steroid, cortisol, corticosteroid equivalnet

Corticosteroid 구조식

short acting
cortisol=hydrocortisone	-
	-
intermediate acting
prednisone	prednisolone
methylprednisolone	-
	-
loncg acting
dexamethasone	-
	-

Corticosteroid equivalnet

	equivalnet dose (mg)	anti- inflammatory	mineralo -corticoid	half life duration of action (hr)	상품명
hydrocortisone	20	1	1	8-12	래피손 정 10 MG 코티소루 주 100 MG
prednisone	5	4	0.8	12-36
prednisolone	5	4	0.8	12-36	소론도 정 5 MG
methylprednisolone	4	5	0.5	12-36	메치론 정 4 MG 메치솔 주 125, 500 MG
dexamethasone	0.75	30	0	36-54	덱사메타손 주 5 MG/1 ML 덱사메타손 정 0.75 MG

Corticosteroid pharmacokinetic

cortisol의 혈장에서의 형태

1. free cortisol : 5 %
2. protein binding cortisol : 80 %
3. cortisol metabolite

✔ 염증 상태에서 cortisol의 binding affinity는 감소되어 해당 구역에서 더 많이 free form으로 존재함

✔ 대부분의 합성 corticosteroid의 경우 단백결합을 하지만 native cortisol보다는 less efficiently 함

✔ cortisol metabolite는 biologically inactive & 단백결합이 약함

📌 corticosteroid(CS) 투여 후 meachanism : cell mediated immunity 억제

• inhibit antigen presentation, cytokine production and lymphocytes proliferation by binding to glucocorticoid receptors found throughout the body.
• corticosteroid 투여 후, lymphocytopenia 유발(induced as a result of redistribution of circulating lymphocytes into other lymphoid compartments)
• A single dose of CS produces lymphocytopenia within 4 hours of administration which normalizes through redistribution into the circulation away from periphery, rather than destruction, within 24 to 48 hours.
• monocytes and eosinophils, which normally accumulate at the inflammatory site, decrease upon administration of CSs.
• CSs induce neutrophilia via the release of neutrophils from the bone marrow into the circulation, reduction in the migration of neutrophils out of the circulation, and demargination of neutrophils from the vascular lining.

reference :

1) wikipedia

2) Samuel, Sophie, Thuy Nguyen, and H. Alex Choi. "Pharmacologic characteristics of corticosteroids." Journal of Neurocritical Care 10.2 (2017): 53-59.