main article: Endocrine and reproductive system內分泌和生殖系統、Taiwanese Antipyretic analgesics classification解熱鎮痛藥、Steroid hormone類固醇激素
- 合稱corticoids皮質類固醇或皮質素,分成兩類:Mineralocorticoids and glucocorticoids(礦物質皮質素和葡萄糖皮質素)
- activity of Mineralocorticoids and glucocorticoids(礦物質皮質素和葡萄糖皮質素
- Mineralocorticoids(礦物質皮質素=留鹽激素: salt(Sodium) retention / K+/H+ excretion and resultant increased blood pressure.Aldosterone醛固酮
- glucocorticoids(葡萄糖皮質素: catabolism and antiinflammatory effect. 俗稱類固醇、美國仙丹或是黑玉丸子。譬如cortisol皮質醇和cortisone可體松。
- mineralocorticoids
- glucocorticoids with mineralocorticoids activity
- glucocorticoids with little or no mineralocorticoids activity
分類[]
mineralocorticoids[]
glucocorticoids with mineralocorticoids activity[]
.
glucocorticoids with little or no mineralocorticoids activity[]
.
Mechanism[]
- salt(Sodium) retention / K+/H+ excretion and resultant increased blood pressure:mineralocorticoids bind with its receptor
- catabolism:glucocorticoids(葡萄糖皮質素 bind with its receptor
- antiinflammatory effect:glucocorticoids藉由促進白血球中的蛋白質lipocortin的生成抑制PLA2
劑量換算[]
品項 | 劑量比例 | Conversion Factor | Equivalent Dose | Half-life (Biologic) | 備註 |
Short-Acting(短效) | |||||
Cortisone | 500 | 0.8 | 25 | 8-12 | |
Hydrocortisone | 400 | 1 | 20 | 8-12 | |
Intermediate-Acting(中效) | |||||
Methylprednisolone | 80 | ||||
Prednisolone | 100 | 5 | 4 | 18-36 | |
Prednisone | 100 | 4 | 5 | 18-36 | 基準 |
Triamcinolone | 80 | 5 | 4 | 18-36 | |
Long-Acting(長效) | |||||
Betamethasone | 14.3 | 28 | 0.6-0.75 | 36-54 | |
Dexamethasone | 13.3 | 30 | 0.75 | 36-54 |
資料來源:http://blog.pixnet.net/mulicia/post/18790616
美國局部類固醇抗發炎強度七級[]
Topical glucocorticoid causes cutaneous vasoconstriction in proportion with their potency.[1] With reference to the United States classification system, topical glucocorticoid can be classified into seven groups, with group 1 being the most potent and group 7 the least potent.[2]
Super-high potency (Group 1)[]
- Betamethasone dipropionate, augmented 0.05%
- Clobetasol propionate 0.05%
- Diflucortolone valerate 0.3% (not available in the US)
- Fluocinonide 0.1%
- Flurandrenolide 4 mcg/cm2
- Halobetasol propionate 0.05%
High potency (Group 2)[]
- Amcinonide 0.1%
- Betamethasone dipropionate 0.05%
- Clobetasol propionate 0.025%
- Desoximetasone 0.25%
- Diflorasone diacetate 0.05%
- Fluocinonide 0.05%
- Halcinonide 0.1%
- Halobetasol propionate 0.01%
Higher-mid potency (Group 3)[]
- Amcinonide 0.1%
- Betamethasone dipropionate 0.05%
- Betamethasone valerate 0.1%
- Desoximetasone 0.05%
- Diflorasone diacetate 0.05%
- Diflucortolone valerate 0.1% (not available in the US)
- Fluocinonide 0.05%
- Fluticasone propionate 0.005%
- Mometasone furoate 0.1%
- Triamcinolone acetonide 0.5%
Medium potency (Group 4)[]
- Betamethasone dipropionate 0.05%
- Clocortolone pivalate 0.1%
- Fluocinolone acetonide 0.025%
- Flurandrenolide 0.05%
- Hydrocortisone valerate 0.2%
- Mometasone furoate 0.1%
- Triamcinolone acetonide 0.1%
Lower-mid potency (Group 5)[]
- Betamethasone dipropionate 0.05%
- Betamethasone valerate 0.1%
- Desonide 0.05%
- Fluocinolone acetonide 0.025%
- Flurandrenolide 0.05%
- Fluticasone propionate 0.05%
- Hydrocortisone butyrate 0.1%
- Hydrocortisone probutate 0.1%
- Hydrocortisone valerate 0.2%
- Prednicarbate 0.1%
- Triamcinolone acetonide 0.1%
Low potency (Group 6)[]
- Alclometasone dipropionate 0.05%
- Betamethasone valerate 0.1%
- Desonide 0.05%
- Fluocinolone acetonide 0.01%
- Triamcinolone acetonide 0.025%
Least potent (Group 7)[]
- Hydrocortisone (base, ≥2%) 2.5%
- Hydrocortisone (base, <2%) 1%
- Hydrocortisone acetate 2.5%
ADR[]
只要使用藥膏治療超過一週,病灶紅腫未改善或是範圍擴大時,回診為建議選擇。
藥化[]
- Mineralocorticoids and glucocorticoids both have the structure of 3-keto 4-ene steroid, thus these two activity can't be seperated. However, some of the glucocorticoids have almost no mineralocorticoids activity, we can classified Mineralocorticoids and glucocorticoids into 3 groups:
- mineralocorticoids
- glucocorticoids with mineralocorticoids activity
- glucocorticoids with little or no mineralocorticoids activity