cortisone

Action and Spectrum

Actions and Spectrum: 

cortisone is a type of steroid hormone that is naturally produced by the adrenal gland. It is a synthetic form of cortisol, which is the primary hormone that regulates the body’s stress response. cortisone has anti-inflammatory and immunosuppressive effects, which means that it can help reduce inflammation and suppress the immune system’s response. 

cortisone is commonly used to treat a variety of conditions, including allergies, asthma, rheumatoid arthritis, and skin disorders. It works by inhibiting the production of inflammatory chemicals called prostaglandins, which are responsible for causing pain, swelling, and redness. 

The spectrum of cortisone is broad, as it can be used to treat a range of conditions affecting different organs and systems in the body. However, its use is associated with several side effects, including weight gain, increased appetite, mood changes, elevated blood sugar levels, and increased risk of infections. 

Drug Interaction

Adverse Reaction

Frequency Defined

>10%

Incr appetite

Indigestion

Insomnia

1-10%

Arthragia

Hirsutism

Cataract

DM

Epistaxis

Black Box Warning

The most significant black box warning od cortisone is the increased risk of infections like TB and sepsis. Corticosteroids like cortisone can reduce the immune system and make it difficult to fight against the infection for the body.

Contraindication / Caution

Systemic fungal infection

If patient have hypersensitivity to cortisone or any other substances which is present in this drug

Use in premature infants

Vaccination with live or attenuated virus vaccines which cannot include smallpox

Herpes simplex

Tuberculosis of the respiratory tract

Administration of a live vaccine in patients who have received a large dose of a corticosteroid in the last 12 months

Cautions:

Peptic ulcer disease

Osteoporosis

Hypertension

Congestive heart failure

Diabetes mellitus

Renal impairment

Cataracts and glaucoma

Myasthenia gravis

Hypothyroidism

Thromboembolic disorder

Pregnancy / Lactation

Pregnancy category: N/A

Lactation: Excreted into human milk is known

Pregnancy Categories:     

Category A: well-controlled and Satisfactory studies do not show risk to the fetus in the first/later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.     

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category

Pharmacology

Cortisone is bonds to glucocorticoid receptor. It is present in many cells in the body. Cortisone can change the gene expression and modulate the activity of different cellular signaling pathways after binding.

Pharmacodynamics:

Cortisone has an anti-inflammatory effects. It reduces the production of inflammatory cytokines and chemokines. This inhibits the migration of immune cells to the sites of inflammation and reduces the permeability of blood vessels. It also inhibits the activity of immune cells like T cells and B cells. They are included in the inflammatory response.

Pharmacokinetics:

Absorption

Cortisone is administrated by orally or injected. When it is administrated orally, it is absorbed by the gut and transported to the liver. Oral administration has poor bioavailability because of the extensive metabolism. When injected. It is absorbed by the blood, and it is more effective.

Distribution

Cortisone is distributed in the body. It binds to the specific receptors and has an impact. It is highly protein bound about 90 to 95%. It mostly binds to cortisol binding albumin and globulin.

Metabolism

Cortisone is metabolized in the liver by the process of oxidation and hydroxylation. The main metabolite of cortisone is cortisol. It is an active form of hormone. Cortisone is converted into the inactive metabolites like cortisone acetate and 20-β dihydrocortisone.

Elimination and Excretion

Cortisone and metabolites are mainly excreted by the urine. The half life of cortisone is about 8 hours and half life of cortisol is about 80 minutes.

Adminstartion

Cortisone is administrated in different forms like injections, topical creams, and oral pills. The dosage and method of administration is dependent on the type and severity of the disease and age and overall health of the patients. The treatment may need regular monitoring to check for any side effects or complications.

Patient Information Leaflet

Generic Name: cortisone

Why do we use cortisone?

Cortisone is a steroid type of the hormone. It is used for the anti-inflammatory and immunosuppressive effects. It is used to treat many diseases like:

Inflammatory conditions: Cortisone can decrease the inflammation and swelling in different diseases like bursitis, arthritis, tendinitis and other types of joint pain.

Allergic reactions: Cortisone can reduce the symptoms of allergic reactions like redness, itching, and swelling.

Asthma: Cortisone is used to treat symptoms of asthma and to prevent attacks of asthma.

Autoimmune disorders: Cortisone can weaken the immune system and reduce the symptoms of autoimmune diseases like lupus, multiple sclerosis, and rheumatoid arthritis.

Skin conditions: Cortisone is used topically to reduce the inflammation in skin diseases like psoriasis, eczema, and allergic rashes.