Cortisone is a very important steroid hormone secreted by the adrenal glands. Glucocorticoid activates the synthesis of carbohydrates from protein, suppresses lymphoid organs, modifies metabolic processes, increases the body's resistance to stress. The pharmaceutical industry has developed an analogue to the human hormone - cortisone acetate. The drug is an effective synthetic corticosteroid.
Characteristics, composition and release form
Cortisone is a glucocorticosteroid in the form of white tablets of crystalline powder, odorless and poorly soluble in water and ethanol. It is similar in chemical structure to cortisol and is considered its inactive metabolic product. The agent is used orally, parenterally, externally. The active substance of the drug is cortisone acetate. Manufacturers produce the drug in the following forms:
- Tablets containing 25 and 50 mg of the active substance, 80 pieces in a cartonpackaging.
- Suspension 2, 5% in vials of 5 or 10 ml, 10 pieces per pack. The content of the active pharmaceutical substance is 0.025 g per 1.0 ml.
Cortisone-containing ointment also belongs to glucocorticoids, but has a narrower pharmacological effect. The tool has anti-allergic and local anti-inflammatory action. The active substance of the ointment is hydrocortisone acetate, which, like cortisone, is a steroid hormone produced by the adrenal cortex. Of the excipients, the composition of the drug includes propylene glycol - a solvent, glucite - a thickener, povidone - an enterosorbent, sodium chloride - a detoxifier.
Pharmacological properties
Glucocorticoid has anti-inflammatory, immunosuppressive, anti-allergic properties, reduces the body's sensitivity.
Anti-inflammatory action is due to the suppression of the formation of 2-lysophospholipid and fatty acid. This leads to inhibition of the synthesis of prostaglandins, a decrease in the release of proteins that stimulate the aggregation of platelets, malignant cells, and leukocytes.
Anti-allergic action is determined by the stabilization of the membrane of the cell organoid, which maintains an acidic environment and the prevention of the release during lysis of cells that have a damaging effect and are involved in changing the structure of the tissue in the place where the allergy has arisen.
Immunosuppressive properties are associated with a decrease in the number of cells capable of recognizing an antigen and giving it a protective response. As well asinhibition of cell proliferation with the transition of lymphocytes into blasts, a decrease in the number of active substances with immunoregulatory and mediator features.
Cortisone acetate increases potassium excretion and sodium retention, which leads to a decrease in the outflow of water from the body. Stimulates enzymes that are responsible for metabolism, increases blood glucose levels, increases protein synthesis.
Indications
According to the instructions for the use of cortisone acetate is prescribed for the following diseases:
- Endocrine disease characterized by the inability of the adrenal glands to produce enough hormones (Addison's disease).
- Hypocortisolism after complete surgical removal of the adrenal glands.
- Disruption of the anterior pituitary gland.
- Congenital disorders of the adrenal cortex.
- Rheumatic diseases.
- Hemolytic anemia.
- Atopic dermatitis.
- Allergic reactions.
- Bronchial airway obstruction.
- Infectious mononucleosis.
- Hepatitis of viral genesis.
- Severe form of vascular insufficiency (collapse).
- Disruption of the body's adaptive response to damage (shock).
Documentary forms of cortisone for external use are used in ophthalmology to treat inflammation of the organs of vision. Ointments are prescribed to stop the pathological protective and adaptive process, reduce swelling and itching.
Contraindications for cortisoneacetate
This is a prescription drug and has quite an impressive list of he alth conditions for which its use is not recommended.
- Increased sensitivity to the components of the drug.
- Invasive diseases.
- Infectious diseases of various origins.
- Pre- and post-vaccination period (8 weeks before vaccination and 2 after).
- AIDS and HIV.
- Peptic ulcer.
- Inflammation of the lining of the esophagus.
- Gastritis.
- Intestinal anastomosis.
- Chronic disease of the lining of the lower digestive tract (ulcerative colitis).
- Diverticulitis.
- Myocardial infarction.
- Hypertension.
- Dyslipidemia.
- Diabetes mellitus.
- Cushing's disease.
- Renal and liver failure.
- III-IV stages of obesity.
The use of the drug is carried out under the supervision of the doctor who prescribed it. Under special attention are patients with cirrhosis of the liver, with a long-term lack of thyroid hormones. With these pathologies, the effect of the medicinal substance may increase and there will be a need to adjust the dose.
If a patient who is prescribed therapy with drugs containing cortisone has recently been in contact with patients with herpes, chickenpox, amoebiasis, tuberculosis, then it is necessary to notify the doctor about this.
Use of tablets and suspensions: dosage
Self-use of a drug carries a largerisk to he alth, the drug should only be taken under the direction of a medical specialist and under his supervision.
The dosage is calculated individually depending on the patient's condition, pathology and its course. The daily intake of Cortisone tablets according to the instructions should not exceed 300 mg. The initial dose of the drug is 10-20 mg at a time up to 4 times a day. Depending on the severity of the pathology, the amount of the substance increases, but a single dose for adults should not exceed 150 mg. As he alth improves, the dosage is gradually reduced to a minimum.
For children, the drug is prescribed in smaller quantities, the dosage depends on the age of the small patient - from 12 to 25 mg at a time.
Suspension is used intramuscularly or into the cavity of the joints. The ampoule is shaken and the contents are injected deep into the buttock from 50 to 300 mg at a time. The daily dose is 1000-1500 mg. The calculation of the drug for children depends on the weight of the child: the most appropriate dose is 6–9 mg per 1 kg of body weight.
Intra-articular administration is carried out at 5–25 mg once every 7 days. Course duration 3-5 weeks.
Cortisone ointment: instructions for use
Drug for external use has a local anti-inflammatory, anti-edematous effect. Cortisone ointment is applied in a thin layer to the affected area of the skin 2-3 times a day. To enhance the therapeutic effect, occlusive dressings are used to seal the diseased area. Durationtherapy depends on the characteristics, severity of the pathology and the effectiveness of treatment. The duration of the course is usually from one to two weeks, with a persistent disease process, therapy can be increased up to 20 days.
The use of ointment in children is possible from the age of two. Measures that enhance the absorption of the glucocorticoid are excluded.
Cortisone during pregnancy and lactation
There are no adequate studies on the use of corticosteroids during pregnancy and lactation. Cortisone tablets are steroid hormones, but they do not have either estrogenic (produced by the ovarian follicular apparatus) or progestogenic (produced by the fetal placenta) activity. Glucocorticosteroids maintain homeostasis. However, during pregnancy, women are more exposed to stress signals, which leads to increased adrenal secretion. High levels of cortisone contribute to high blood pressure, which can lead to miscarriage.
The drug can be used during pregnancy only if the benefit outweighs the risk of adverse effects. If there is even a small chance of harming the fetus, then such therapy is considered inappropriate and even dangerous. If a woman in position took cortisone, then born babies need to be carefully monitored due to possible hypofunction of the adrenal glands.
During lactation it is also better to stop usingdrug due to the fact that it is secreted into milk. If there is an urgent need to use a corticosteroid, then it is better to stop breastfeeding.
Side effects
The frequency of formation and explication of undesirable effects depends on the duration of use, dosage and adherence to cyclic fluctuations in the appointment.
- On the part of the endocrine system after taking cortisone acetate, steroid diabetes mellitus, suppression of adrenal function, Itsenko-Cushing's syndrome, and delayed sexual development in children can be observed.
- Metabolic processes: hypocalcemia, hypernatremia, increased sweating, weight gain, reflex convulsive muscle contraction, fatigue, loss of strength.
- Cardiovascular system: arrhythmia, sinus rhythm disorder (bradycardia), high blood pressure, thrombophilia, development of heart failure.
- CNS and sensory organs: impaired consciousness from confusion to coma (delirium), impaired ability to navigate in space, hallucinations, euphoria, causeless mood changes in any direction, paranoia, nervousness, frequent insomnia, sudden onset headaches, increased intraocular pressure, displacement of the eyeball - bulging eyes (exophthalmos).
- Musculoskeletal system: osteoporosis, muscle atrophy, steroid myopathy.
- Digestive system: pancreatitis, inflammation of the esophagus with the appearance of erosions and ulcers, flatulence, nausea,vomiting.
- Allergic reactions.
- Acne.
- Thinning of the skin.
Precautions
Intraocular pressure should be checked during therapy.
According to the instructions, cortisone acetate should be prescribed to children only for absolute indications and carefully monitored by a doctor. With long-term therapy, it is necessary to monitor the dynamics of growth and development. If the child has been in contact with patients affected by chickenpox or measles, specific immunoglobulins are prescribed for prevention.
Cancel the drug gradually by gradually reducing the dose, in order to avoid the formation of a withdrawal syndrome.
Interaction with other drugs
The therapeutic properties of various drugs in the interaction of cortisone acetate may vary depending on the type of drug.
- Glucocorticosteroid enhances the healing properties of anticoagulants (drugs that reduce blood clotting), antiplatelet agents (drugs that prevent blood clots.
- Increases the side effects of NSAIDs, steroid female sex hormones (estrogens), cardiac glycosides, steroid anabolics, the antifungal drug Amphotericin B, the cystic drug L-asparaginase.
- Reduces the effectiveness of hypoglycemic (glucose lowering), antihypertensive drugs and diuretics (diuretics).
- Derivatives of barbituric acid reduce the effectiveness of cortisone.
Expiration date and storage rules
According to the instructions "Cortisone" intablets are stored for 5 years from the date of manufacture in a dark place at t +25°C. The shelf life of the ointment and suspension is 3 years, they must be stored at a temperature of + 15 ° C. Do not freeze the product for external use.
Reviews
Reviews about cortisone doctors are only good. Doctors have long and successfully used a synthetic corticosteroid. In their opinion, the negative consequences are due solely to non-compliance with medical recommendations.
Reviews from patients are not so favorable due to side effects. Some patients complain of headaches, bouts of nausea, lack of taste in food during course therapy. Patients experience great relief after the end of treatment. But doctors say that this is largely a consequence of the fact that the person has recovered.
Analogues
The main analogs of cortisone acetate and hydrocortisone are Akortin, Dexamethasone, Metipred, Canison plus. Also used are "Avamys", "Betaderm", "Alteson", "Rinocorten", "Cirtodrin".
