Systemic corticosteroids asthma exacerbation

Corticosteroids are more potent than NSAIDs in reducing inflammation and restoring function when the disease is active. Corticosteroids are particularly helpful when internal organs are affected. Corticosteroids can be given by mouth, injected directly into the joints and other tissues, or administered intravenously. Unfortunately, corticosteroids have serious side effects when given in high doses over prolonged periods, and the doctor will try to monitor the activity of the disease in order to use the lowest doses that are safe. Side effects of corticosteroids include weight gain , thinning of the bones and skin, infection, diabetes , facial puffiness, cataracts , and death (necrosis) of the tissues in large joints.

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 . [43] 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 . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] 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 $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] 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 prostaglandins and leukotrienes was fully understood in the early 1980s.

Greenspun, Bertram. "Systemic Lupus Erythematosus." eMedicine . Eds. Martin K. Childers, et al. 23 Apr. 2009. Medscape. 21 Jul. 2009 <http:///article/305578-overview>. Hahn, Bevrah, and Betty P. Tsao. "Systemic Lupus Erythematosus and Related Syndromes." Kelley's Textbook of Rheumatology. Eds. Edward Harris, et al. 7th ed. Philadelphia: . Saunders, 2005. MD Consult . Elsevier, Inc. 21 Jul. 2009 <http://>. Sjowali, Christopher, et al. "Serum Levels of Autoantibodies Against Monomeric C-Reactive Protein Are Correlated with Disease Activity in Systemic Lupus Erythematosus." Arthritis Research & Therapy 6 2 (2004): 87-94. Medscape Today . Medscape. 21 Jul. 2009 <http:///viewarticle/466990>. Source: Medical Disability Advisor

Potential oral or head and neck findings of bulimia and anorexia include dental erosion, xerostomia, increased rate of caries, and sialadenosis. Vomiting exposes teeth to acidic gastric contents, which leads to enamel erosion. The erosion pattern tends to involve the lingual surfaces of the maxillary anterior teeth ( Figure 12 ) and, in severe cases, the buccal surfaces of the posterior mandibular teeth. 39 Patients may have dental sensitivity to cold or sweet stimuli. Xerostomia may be caused by medications often used by patients with bulimia or anorexia (., antidepressants, diuretics, laxatives), as well as by vomiting and excessive exercise. 40 Because the buffering and cleansing properties of saliva are important for prevention of tooth decay, xerostomia leads to increased caries risk. Additionally, sialadenosis affects approximately 25 percent of patients with bulimia; bilateral parotid enlargement is the most common presentation. 41

Systemic corticosteroids asthma exacerbation

systemic corticosteroids asthma exacerbation

Potential oral or head and neck findings of bulimia and anorexia include dental erosion, xerostomia, increased rate of caries, and sialadenosis. Vomiting exposes teeth to acidic gastric contents, which leads to enamel erosion. The erosion pattern tends to involve the lingual surfaces of the maxillary anterior teeth ( Figure 12 ) and, in severe cases, the buccal surfaces of the posterior mandibular teeth. 39 Patients may have dental sensitivity to cold or sweet stimuli. Xerostomia may be caused by medications often used by patients with bulimia or anorexia (., antidepressants, diuretics, laxatives), as well as by vomiting and excessive exercise. 40 Because the buffering and cleansing properties of saliva are important for prevention of tooth decay, xerostomia leads to increased caries risk. Additionally, sialadenosis affects approximately 25 percent of patients with bulimia; bilateral parotid enlargement is the most common presentation. 41

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