmacological knowledge regarding these drugs and warnings of steroid misuse are neglected. The illicit use of Androgenic Anabolic Steroids (AAS) to obtain an athletic, healthy looking body can lead to serious and often irreversible organ damage [1]. Anabolic steroids with 17 alpha carbon substitutions have been associated with a cholestatic injury with little hepatocellular injury. In the case of hepatoxicity and severe cholestasis the prompt withdrawal of the steroid and the administration of ursodeoxycholic acid are recommended [2]. Steroid also is known to cause acute pancreatitis which would result in acute onset abdominal pain and vomiting. Possible mechanisms for drug-induced pancreatitis include immune-mediated inflammatory response, direct cellular toxicity, arteriolar thrombosis, and metabolic effects.
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Arul Balasubramanian, Rinson Reji, Rosmy Jose, Sarika Sasidharan, and Kothai Ramalingam. "Drug utilization review of corticosteroids in a tertiary care hospital of Salem District, Tamilnadu, India." International Journal of Research in Pharmaceutical Sciences 10, no. 3 (July 20, 2019): 2246–49. http://dx.doi.org/10.26452/ijrps.v10i3.1459.
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Corticosteroids are widely used compounds for allergic reactions, autoimmune diseases, inflammatory conditions, hormone replacement therapy etc. Hence, with widespread use and actions, these have several interactions with drugs and diseases. The purpose of this study was to obtain information about Corticosteroids prescribing and utilization pattern, to understand the prescribing behaviour of physicians and to identify drug interactions. A retrospective observational study was conducted in the department of dermatology and general medicine in a tertiary care hospital for 6 months. All the patients receiving any category of steroid therapy were included, and the prescribing and tapering pattern of steroids were reviewed. Drug utilization pattern (DUR) was observed and analysed among 150 patients during the study period. The results revealed that steroids were prescribed for various respiratory illnesses (66%) and skin-related conditions (34%). The steroid utilization was found to be more in elderly patients, particularly in males. Intravenous administration was common in 33% of cases. Budesonide was the most commonly prescribed steroid (36%), followed by Hydrocortisone (24%) and Dexamethasone (14%). The most frequent drug-drug interaction was between Hydrocortisone and Theophylline as well as Hydrocortisone and Hypoglycaemic agents. Most drugs were prescribed rationally, although some factors like prescribing drugs in the brand name, without mentioning route of administration, frequency and dose were deviating away from rationality. Not much variation was found in the pattern of prescription amongst healthcare professionals. Although most of the drugs were prescribed rationally, the involvement of a clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.
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Cassinotti, A., S. Saibeni, A. De Silvestri, N. Mezzina, D. Di Paolo, E. Alimenti, M. L. Annunziata, et al. "P771 Biologics versus azathioprine in steroid-dependent ulcerative colitis: results from the A.U.R.O.R.A. database." Journal of Crohn's and Colitis 17, Supplement_1 (January 30, 2023): i900. http://dx.doi.org/10.1093/ecco-jcc/jjac190.0901.
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Abstract Background The A.U.R.O.R.A. database is an Italian multicenter retrospective cohort of patients with ulcerative colitis (UC) treated with the first biological drugs (infliximab biosimilar- IFX-B, adalimumab-ADA, golimumab-GOL, vedolizumab-VDZ) approved in Italy after patent expire of IFX-originator. In a previous published study,1 we showed similar efficacy among all drugs according to the rigorous outcome of 1-year “continuous clinical remission” (CCR). In this study, we focused only on steroid-dependent UC, by comparing all drugs to each other and to patients treated with steroids followed by azatioprine (AZA) monotherapy. Methods All consecutive patients with steroid-dependent UC, treated with IFX-B, ADA, GOL or VDZ after their approval in 2014-2019, were followed-up for 1 year or until drug discontinuation for relapse or adverse events. All drugs were compared to each other and to steroid-dependent patients treated with steroids + AZA in 2006-2014. A propensity score analysis was performed to balance differences at baseline. The primary endpoint was the 1-year CCR, defined as steroid-free clinical remission with Mayo partial score ≤2 (with no bleeding), without any clinical relapse or treatment optimization after the first remission was achieved, and without drug withdrawal due to adverse events. Treatment optimization was defined as the addition of systemic/topical steroids, oral/topical mesalazine or any dose escalation of biologics Results 370 patients (IFX-B=62, ADA=68, GOL=56, VDZ=100, AZA 84) with steroid-dependent UC were included. No significant differences were found among each biological drug according to the 1-year CCR primary end-point (34%, 29%, 30%, 39%, respectively). In patients naive to immunesuppressors and biologics (n= 17, 25, 24 10, 79, respectively), AZA showed significantly higher rate of CCR (68%) than each biological drug (35%, 44%, 33%, 60%; p=0.000 for each comparison) or all biologics as a whole (41%; p=0.012). Adverse events occurred significantly less frequently with ADA (8%) than IFX (29%), GOL (20%) and AZA (26%) in the overall population, but were similar across all drugs in the naive population. Discontinuation for adverse events occurred more frequently (p<0.05) with both IFX-B (16%) and AZA (14%) than ADA (3%), GOL (4%), and VDZ (1%) in the overall population, but not in the naive population (18%, 15%, 4%, 4%, 0%, respectively). Conclusion In steroid-dependent UC, anti-TNF-alpha agents and VDZ were equally effective at 1 year according to the concept of CCR. AZA still appears an effective first-line strategy in the biological era. 1Cassinotti A. et al. Eur J Gastroenterol Hepatol. 2022;34:1238-46. Guided Poster Session
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Bharat Sharma. "Medically Significant Hypersensitivity Reaction to Dapsone: A Case Report." International Healthcare Research Journal 2, no. 1 (April 10, 2018): 10–11. http://dx.doi.org/10.26440/ihrj/02_01/157.
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The drug Dapsone is a component of the World Health Organization multidrug therapy being used against leprosy. Although it has shown a good efficacy during the years, a few subjects develop adverse drug reactions associated with dapsone .We report a case of a patient who was prescribed dapsone as part of multiple drug therapy for leprosy following which he developed Dapsone induced Hypersensitivity Syndrome (DHS). He was prescribed steroids with a tapering dose. His condition worsened after weaning of the oral steroids. He also developed steroid-induced diabetes which was stabilized using anti-diabetic drugs.
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Zhang, Yang, Peiyao Xiao, Delong Pan, and Xiuling Zhou. "New Insights into the Modification of the Non-Core Metabolic Pathway of Steroids in Mycolicibacterium and the Application of Fermentation Biotechnology in C-19 Steroid Production." International Journal of Molecular Sciences 24, no. 6 (March 9, 2023): 5236. http://dx.doi.org/10.3390/ijms24065236.
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Androsta-4-ene-3,17-dione (AD), androsta-1,4-diene-3,17-dione (ADD), and 9α-hydroxy-4-androstene-3,17-dione (9-OHAD), which belong to C-19 steroids, are critical steroid-based drug intermediates. The biotransformation of phytosterols into C-19 steroids by Mycolicibacterium cell factories is the core step in the synthesis of steroid-based drugs. The production performance of engineered mycolicibacterial strains has been effectively enhanced by sterol core metabolic modification. In recent years, research on the non-core metabolic pathway of steroids (NCMS) in mycolicibacterial strains has made significant progress. This review discusses the molecular mechanisms and metabolic modifications of NCMS for accelerating sterol uptake, regulating coenzyme I balance, promoting propionyl-CoA metabolism, reducing reactive oxygen species, and regulating energy metabolism. In addition, the recent applications of biotechnology in steroid intermediate production are summarized and compared, and the future development trend of NCMS research is discussed. This review provides powerful theoretical support for metabolic regulation in the biotransformation of phytosterols.
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Bohl, Martin, and Manfred Wunderwald. "Molecular Mechanics Investigation on Conformational Flexibility of 14β Steroids in Drug-Receptor Interactions." Zeitschrift für Naturforschung C 41, no. 3 (March 1, 1986): 297–300. http://dx.doi.org/10.1515/znc-1986-0309.
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The interaction between two 14 β steroids being still unsynthesized and a model receptor binding site is theoretically studied by a molecular mechanics scheme. Both com pounds containing seven-membered rings in the 17 β position are found to form stable hydrogen bonds to the receptor and can be attributed to be potential inhibitors of the Na +,K + -ATPase activity. Substantial steroid conformational changes necessary for an efficient receptor binding are calculated to reduce the interaction energy by only 10 kJ mol -1. Therefore, alterations in steroid structure should be generally taken into consideration in the investigation of steroid-receptor interactions.
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David Smith and Venu Sen. "The Toxicity of Corticosteroids." International Healthcare Research Journal 5, no. 10 (January 30, 2022): RV5—RV9. http://dx.doi.org/10.26440/ihrj/0510.01498.
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Minimization of steroid therapy has always been one of the main objectives of immunosuppressive protocols after kidney transplantation, due to numerous side effects. The use of a further reduced daily dose of steroids is considered by many to be a fair compromise between toxicity and efficacy. Unfortunately, the great inter-individual variability of the pharmacokinetics of steroids does not prevent the appearance of major side effects in a variable percentage of patients, even with the low dose used. A drug interaction between steroids and drugs used after transplantation can also contribute to increasing daily exposure to the drug. Steroid discontinuation is still the only procedure capable of achieving the desired goal. This procedure is associated with a greater risk of acute rejection, without however reducing the survival of the transplant. It should be offered to patients at low immunological risk. Early discontinuation, during the first week of transplantation, is also the modality suggested by some guidelines, although a later suspension also offers excellent results. Induction therapy is always recommended in the case of early discontinuation.
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n, kr, and smail Demir. "Efficacy of antiviral therapy in the treatment of peripheral facial paralysis: a tertiary institution experience." Annals of Medical Research 30, no. 6 (2023): 1. http://dx.doi.org/10.5455/annalsmedres.2023.05.125.
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Objective: For the treatment of peripheral facial paralysis, the superiority of the use of steroid alone and the use of steroid + antiviral over each other has not been clarified in the literature. In this study, the efficacy of using steroid treatment alone and using a combination of steroid+antiviral treatment in patients we followed up with peripheral facial paralysis in our clinic was questioned retrospectively. It was aimed to clarify the efficacy and superiority of steroid alone and steroid+antiviral therapy in patients with peripheral facial paralysis. Materials and Methods: One hundred and ten patients who received only steroids and 62 patients who received combination therapy were included in the study. Age, gender, regular drug use, smoking, previous history of facial paralysis, comorbid diseases, initial stage of the disease (House-Brackman/HB staging), treatment protocol and response to treatment were recorded from the files examined. Patients with HB stage ≤2 at the 6th month follow-up were considered to have responded well or completely to the treatment. Results: When the group receiving only steroid treatment and the group receiving steroid + antiviral treatment were compared in terms of age, chronic drug use, gender, and previous facial paralysis, no statistically significant difference was observed. The groups were compared in terms of response to treatment, 88.2% improvement was observed in the steroid group (HB stage ≤2), and 91.9% improvement was observed in the combined treatment group. No statistically significant difference was observed (p=0.605). Conclusion: For the treatment of peripheral facial paralysis, the superiority of steroid use alone and combined antiviral + steroid use has not been proven. In the light of the literature, it is recommended that the patient be treated with steroids at the earliest stage.
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Suardamana, Ketut, Pande Ketut Kurniari, and I. Made Arya Winangun. "Systemic lupus erythematosus patient on steroid therapy that develop to a Stevens-Johnson syndrome: a case report." International Journal of Advances in Medicine 9, no. 6 (May 24, 2022): 746. http://dx.doi.org/10.18203/2349-3933.ijam20221363.
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Stevens-Johnson syndrome (SJS) is a cutaneous immunity reaction involving the skin and mucosa and is an emergency condition that can be fatal. The incidence of this disease is relatively rare in the range of 1-2 per 1.000.000 population. The pathogenesis of SJS involves the immune system response of antigenic drug to body tissues but it still cannot be fully explained to date. We reported a woman, 35 years old with systemic lupus erythematosus (SLE) who had been on steroid therapy and in the course of treatment developed into SJS after administration of anti-epileptic drug. Steroids have anti-inflammatory effects mainly due to decreased syntheses or suppression of inflammatory mediators. SJS still can develop in patient with SLE who had been on steroid therapy. Giving steroid that indicated for the treatment of a disease including SLE, cannot prevent the occurrence of an allergic event including SJS. The presence of steroid can extend the duration of starting the drug with the occurrence of SJS and reduce the severity of the disease. Steroid still have a role in treatment that can be used both in SJS and SLE.
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DuRant, Robert H., Luis G. Escobedo, and Gregory W. Heath. "Anabolic-Steroid Use, Strength Training, and Multiple Drug Use Among Adolescents in the United States." Pediatrics 96, no. 1 (July 1, 1995): 23–28. http://dx.doi.org/10.1542/peds.96.1.23.
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Objective. This study examined the relationships between anabolic-steroid use and the use of other drugs, sports participation, strength training, and school performance among a nationally representative sample of US high school students. Design. Randomized survey data from the 1991 Centers for Disease Control and Prevention Youth Risk Behavior Survey. Setting. Public and private schools in the 50 United States and District of Columbia. Patients. A total of 12 272 9th through 12th grade students. Main Outcome Measured. Prevalence of anabolicsteroid use. Results. The frequency of anabolic-steroid use was significantly associated with the frequency of use of cocaine, the use of other drugs such as amphetamines and heroin, tobacco smoking, and alcohol use. The weighted prevalences of anabolic-steroid use were higher among male (4.08%) than female students (1.2%). Students living in the South (3.46%) reported higher prevalences than students in the Midwest (3.0%), West (2.02%), or Northeast (1.71%). Students with self-perceived below-average academic performances (5.10%) and students reporting injected drug use also reported higher anabolic-steroid use (51.57%). Based on a multiple logistic regression, the following variables were found to be significant predictors of anabolic-steroid use: injectable drug use (odds ratio [OR], 17.86), use of other drugs (OR, 4.19), male gender (OR, 2.79), alcohol use (OR, 1.38), and strength training (OR, 1.73). The variables that were significantly associated with anabolic-steroid use varied by gender and by region of the country. Conclusion. These data suggest that adolescent anabolic-steroid users in this country are more likely to engage in strength training, injected drug use, and the use of multiple drugs, even after controlling for sports participation and poorer academic performance. These data confirm previous findings of an association between multiple drug use and anabolic-steroid use. Also, engaging in strength-training exercises continued to be associated with anabolic-steroid use after controlling for drug use and other predictors.
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Saloniemi, Taija, Heli Jokela, Leena Strauss, Pirjo Pakarinen, and Matti Poutanen. "The diversity of sex steroid action: novel functions of hydroxysteroid (17β) dehydrogenases as revealed by genetically modified mouse models." Journal of Endocrinology 212, no. 1 (November 1, 2011): 27–40. http://dx.doi.org/10.1530/joe-11-0315.
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Disturbed action of sex steroid hormones, i.e. androgens and estrogens, is involved in the pathogenesis of various severe diseases in humans. Interestingly, recent studies have provided data further supporting the hypothesis that the circulating hormone concentrations do not explain all physiological and pathological processes observed in hormone-dependent tissues, while the intratissue sex steroid concentrations are determined by the expression of steroid metabolising enzymes in the neighbouring cells (paracrine action) and/or by target cells themselves (intracrine action). This local sex steroid production is also a valuable treatment option for developing novel therapies against hormonal diseases. Hydroxysteroid (17β) dehydrogenases (HSD17Bs) compose a family of 14 enzymes that catalyse the conversion between the low-active 17-keto steroids and the highly active 17β-hydroxy steroids. The enzymes frequently expressed in sex steroid target tissues are, thus, potential drug targets in order to lower the local sex steroid concentrations. The present review summarises the recent data obtained for the role of HSD17B1, HSD17B2, HSD17B7 and HSD17B12 enzymes in various metabolic pathways and their physiological and pathophysiological roles as revealed by the recently generated genetically modified mouse models. Our data, together with that provided by others, show that, in addition to having a role in sex steroid metabolism, several of these HSD17B enzymes possess key roles in other metabolic processes: for example, HD17B7 is essential for cholesterol biosynthesis and HSD17B12 is involved in elongation of fatty acids. Additional studiesin vitroandin vivoare to be carried out in order to fully define the metabolic role of the HSD17B enzymes and to evaluate their value as drug targets.
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Ziemer, Mirjana, Eleni Koukoulioti, Jan-Christoph Simon, and Thomas Berg. "Managing immune checkpoint-inhibitor-induced severe autoimmune-like hepatitis by liver-directed topical steroids." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 3073. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.3073.
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3073 Background: The CTLA4-antibody ipilimumab, and PD-1-antibodies pembrolizumab as well as nivolumab have revolutionized antineoplastic therapies. Induction of autoimmune-like drug-induced liver injury (DILI) is within the spectrum of adverse reactions of these new drugs and has been observed in about 1-5 % of patients, developing predominantly within the first 6 to 12 weeks after start of treatment. Immediate application of systemic steroids and a permanent discontinuation of immune checkpoint-inhibition therapy are recommended for any alanine aminotransferase increase ≥ WHO grade 3. In severe autoimmune-like DILI the permanent discontinuation of the immune checkpoint inhibitor is recommended, as drug re-exposure might be associated with a significant risk of a fulminant DILI. Methods: We report six patients with severe grade 3 autoimmune-like DILI (according to Common Terminology Criteria for Adverse Events 4.3) treated with long-term application of budesonide, a liver-directed topical steroid. Results: Immune checkpoint inhibitors were stopped and methylprednisolone was applied initially with a dose of 1 mg/kg body weight and tapered thereafter. To reduce systemic steroids and to minimize the exposure time to systemic steroids, the topical steroid budesonide 3 mg three times per day was additionally given in combination with N-acetylcysteine and ursodeoxycholic acid. Under this multimodal approach transaminases normalized and the respective immune-checkpoint inhibitor could be re-started without re-manifestation of DILI under the continuous treatment with budesonide. Conclusions: Budesonide - a liver-directed topical steroid - might be an interesting approach to target liver related autoimmune adverse reactions induced by immune checkpoint inhibitors without compromising their anti-cancer effect. We were able to safely and effectively re-introduce and continue immune checkpoint inhibitors under the continuous application of the topical steroid without showing any further liver toxicity.
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Stoll, Anna, Michele Iannone, Giuseppina De Gregorio, Francesco Molaioni, Xavier de la Torre, Francesco Botrè, and Maria Kristina Parr. "Influence of Indomethacin on Steroid Metabolism: Endocrine Disruption and Confounding Effects in Urinary Steroid Profiling of Anti-Doping Analyses." Metabolites 10, no. 11 (November 14, 2020): 463. http://dx.doi.org/10.3390/metabo10110463.
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Anabolic androgenic steroids (AAS) are prohibited as doping substances in sports by the World Anti-Doping Agency. Concentrations and concentration ratios of endogenous AAS (steroid profile markers) in urine samples collected from athletes are used to detect their administration. Certain (non-prohibited) drugs have been shown to influence the steroid profile and thereby sophisticate anti-doping analysis. It was shown in vitro that the non-steroidal anti-inflammatory drug (NSAID) indomethacin inhibits selected steroid-biotransformations catalyzed by the aldo-keto reductase (AKR) 1C3, which plays a key role in the endogenous steroid metabolism. Kinetic parameters for the indomethacin-mediated inhibition of the AKR1C3 catalyzed reduction in etiocholanolone were determined in vitro using two comparing methods. As NSAIDs are very frequently used (not only) by athletes, the inhibitory impact of indomethacin intake on the steroid metabolism was evaluated, and steroid profile alterations were detected in vivo (one male and one female volunteer). Significant differences between samples collected before, during or after the intake of indomethacin for selected steroid profile markers were observed. The presented results are of relevance for the interpretation of results from doping control analysis. Additionally, the administration of NSAIDs should be carefully reconsidered due to their potential as endocrine disruptors.
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M., Muniraju, Shambulinga Killera, and Safina Kauser. "A polydrug regime for treatment of sudden sensorineural hearing loss." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 12 (November 24, 2020): 2275. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205072.
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<p>Sudden sensorineural hearing loss (SSNHL) is a very frightening and incapacitating event and it impairs the patient's quality of life. Steroids are considered the first line of treatment. Intratympanic dexamethasone produces a significantly higher perilymph concentration of steroids. The aim of our study was to assess the efficacy of multi-drug regimen in the management of SSNHL, to analyse the recovery and to assess use of intratympanic steroid injections (ITSI) as a primary treatment. This is a prospective study presenting as a case series of 5 cases of SSNHL. Our treatment included intratympanic steroids, oral steroids, antiplatelet drugs, rheological-agents and neuro vitamins. Complete recovery was seen in 2 (40%), partial recovery in 2 (40%), 1 patient was lost to follow up. In the patient with bilateral SSNHL, the ITSI was administered in the right ear only; which showed a significant improvement. SSNHL is described as a decline in hearing of 30 dB or more, on 3 or more frequencies over 3 days or less, with tinnitus and ear fullness. Early presentation and intervention within 72 hours is the ideal treatment. Since viral infections and vascular compromise are considered as probable theories for SSNHL, steroids, with anticoagulants, antiplatelet and rheological-agents are used as an effective therapy. Our study shows that a multi-drug treatment of SSNHL can be much more effective than a single drug treatment. We also conclude that using intratympanic steroid injections have a greater improvement as seen in the case of bilateral SSNHL.</p><p> </p>
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Shende, Mulchand, Bhupesh Ghutke, Dhanshree Panekar, and Aparna Kachewar. "Assessment of drug utilization pattern of steroids in a district general hospital in Amravati region." Research Results in Pharmacology 5, no. 2 (June 27, 2019): 57–64. http://dx.doi.org/10.3897/rrpharmacology.5.32584.
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Introduction: Rational use of corticosteroids is very important in the long term for improving patient safety. The main objective of the study was to analyze the prescribing patterns of steroids in a district general hospital, Amravati. Materials and methods: A prospective observational study was carried out over a period of six months in a district general hospital. All patients receiving any category of steroid therapy were enrolled, and the prescribing tapering patterns of steroids were reviewed. The demographic data, disease data and data on the utilization of various steroids were analyzed, and the knowledge of the patients was assessed by using a Michigan questionnaire. Results and discussion: 179 patients were recruited for the study. Steroids were prescribed for various (29.6%) respiratory conditions, (10.1%) CVS diseases, (11.7%) CNS, (1.6%) in hepatic disorders, (1.1%) musculoskeletal disorders, (3.4%) skeletal disorders, (0.6%) renal impairments, (3.9%) GI disorders, (19.0%) skin diseases and (19.0%) other diseases. The utilization of steroid dexamethasone was the most commonly prescribed to 111 patients (63.8%) followed by hydrocortisone (57 patients, 32.8%) and prednisolone (6 patients, 3.4 %). Dexamethasone was most commonly associated with adverse effects (1.8% of such as headaches, abdominal pains, and rashes), followed by prednisolone (0.8% of such as facial swelling), clobetasol (0.4%) and fluticasone (0.4 %). Conclusions: Very little variation was found in the prescription pattern amongst the healthcare professionals. Most of the drugs were prescribed rationally; the significance of the study is to improve the patient safety in the long-term use of steroid therapy by observing the prescribing patterns as irrational use of steroids can increase the risk of adverse effects.
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Maheshwari, Vatsala, Richa Chaturvedi, Sonali Meshram, and Rahul Bhalsinge. "Evaluation of Adverse Drug Reactions caused by Topical Steroids in Patients Presenting in Dermatology Department of Teaching Institute of Tertiary Health Care Centre of Central India." Biomedical and Pharmacology Journal 14, no. 02 (June 28, 2021): 955–59. http://dx.doi.org/10.13005/bpj/2196.
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Introduction : Topical steroids are most commonly being used today. Mostly these are being misused due to lack of awareness of their adverse effects. Malpractice and easy availability of these agents also responsible for their abuse. Aim : To Evaluate Topical Steroid abuse in various parameters according to CDSCO ADR forms. Objectives : This study was conducted to know the extent of abuse of topical steroid ,along with clinical profile and mode of accessibility in dermatology department of a teaching institute of tertiary health care centre of central India. Material and Method: First 200 patients of adverse drug reaction attending dermatology department were screened according to ICSR form of CDSCO in a period of December 2015 to November 2016 and 181 patients of them who gave history of topical steroid application were further analyzed. Result: Most commonly affected people belong to age of 21 to 30 years (41.98%),Tinea incognito (58%) was the commonest manifestation of steroid abuse, Tinea (58%)was the most common indication of steroid application, self medication (46.40%) was most common mode of steroid accessibility, betamethasone (61.87%) was most commonly applied topical steroid. Conclusion :Self medication and over the counter drug use were most common mode of steroid accessibility both can be controlled by making strict health regulatory policies . Simultaneously health education program must be targeted to young population who are more vulnerable to steroid abuse to make them aware regarding harmful effects of unguided or misguided use of topical steroid.
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Dolan, A. L. "Finasteride: a steroid-unsparing drug?" Rheumatology 38, no. 3 (March 1, 1999): 285a—286. http://dx.doi.org/10.1093/rheumatology/38.3.285a.
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Pollard, B. J. "Which drug-steroid or benzylisoquinolinium?" Intensive Care Medicine 19, S2 (February 1993): S86—S90. http://dx.doi.org/10.1007/bf01708807.
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Osman, Afaf, Wanis Ibrahim, Izzat Khanjar, Nabeel Abdulla, Rania Eltahir, and Eman Alhamoud. "Sudden worsening of DRESS syndrome on tapering steroid dose with dramatic improvement on N-acetylcysteine and steroid dose escalation." Ibnosina Journal of Medicine and Biomedical Sciences 06, no. 02 (April 2014): 101–5. http://dx.doi.org/10.4103/1947-489x.210362.
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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a serious and life-threatening drug reaction characterized by fever, skin rash, peripheral eosinophilia, presence of atypical lymphocytes in peripheral blood smear, generalized lymphadenopathy and involvement of other body organs. The only agreed-upon therapy for DRESS in literature is withholding the culprit drug. There are no controlled trials on the use of steroids in this condition. Reports on the use of N-acetylcysteine in DRESS are very few. We report here a case of 36 year old female with severe DRESS that deteriorated rapidly upon tapering steroid therapy and dramatically improved on combination of pulse steroid therapy and N-acetylcysteine. This paper suggests that higher doses and gradual tapering of corticosteroid is a wise approach in treating patients with DRESS. It further emphasizes the possible beneficial role of N-acetylcysteine in this condition.
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Zhao, Ming, Xiangfei Li, Liangbin Xiong, Kun Liu, Yan Liu, Zhenglian Xue, and Rumeng Han. "Green Manufacturing of Steroids via Mycolicbacteria: Current Status and Development Trends." Fermentation 9, no. 10 (October 3, 2023): 890. http://dx.doi.org/10.3390/fermentation9100890.
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Steroids, the second largest drug category ranked after antibiotics, find widespread use in treatments for reproductive health, endocrine regulation, and inflammation. Advances in steroidal chemistry to date have led to the widespread use of sterols as starting substances in the development of environmentally friendly biotechnologies for steroid production, including biocatalysis, microbial transformations, and biosynthesis using engineered micro-organisms. In this review, we synthesize some of the recent advancements in steroid biocatalysis using the Mycolicibacterium species, including the identification and modification of crucial elements for enhanced production. We also delve into the detailed characterization and reconstruction of metabolic pathways in specific microbial strains, shedding light on their potential for steroid biosynthesis. Additionally, we highlight the development of innovative de novo biosynthesis pathways for steroids within engineered cell factories. These results collectively provide an overview of the current landscape and emerging trends in green steroid manufacturing within the steroidal pharmaceutical industry.
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Spencer, G. M., and S. A. Whitehead. "A comparison of the effects of gonadal steroids on naloxone-induced LH secretion in gonadectomized rats." Journal of Endocrinology 110, no. 2 (August 1986): 327–34. http://dx.doi.org/10.1677/joe.0.1100327.
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ABSTRACT The effects of the opiate antagonist naloxone on serum LH concentrations was investigated in gonadectomized rats given different regimes of steroid pretreatment. Two injections of testosterone given 48 and 24 h before naloxone treatment failed to reinstate LH responses to this drug in castrated rats while subcutaneous testosterone-filled silicone elastomer capsules implanted for a week were effective in this respect. Injections of oestrogen, oestrogen plus progesterone or progesterone alone all restored LH responses to naloxone in ovariectomized rats when given 48 and/or 24 h before drug treatment, although the magnitude of these responses varied according to the precise steroid treatments. The hypothalamic-pituitary axis was also responsive to naloxone just before the progesterone-induced LH surge in oestrogen-primed ovariectomized rats. Results show that gonadal steroids are permissive to the effects of opiate drugs, but they suggest that endogenous opioid systems do not necessarily mediate the negative feedback effects of steroids. Some other factor(s), as yet unidentified in the rat, may control the opioid modulation of gonadotrophin secretion or exert an independent inhibitory effect on gonadotrophin release. J. Endocr. (1986) 110, 327–334
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Lee, Hyun-Jin, Munyoung Chang, and Seog-Kyun Mun. "Intratympanic injection for treatment of inner ear diseases." Journal of the Korean Medical Association 66, no. 10 (October 10, 2023): 589–96. http://dx.doi.org/10.5124/jkma.2023.66.10.589.
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Background: Intratympanic injection has emerged as a novel approach to bypass the blood-labyrinth barrier and effectively deliver drugs into the inner ear. This technique is used for treatment of various inner ear diseases and overcomes the limitations of systemic drug therapy. In this paper, we provide an overview of the application of intratympanic injection using steroids and gentamicin and highlight the major diseases and summarize the reported efficacy of this approach.Current Concepts: Intratympanic steroid injections have been used for treatment of various inner ear diseases, including sudden sensorineural hearing loss, Ménière disease, and tinnitus. Therapeutic effects of steroids include reducing inflammation, modulating the immune response, improving cochlear blood flow, and maintaining ion homeostasis. Intratympanic gentamicin injections are primarily used to minimize hearing loss and control vertigo symptoms in patients with Ménière disease. Gentamicin selectively injures vestibular hair cells with minimal ototoxicity compared with other aminoglycoside antibiotics.Discussion and Conclusion: Intratympanic injections offer several advantages, including targeted drug delivery, minimal systemic adverse effects, and rapid action. Reportedly, intratympanic steroid injections used as primary or salvage treatment are associated with positive outcomes in patients with sudden sensorineural hearing loss. Ménière disease also shows positive outcomes following intratympanic steroid and gentamicin injections. However, studies have reported conflicting results, and further research is required to standardize dosing and administration protocols. Intratympanic injections are a promising therapeutic option, and ongoing research is essential to optimize their efficacy and safety.
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Hohoayi, Abigail, Aaron O. Antwi, Veronica Amoah, Newman Osafo, Paul P. O. Sampene, and George Ainooson. "Coadministration of Stigmasterol and Dexamethasone (STIG+DEX) Modulates Steroid-Resistant Asthma." Mediators of Inflammation 2022 (August 24, 2022): 1–14. http://dx.doi.org/10.1155/2022/2222270.
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Airway inflammation in asthma is managed with anti-inflammatory steroids such as dexamethasone (DEX). However, about 20% of asthmatics do not respond to this therapy and are classified as steroid-resistant. Currently, no effective therapy is available for steroid-resistant asthma. This work therefore evaluated the effect of a plant sterol, stigmasterol (STIG), and stigmasterol-dexamethasone combination (STIG+DEX) in LPS-ovalbumin-induced steroid-resistant asthma in Guinea pigs. To do this, the effect of drugs on inflammatory features such as airway hyperreactivity and histopathology of lung tissue was evaluated. Additionally, the possible pathway of drug action was assessed by measuring events such neutrophil levels, oxidative and nitrative stress, and histone deacetylase 2 (HDAC2) and interleukin 17 (IL-17) levels. STIG alone did not affect inflammatory features, although it caused some changes in the molecular events associated with steroid-resistant asthma. However, STIG+DEX caused significant modulation of inflammatory features by protecting against destruction of lung tissue. The modulation of inflammatory features was associated with significant inhibition of neutrophilia and oxidative and nitrative stress, decrease in HDAC2, and increase in IL-17 levels that are usually associated with steroid-resistant asthma. Our findings show that although STIG and DEX individually do not protect against steroid-resistant asthma, their coadministration results in significant modulation of inflammatory features and the associated molecular events that lead to steroid-resistant asthma.
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Szczurowska, Ewa, Eszter Szánti-Pintér, Alena Randáková, Jan Jakubík, and Eva Kudova. "Allosteric Modulation of Muscarinic Receptors by Cholesterol, Neurosteroids and Neuroactive Steroids." International Journal of Molecular Sciences 23, no. 21 (October 28, 2022): 13075. http://dx.doi.org/10.3390/ijms232113075.
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Muscarinic acetylcholine receptors are membrane receptors involved in many physiological processes. Malfunction of muscarinic signaling is a cause of various internal diseases, as well as psychiatric and neurologic conditions. Cholesterol, neurosteroids, neuroactive steroids, and steroid hormones are molecules of steroid origin that, besides having well-known genomic effects, also modulate membrane proteins including muscarinic acetylcholine receptors. Here, we review current knowledge on the allosteric modulation of muscarinic receptors by these steroids. We give a perspective on the research on the non-genomic effects of steroidal compounds on muscarinic receptors and drug development, with an aim to ultimately exploit such knowledge.
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Batth, Rituraj, Clément Nicolle, Ilenuta Simina Cuciurean, and Henrik Toft Simonsen. "Biosynthesis and Industrial Production of Androsteroids." Plants 9, no. 9 (September 3, 2020): 1144. http://dx.doi.org/10.3390/plants9091144.
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Steroids are a group of organic compounds that include sex hormones, adrenal cortical hormones, sterols, and phytosterols. In mammals, steroid biosynthesis starts from cholesterol via multiple steps to the final steroid and occurs in the gonads, adrenal glands, and placenta. This highly regulated pathway involves several cytochrome P450, as well as different dehydrogenases and reductases. Steroids in mammals have also been associated with drug production. Steroid pharmaceuticals such as testosterone and progesterone represent the second largest category of marketed medical products. There heterologous production through microbial transformation of phytosterols has gained interest in the last couple of decades. Phytosterols being the plants sterols serve as inexpensive substrates for the production of steroid derivatives. Various genes and biochemical pathways involved in phytosterol degradation have been identified in many Rhodococcus and Mycobacterium species. Apart from an early investigation in mammals, presence of steroids such as androsteroids and progesterone has also been demonstrated in plants. Their main role is linked with growth, development, and reproduction. Even though plants share some chemical features with mammals, the biosynthesis is different, with the first C22 hydroxylation as an example. This is performed by CYP11A1 in mammals and CYP90B1 in plants. Moreover, the entire plant steroid biosynthesis is not fully elucidated. Knowing this pathway could provide new processes for the industrial biotechnological production of steroid hormones in plants.
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Anshel, Mark H., and Kenneth G. Russell. "Examining Athletes' Attitudes toward Using Anabolic Steroids and Their Knowledge of the Possible Effects." Journal of Drug Education 27, no. 2 (June 1997): 121–45. http://dx.doi.org/10.2190/714t-aum5-neul-8y0q.
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One goal of contemporary sports leaders is to eradicate the use of banned drugs in competitive sport. A common approach to achieving this outcome is to provide athletes with adequate education about the effects of drug use. Ostensibly, educational programs about the deleterious effects of using anabolic steroids are thought to discourage their intake. Thus, the purpose of this study was to examine the relationships between the athletes' knowledge about the long-term effects of anabolic steroids and their attitudes toward this type of drug. Multiple regression analyses indicated relatively low R2′s and correlations between the various components of subjects' knowledge and their attitude toward steroid ingestion. This suggests that educational programs for athletes about taking anabolic steroids may have limited value in terms of creating appropriate, responsible attitudes toward this illegal, unethical, and medically questionable practice.
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Lajarin, F., R. Zaragoza, I. Tovar, and P. Martinez-Hernandez. "Evolution of serum lipids in two male bodybuilders using anabolic steroids." Clinical Chemistry 42, no. 6 (June 1, 1996): 970–72. http://dx.doi.org/10.1093/clinchem/42.6.970.
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Abstract We followed weekly the evolution of serum lipid concentrations in two bodybuilders undergoing a cycle of treatment with anabolic steroids. These drugs caused maximum depression of high-density lipoprotein cholesterol concentrations by 69.1% in the fifth week after the beginning of the cycle for subject 1, and by 72.4% in the fourth week for subject 2. Maximum increases in low-density lipoprotein cholesterol concentrations were 144% and 156%, respectively. Total cholesterol and apolipoprotein (apo) B were highly increased with anabolic steroid use. We also saw depression of apo A-I by 84% and 91%, and lipoprotein(a) decreased to undetectable amounts in both cases. These effects were reversed 10 weeks after the end of the steroid cycle in subject 1, but subject 2 still presented abnormal concentrations of serum lipids 13 weeks after drug cessation. The periods until reversibility of anabolic steroid effects on lipids were longer than those reported in previous studies.
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Reguera, Leslie, Cecilia I. Attorresi, Javier A. Ramírez, and Daniel G. Rivera. "Steroid diversification by multicomponent reactions." Beilstein Journal of Organic Chemistry 15 (June 6, 2019): 1236–56. http://dx.doi.org/10.3762/bjoc.15.121.
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Reports on structural diversification of steroids by means of multicomponent reactions (MCRs) have significantly increased over the last decade. This review covers the most relevant strategies dealing with the use of steroidal substrates in MCRs, including the synthesis of steroidal heterocycles and macrocycles as well as the conjugation of steroids to amino acids, peptides and carbohydrates. We demonstrate that steroids are available with almost all types of MCR reactive functionalities, e.g., carbonyl, carboxylic acid, alkyne, amine, isocyanide, boronic acid, etc., and that steroids are suitable starting materials for relevant MCRs such as those based on imine and isocyanide. The focus is mainly posed on proving the amenability of MCRs for the diversity-oriented derivatization of naturally occurring steroids and the construction of complex steroid-based platforms for drug discovery, chemical biology and supramolecular chemistry applications.
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A, Umamaheswari, Bhuvaneswari K, and Ramalingam S. "STEROID-INDUCED ANAPHYLAXIS." Asian Journal of Pharmaceutical and Clinical Research 10, no. 8 (August 1, 2017): 1. http://dx.doi.org/10.22159/ajpcr.2017.v10i8.18885.
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To report a severe adverse drug reaction (ADR) due to administration of injection hydrocortisone sodium succinate and to explore the possibility of an association between injection hydrocortisone and the severe ADR. After getting ethics approval from the institution, ADR form and patient’s clinical record from the Department of Cardiology, in a Private Medical College was received. In that, it was recorded as a 75-year-old male patient, a case of unstable angina with troponin T - positive, was posted for coronary angiogram developed a severe reaction to intravenous (IV) hydrocortisone 100 mg stat, given to prevent allergy to contrast dye used in the procedure. 5 minutes after drug administration, he developed sudden itching all over the body, hypotension blood pressure: 60 mmHg and swelling of lips. No other drugs had been given at that time. The patient was already on aspirin 150 mg, clopidogrel 75 mg, and atorvastatin 80 mg, and enoxaparin 40 mg. The procedure was abandoned, and the patient was given injection pheniramine maleate 45.5 mg IV, injection dopamine 10 mcg/kg/min IV. He symptomatically improved within 6 hrs. Causality analysis using the WHO scale categorizes it as probable, as anaphylaxis occurred immediately after administration of hydrocortisone, no other drugs were given at that time, and rechallenge was not done. Very few cases of various steroid-induced anaphylaxis have been reported worldwide. This one among the rare ADR report may be due to the steroid or the excipients in the preparation. Skin prick test or in vitro (radioallergosorbent test assay) test can be done immediately to confirm the causative allergen in this case and would also help in identifying specific agents that will be tolerated in the future treatment.
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Huynh, Thanh-Hao, Pei-Chin Chen, San-Nan Yang, Feng-Yu Lin, Tung-Pin Su, Lo-Yun Chen, Bo-Rong Peng, et al. "New 1,4-Dienonesteroids from the Octocoral Dendronephthya sp." Marine Drugs 17, no. 9 (September 11, 2019): 530. http://dx.doi.org/10.3390/md17090530.
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Two new steroids, dendronesterones D (1) and E (2), featuring with 1,4-dienone moiety, along with three known steroids, methyl 3-oxochola-4,22-diene-24-oate (3), 5α,8α-epidioxy-24(S)- methylcholesta-6,22-dien-3β-ol (4), and 5α,8α-epidioxy-24(S)-methylcholesta-6,9(11),22-trien-3β-ol (5), were isolated from an octocoral Dendronephthya sp. The structures of steroids 1 and 2 were elucidated by using spectroscopic methods and steroid 1 was found to exhibit significant in vitro anti-inflammatory activity in lipopolysaccharides (LPS)-induced RAW264.7 macrophage cells by inhibiting the expression of the iNOS protein.
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Blanco, Maria-Jesus, Daniel La, Quinn Coughlin, Caitlin A. Newman, Andrew M. Griffin, Boyd L. Harrison, and Francesco G. Salituro. "Breakthroughs in neuroactive steroid drug discovery." Bioorganic & Medicinal Chemistry Letters 28, no. 2 (January 2018): 61–70. http://dx.doi.org/10.1016/j.bmcl.2017.11.043.
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Voishvillo, N. E., A. M. Turuta, A. V. Kamernitskii, N. D. Dzhlantiashvili, and V. K. Dacheva-Spasova. "Steroid transformations." Pharmaceutical Chemistry Journal 26, no. 2 (February 1992): 177–82. http://dx.doi.org/10.1007/bf00766462.
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MacCann, Rachel, Paul Hollywood, Samuel McConkey, and David Lorigan. "P171 Drug-drug interactions in hiv patients taking pharmacokinetic enhancers." Sexually Transmitted Infections 93, Suppl 1 (June 2017): A72.2—A73. http://dx.doi.org/10.1136/sextrans-2017-053232.214.
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IntroductionAntiretroviral medications have the potential to produce serious drug interactions by interfering with the hepatic cytochrome P450 cascade. Ritonavir, a protease inhibitor, is a known CYP450 inhibitor that is commonly used in the treatment of HIV1. Iatrogenic Cushing’s syndrome is caused by exposure to glucocorticoids and may be promoted by interaction with additional drugs that result in hypothalamic-pituitary adrenal axis suppression2. It is well documented in HIV patients receiving inhaled steroids in combination with a ritonavir-containing antiretroviral regimen3. Following one such severe drug-drug interaction in a patient, a clinical audit was conducted to identify potential drug-drug interactions in a HIV clinic at Beaumont Hospital, Dublin.Methods200 patients receiving Ritonavir were interviewed and screened for harmful prescribed and non-prescribed co-medications. Patients receiving regular steroid doses and Ritonavir were identified and all drugs were cross-referenced to the Liverpool Drug Interactions website to highlight any dangerous drug interactions.Results86% of patients had concomitant prescribed medications, three-quarters of which were undocumented. Furthermore, 45% of patients used regular over the counter-medication and 2.7% used recreational drugs. 8% of patients were flagged for potentially dangerous drug-drug interactions and of these, 15% contained steroids.DiscussionThe interaction between corticosteroids and PIs is significant and deserves close attention and evaluation. Timely communication among all prescribing physicians for a given patient is indicated in order to proactively detect significant interactions before they manifest themselves clinically.
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Akshaya, N., Ravi Krishna, and N. Venkateswaramurthy. "Steroids Induced Hyperglycemia: Its Effects and Management." Journal of Drug Delivery and Therapeutics 13, no. 6 (June 15, 2023): 166–71. http://dx.doi.org/10.22270/jddt.v13i6.6074.
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Steroids are medications that have been widely utilized for a number of ailments, both acute and chronic. The action of endogenous steroids, nuclear hormones that penetrate cell membranes to bind to certain glucocorticoid receptors in the cytoplasm of target cells to form glucocorticoid-receptor (GR) complexes, is mimicked by synthetic glucocorticoids. The translocated activated GR complex regulates DNA transcription in the cell nucleus. The main factor for drug-induced hyperglycemia is steroids. They not only worsen hyperglycemia in those who already have diabetes mellitus (DM), but they can also lead to DM in people who've not previously experienced it. Their incidence can reach up to 46% of patients, and their glucose levels can rise by up to 68% over baseline. Steroid effects are often narrow and reversible. Drug-induced diabetes is supposed to go away as steroid doses are decreased because their impact on endocrine metabolism returns to normal; however, this is often not the case. The synthesis of lipolysis, proteolysis, and hepatic glucose is increased by glucocorticoids (GCs) because they act as a substrate for oxidative stress metabolism. A wide range of medical conditions has been treated with GCs. Although steroid-induced hyperglycemia has been proven to be medically effective, it is still a widespread and potentially dangerous issue that must be taken into consideration when administering any GC dose. The most common scenario requires the use of insulin, particularly when the serum glucose level is greater than 200 mg/dL.
Keywords: Steroids, Glucocorticoids, Hyperglycemia, Resistance, Insulin
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null. "New steroids and steroid-long-acting ?2 agonist combinations." Expert Opinion on Therapeutic Patents 13, no. 4 (2003): 557–61. http://dx.doi.org/10.1517/eotp.13.4.557.23123.
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Seymour, N., M. Robinson, D. Richardson, H. Mohammed, D. Williams, and J. A. McGilligan. "Prescribing intranasal steroids in HIV-positive patients: systematic review of the literature." Journal of Laryngology & Otology 135, no. 9 (August 13, 2021): 755–58. http://dx.doi.org/10.1017/s0022215121001791.
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AbstractBackgroundThere are significant drug–drug interactions between human immunodeficiency virus antiretroviral therapy and intranasal steroids, leading to high serum concentrations of iatrogenic steroids and subsequently Cushing's syndrome.MethodAll articles in the literature on cases of intranasal steroid and antiretroviral therapy interactions were reviewed. Full-length manuscripts were analysed and the relevant data were extracted.ResultsA literature search and further cross-referencing yielded a total of seven reports on drug–drug interactions of intranasal corticosteroids and human immunodeficiency virus protease inhibitors, published between 1999 and 2019.ConclusionThe use of potent steroids metabolised via CYP3A4, such as fluticasone and budesonide, are not recommended for patients taking ritonavir or cobicistat. Mometasone should be used cautiously with ritonavir because of pharmacokinetic similarities to fluticasone. There was a delayed onset of symptoms in many cases, most likely due to the relatively lower systemic bioavailability of intranasal fluticasone.
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Gómez Bravo, Lizbeth Alejandra. "Revisión Bibliográfica: Glaucoma inducido por el uso de corticoides." Revista Médica del Hospital José Carrasco Arteaga 14, no. 2 (December 15, 2022): 117–26. http://dx.doi.org/10.14410/2022.14.2.rb.18.
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Glaucoma stands out for being a silent pathology; it courses with degeneration of the optic nerve, causing alterations in visual acuity and, in the worst case, it evolves into irreversible blindness. This condition has been linked to the use of corticosteroids, drugs that are currently frequently used to treat various pathologies. The therapeutic use of steroids can trigger an increase intraocular pressure, depending on the drug, the time and the route of administration, and leads to glaucoma induced by corticosteroids. Steroid induced glaucoma is considered a public health problem, and it is a preventable condition. There are several aspects that are still little known about this pathology, such as its general incidence and its exact pathophysiology; likewise, there are currently new diagnostic methods and innovative treatments. That is why the aim of this bibliographical review is to describe the role of steroids in the development of glaucoma, to establish its epidemiological profile, its characteristic clinical picture, risk factors, diagnostic methods, and finally to describe the different treatments available for Steroid induced glaucoma.
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Yasui, Yukihiko, David A. Hart, Norihiko Sugita, Ryota Chijimatsu, Kota Koizumi, Wataru Ando, Yu Moriguchi, et al. "Time-Dependent Recovery of Human Synovial Membrane Mesenchymal Stem Cell Function After High-Dose Steroid Therapy: Case Report and Laboratory Study." American Journal of Sports Medicine 46, no. 3 (December 11, 2017): 695–701. http://dx.doi.org/10.1177/0363546517741307.
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Background: The use of mesenchymal stem cells from various tissue sources to repair injured tissues has been explored over the past decade in large preclinical models and is now moving into the clinic. Purpose: To report the case of a patient who exhibited compromised mesenchymal stem cell (MSC) function shortly after use of high-dose steroid to treat Bell’s palsy, who recovered 7 weeks after therapy. Study Design: Case report and controlled laboratory study. Methods: A patient enrolled in a first-in-human clinical trial for autologous implantation of a scaffold-free tissue engineered construct (TEC) derived from synovial MSCs for chondral lesion repair had a week of high-dose steroid therapy for Bell’s palsy. Synovial tissue was harvested for MSC preparation after a 3-week recovery period and again at 7 weeks after therapy. Results: The MSC proliferation rates and cell surface marker expression profiles from the 3-week sample met conditions for further processing. However, the cells failed to generate a functional TEC. In contrast, MSCs harvested at 7 weeks after steroid therapy were functional in this regard. Further in vitro studies with MSCs and steroids indicated that the effect of in vivo steroids was likely a direct effect of the drug on the MSCs. Conclusion: This case suggests that MSCs are transiently compromised after high-dose steroid therapy and that careful consideration regarding timing of MSC harvest is critical. Clinical Relevance: The drug profiles of MSC donors and recipients must be carefully monitored to optimize opportunities to successfully repair damaged tissues.
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Penning, Trevor M., Phumvadee Wangtrakuldee, and Richard J. Auchus. "Structural and Functional Biology of Aldo-Keto Reductase Steroid-Transforming Enzymes." Endocrine Reviews 40, no. 2 (August 20, 2018): 447–75. http://dx.doi.org/10.1210/er.2018-00089.
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Abstract Aldo-keto reductases (AKRs) are monomeric NAD(P)(H)-dependent oxidoreductases that play pivotal roles in the biosynthesis and metabolism of steroids in humans. AKR1C enzymes acting as 3-ketosteroid, 17-ketosteroid, and 20-ketosteroid reductases are involved in the prereceptor regulation of ligands for the androgen, estrogen, and progesterone receptors and are considered drug targets to treat steroid hormone–dependent malignancies and endocrine disorders. In contrast, AKR1D1 is the only known steroid 5β-reductase and is essential for bile-acid biosynthesis, the generation of ligands for the farnesoid X receptor, and the 5β-dihydrosteroids that have their own biological activity. In this review we discuss the crystal structures of these AKRs, their kinetic and catalytic mechanisms, AKR genomics (gene expression, splice variants, polymorphic variants, and inherited genetic deficiencies), distribution in steroid target tissues, roles in steroid hormone action and disease, and inhibitor design.
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Udupa, Karteek R. N., Mahesh Eshwarappa, K. C. Gurudev, M. S. Gireesh, Rajshekar Reddy, and Mohammed Yousuff. "Clinico-biochemical Profile of Biopsy-proven Minimal Change Disease in Adults from a Tertiary Care Center in South India." Saudi Journal of Kidney Diseases and Transplantation 34, no. 3 (2023): 242–49. http://dx.doi.org/10.4103/1319-2442.393997.
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Minimal change disease (MCD) is the most common cause of nephrotic syndrome (NS) in children, and in adults, it contributes to 10%–25% of NS. MCD in adults follows a slightly different course associated with increased incidence of steroid resistance, hematuria, and HTN. This is a prospective-record analysis study aimed to analyze the profile of MCD in adults, response to treatment, and relapse rates. A retrospective observational study was carried out and data were collected retrospectively from all biopsy-proven MCD patients between 2012 and 2018. A total of 86 adults were diagnosed to have biopsy-proven MCD. Of these, 32 were excluded due to insufficient data/lost for follow-up. The IBM SPSS Statistics version 22.0 was used for the statistical analysis. Descriptive analysis includes expression of all the explanatory and outcome variables in terms of frequency and proportions for categorical variables whereas in terms of mean ± standard deviation for continuous variables. Chi-square test was used to compare the age, gender, remission, renal failure and response of different drugs, treatment durations, comorbidity conditions, relapse episodes, and different types of infections based on the degree of proteinuria among study patients. A total of 54 biopsy-proven adult MCD patients were analyzed. The mean age of the patients studied was 36.67 years, with the oldest patient being 76 years. In the study group, 37 (68.5%) patients were male and 14 (31.5%) were female. In the study population, 20 (37%) were hypertensive, 3 (5.6%) were diabetic, and 10 (18.5%) had renal failure at presentation. On treatment, 52 out of 54 patients received steroids, of which 41 (75.9%) were steroid responsive, 6 (11.1%) steroid dependent, and 7 (13%) steroid resistant. The mean time for remission in steroidsensitive patients was 8.8 weeks. Among the steroid-dependent and steroid-resistant patients, 11 patients received calcineurin inhibitors (CNIs), of which 3 were CNI resistant. In the study Group 1 patient received cyclophosphamide and two received rituximab. In the study population, two patients failed to achieve remission and one patient was initiated on hemodialysis and later lost for follow-up. Minimal change NS is a type of NS which is highly responsive to steroids with good prognosis in children. Adult MCD patients require a higher and prolonged course of steroid when compared to children. CNIs and rituximab form a promising second-line drug in patients who are steroid resistant/dependent. However, CNI dependency or relapse after stopping steroids is a concern.
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Kim, Young-Bea, Woo-Seung Lee, and Jun-Sung Won. "The effects of a single-dose subacromial injection of a nonsteroidal anti-inflammatory drug in geriatric patients with subacromial impingement syndrome: a randomized double-blind study." Clinics in Shoulder and Elbow 24, no. 1 (March 1, 2021): 4–8. http://dx.doi.org/10.5397/cise.2021.00052.
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Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs.Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation.Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671).Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.
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Akbari, Mitra. "Efficacy of Topical Tacrolimus 0.05% Suspension in Steroid-Resistant and Steroid-Dependent Vernal Keratoconjunctivitis." Pakistan Journal of Medical and Health Sciences 15, no. 7 (July 30, 2021): 2150–55. http://dx.doi.org/10.53350/pjmhs211572150.
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Objective: The purpose of this study was to investigate the safety and effectiveness of topical tacrolimus 0.05% suspension in the management of prolonged steroid-dependent and -resistant vernal keratoconjunctivitis (VKC). Materials and methods: The present interventional prospective case series were conducted on the research units suffering from refractory VKC between 2017, April and 2020, December. Despite routine drug treatment, consisting of topical steroids (steroid-resistant group), all subjects exhibited active symptomatic illness or were dependent on topical steroids (steroid-dependent group). After discontinuation of all medications for at least 1 week, the patients received eye drop (topical tacrolimus 0.05%) minimally for six months. Objective and subjective signs and symptoms were examined for alterations after one week, and one and six months of treatment. Analyses were continued for probable systemic and ocular adverse effects. Results: The study included 28 eyes of 14 participants (including 4 females and 10 males), with the mean age of 22 ± 8 years (between 11 and 38 years), and the mean VKC duration of 12 ± 6 years (between 5 and 23 years), as well as follow up period of 10±2 months (between 6 and 12 months). The results showed an improvement (P<0.001) in the symptoms such as mucus discharge, foreign body sensation, photosensitivity, redness, burning and itching. The initial sign was conjunctival hyperemia, which improved one week after treatment. Other objective signs including, conjunctival and limbal papillary hypertrophy, corneal pannus and corneal punctate epithelial erosions improved at least one month after treatment. No changes were observed in corneal opacity during follow-up (p> 0.05). There were no systemic or ocular adverse effects. Conclusion: This is the first time that tacrolimus suspension drops 0.05%, are used in these cases. Topical tacrolimus 0.05% was shown to be an effectiveness and safe agent to treat the refractory VKC. This drug is recommended to be prescribed prior to the appearance of side effects such as corneal opacity, irreversible deficiency in limbal stem cell, and steroid side effects. Keywords: Vernal keratoconjunctivitis, Tacrolimus eye drop, Refractory
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Fuentes, Robert J., Art Davis, Barry Sample, and Kim Jasper. "Sentinel Effect of Drug Testing for Anabolic Steroid Abuse." Journal of Law, Medicine & Ethics 22, no. 3 (1994): 224–30. http://dx.doi.org/10.1111/j.1748-720x.1994.tb01299.x.
Full textAbstract:
George Will, the well-known pundit, once observed: “A society's recreation is charged with moral significance. Sport—and a society that takes it seriously—would be debased if it did not strictly forbid things that blur the distinction between the triumph of character and the triumph of chemistry.” In opposition, Dan Duchaine, the highly publicized “steroid guru” and counter-culture columnist, declared: “There comes a time for many in competitive athletics where winning is more important than those initial goals of health, recreation, and relaxation.” The parallels of these two philosophies to life in general are patent simply by substituting “sports” and “winning” for “career” and “success,” respectively.This paper will review the basis for banning anabolic steroids in athletics, and consider especially the recent medical findings that support this prohibition. This survey leads into a discussion of the available deterrents, and the secondary, but essential, role of random drug testing as a final safeguard.
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YUE, De-bo, Bai-liang WANG, Kun-peng LIU, and Wan-shou GUO. "Efficacy of multimodal cocktail periarticular injection with or without steroid in total knee arthroplasty." Chinese Medical Journal 126, no. 20 (October 20, 2013): 3851–55. http://dx.doi.org/10.3760/cma.j.issn.0366-6999.20131389.
Full textAbstract:
Background Multimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid. Methods This is a prospective, double-blinded, randomized and control study. Seventy-two patients with osteoarthritis that met clinical criteria for total knee arthroplasty were recruited into the study, and were randomized to receive either multimodal cocktail periarticular injection with steroid or without steroid. Pain was assessed by visual analogue scale (VAS) at preoperative and postoperative at rest, and during activity. The range of motion was recorded preoperatively and postoperatively. The amount of daily and cumulative morphine consumption were measured by patient-controlled analgesia in the first 72 hours postoperatively. The duration of celecoxib usage was also recorded at the last follow-up. Results There were no differences between the non-steroid and steroid groups with regard to VAS at rest and during activity, or range of motion, at any postoperative observation time. The postoperative Knee Society Knee Score in the steroid group improved significantly as compared with that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; P <0.0045), three-month follow-up (90.2±16.3 and 72.5±16.6; P <0.0027), but after postoperative six-month the Knee Society Knee Score showed no significant difference between the groups. There was no significant difference in consumption of the morphine about daily or total consumption within 72 hours between the two groups. The duration of celecoxib usage in patients in the steroid group was significantly shorter than that in the non-steroid group ((7.2±0.7) compared with (10.5±1.9) weeks; P=0.012). Conclusion The patients who received the steroid injection had faster rehabilitation and less non-steroidal anti-inflammatory drugs consumption.
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Jourieh, Mohammad. "Safety and Efficacy of Suprachorodial Injection of Triamcinolone Acetonide: Review of a Novel Treatment." US Ophthalmic Review 17, no. 1 (2023): 25. http://dx.doi.org/10.17925/usor.2023.17.1.25.
Full textAbstract:
Suprachoroidal injection is a unique, minimally invasive procedure for drug delivery to the posterior segment of the eye. Drugs can be delivered easily via microneedles that are slightly longer than the scleral and conjunctival thickness at pars plana. Suprachoroidal delivery of corticosteroids allows higher steroid concentration in the posterior segment tissues with minimal drug concentration in the anterior segment, which decreases the risk of other adverse ocular events like steroid-induced elevation of intraocular pressure and cataract progression. Several clinical trials have evaluated the safety and efficacy of suprachoroidal injection of triamcinolone acetonide in various ocular conditions. This article reviews the novel treatment as a promising route for drug delivery.
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Ermolenko, Ekaterina V., Andrey B. Imbs, Tatyana A. Gloriozova, Vladimir V. Poroikov, Tatyana V. Sikorskaya, and Valery M. Dembitsky. "Chemical Diversity of Soft Coral Steroids and Their Pharmacological Activities." Marine Drugs 18, no. 12 (December 2, 2020): 613. http://dx.doi.org/10.3390/md18120613.
Full textAbstract:
The review is devoted to the chemical diversity of steroids produced by soft corals and their determined and potential activities. There are about 200 steroids that belong to different types of steroids such as secosteroids, spirosteroids, epoxy- and peroxy-steroids, steroid glycosides, halogenated steroids, polyoxygenated steroids and steroids containing sulfur or nitrogen heteroatoms. Of greatest interest is the pharmacological activity of these steroids. More than 40 steroids exhibit antitumor and related activity with a confidence level of over 90 percent. A group of 32 steroids shows anti-hypercholesterolemic activity with over 90 percent confidence. Ten steroids exhibit anti-inflammatory activity and 20 steroids can be classified as respiratory analeptic drugs. Several steroids exhibit rather rare and very specific activities. Steroids exhibit anti-osteoporotic properties and can be used to treat osteoporosis, as well as have strong anti-eczemic and anti-psoriatic properties and antispasmodic properties. Thus, this review is probably the first and exclusive to present the known as well as the potential pharmacological activities of 200 marine steroids.
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CRAMPIN, A. C., T. L. LAMAGNI, V. D. HOPE, J. A. NEWHAM, K. M. LEWIS, J. V. PARRY, and O. N. GILL. "The risk of infection with HIV and hepatitis B in individuals who inject steroids in England and Wales." Epidemiology and Infection 121, no. 2 (October 1998): 381–86. http://dx.doi.org/10.1017/s0950268898001265.
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Data on injecting anabolic steroid users, within the national Unlinked Anonymous HIV Prevalence Monitoring Survey of injecting drug users (IDUs) were analysed to determine their risk of acquiring blood borne viruses. One hundred and forty-nine participants who had injected anabolic steroids in the previous month were identified from 1991–6, contributing 1·4% of all participation episodes in the survey. Rates of needle and syringe sharing by steroid users were low. Three of the 149 (2·0%) had anti-HBc and none had anti-HIV in their salivary specimens. The prevalence of anti-HBc in steroid injectors was significantly lower than in heroin injectors, 275/1509 (18%) (P<0·001), or in amphetamine injectors, 28/239 (12%) (P<0·001). The risk of blood borne virus transmission amongst these steroid injectors is low, probably due to hygienic use of injecting equipment and low levels of sharing. It is important to distinguish steroid injectors from other IDUs because they are a distinct group in terms of lifestyle and injecting practice.