For many years

For many years antiinflammatory influence of glucocorticoids spoke stabilisation of lysosomic membranes, but lately a number of researchers was confirmed with these data. Representations about influence of corticosteroids on synthesis of Prostaglandinums have been reconsidered also. Earlier believed, that Prednisolonum and similar preparations do not buy cipro cheap render appreciable action on a metabolism of Prostaglandinums (unlike obvious effect of nonsteroid antiinflammatory preparations at the expense of enzyme inhibition ). It has been found out Later, that actually appointment of corticosteroids leads to reduction of synthesis of Prostaglandinums, but is perfect other by. It has appeared, that, not influencing on , they oppress activity of enzyme , releasing arachidonic acid from difficult complexes in cellular membranes. As Prostaglandinums are synthesised from arachidonic acid, reduction of formation by last under the influence of corticosteroids results finally and in reduction of formation of Prostaglandinums, limiting to that intensity of inflammatory process.
Immunodepressive action of glucocorticoids is realised by different ways. Most obvious of them is lytic action on lymphoid system, especially on T-limfotsity, responsible first of all for cellular immune reactions. According to it the last are braked most distinctly (including allergic reactions of the slowed down type and immunity). Besides immediate overwhelming influence on T-limfotsity, reduction of quantity of circulating monocytes and inhibition of their function as normally functioning monocytes play an essential "secondary" role in development of cellular immune reactions matter. Though V-limfotsity are less sensitive to lytic and according to braking influence of glucocorticoids, these preparations in certain degree oppress also humoral immune reactions - synthesis of immunoglobulins and concrete antibodies. It is necessary to consider oppression of ability of monocytes to metabolize antigens and to transfer them in adequate form V-limfotsitam.
Clinically obvious suppression of immune reactions by glucocorticoids can depend not only on actually immunodepressive action, but also from normalisation of capillary permeability (difficulty of contact of antigens with antibodies, an obstacle to passage of immune complexes through the basic membrane of vessels), and also from the nonspecific antiinflammatory effect shown in relation to any types of an inflammation (including to immune) irrespective of the processes which have caused it.
Extremely fast medical action of glucocorticoids at acute immune crises (for example, an autoimmune hemolysis, an autoimmune thrombocytopenia etc.) gives the basis to believe, that these preparations interfere also with reaction of an antigen with an antibody, but concrete mechanisms of such influence while are unknown.
At rheumatic diseases glucocorticoids apply almost exclusively in the form of tablets. Prednisolonum is issued in tablets on 5 mg, and also on 1 and 2,5 mg, Prednisonum - on 1 and 5 mg, Methylprednisolonum - on 2-4 and 16 mg, Triamcinolonum (Kenacortum, Polcortolonum) - on 1-2 and buy rimonabant cheap 4 mg, () - on 6 and 12 mg, dexamethasone - on 0,5, 0,75 and 2 mg, betamethasone - on 0,5 mg, - on 2 mg, Cortisonum - on 25 mg. On antiinflammatory medical effect of Prednisolonum of 5 mg are roughly equivalent 5 mg of Prednisonum, 4 mg of Methylprednisolonum or Triamcinolonum, mg , 0,75 mg of dexamethasone or betamethasone, 2 mg , 25 mg of Cortisonum or Hidrocortizonum.
If it is impossible to enter these preparations inside, they can be used in (thus a dose enlarge by 25-50 %). Practically unique glucocorticoid which could be applied to long parenteral treatment, Hidrocortizonum is, but it considerably concedes to Prednisolonum and other modern preparations on shipping. Other glucocorticoids existing in the form of injection forms (Prednisolonum, Methylprednisolonum, dexamethasone), at intramuscular and the more so intravenous introduction are metabolized much faster in this connection their action quickly and in most cases is not enough for carrying out of long treatment. For reception of equivalent medical effect it should to enter doses, in 2-4 times big, than at appointment inside, and to use frequent injections. For last years successful attempts of creation of the parenteral prolonged preparations (in particular, , or Kenalogum), used, however, not for active "overwhelming" treatment, and basically as agents of supporting or local (intraarticulate) therapy are undertaken by corticosteroids.