Glucocorticoids. This is a group of drugs with undoubtedly the most vivid and quickly manifested anti-inflammatory effect, and when using doses higher than 3-4 mg / kg and an immunosuppressive effect. Reducing the phospholipase activity of glucocorticoids have a close to NSAIDs, but significantly more powerful anti-inflammatory effect.
Of the drugs of this series, the most used in rheumatological practice are prednisone, dexamethasone, trimycinolone. With oral use, prednisone is the best; of the listed drugs.
The wide and long experience of using glucocorticoids led to a considerable disappointment in the need for their naming (Table 14). It turned out that the side effects of such treatment, especially with the irrational use of drugs, are so significant that they can be quite comparable in a number of cases with the action of the pathological process against which they are assigned. Moreover, these drugs, rendering very bright not
the mediocre effect practically does not affect the prognosis of YUHA and RA, not to mention the fact that with prolonged use most hormone-dependent patients develop hormone dependence. In this regard, the indications for the appointment of glucocorticoids in recent years, more and more narrowed.
However, in a number of patients it is necessary to prescribe hormone therapy, and now certain ways have been outlined in overcoming the side effects of these drugs. It turned out that the necessary anti-inflammatory effect can be achieved with a single daily dose of the entire daily dose. In this case, the risk of adverse effects of the drug is significantly reduced. Hence, intermittent glucocorticoid treatment regimens are recommended (and in a number of patients it is well justified): giving the entire daily dose once, usually in the morning or every other day.
Another trend is the use of ultra-high doses (1.0 gram) of prednisolone (methylprednisolone) parenteral for 2–3 days. Such therapy is well established for systemic lupus erythematosus. There are also reports on the & efficacy of such treatment regimens in systemic forms of UHA