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Ergebnisse der Inneren Medizin und Kinderheilkunde / Advances in Internal Medicine and Pediatrics (English, German, Paperback, Softcover reprint of the original 1st ed. 1989)
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Ergebnisse der Inneren Medizin und Kinderheilkunde / Advances in Internal Medicine and Pediatrics (English, German, Paperback, Softcover reprint of the original 1st ed. 1989)
Series: Ergebnisse der Inneren Medizin und Kinderheilkunde. Neue Folge / Advances in Internal Medicine and Pediatrics, 58
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More than 30 years ago the first report concerning the therapeutic
use of glucocorti- coids appeared. Even if the pediatrician is
aware of the large number of clinical and experimental studies that
have accumulated during the past three decades he is still faced
with the uncertainties of corticosteroid therapy in children's
diseases especially with regard to pharmacodynamic effects and
pharmacokinetics. There is no doubt that these drugs have
considerably reduced morbidity and mor- tality in children
suffering from asthma, nephrosis, rheumatoid arthritis, leukemia,
or other diseases, but in some cases they may do more harm than the
underlying disease for which they are prescribed. Thus, in order to
obtain optimum benefit with mini- mum risk, the advantages of
glucocorticoid therapy should be carefully considered before
embarking on a program, especially one of chronic high-dose
administration. 2 General Pharmacology and Physiology The primary
function of corticosteroids is protection from various "stresses"
in every- day life and they are involved in our ability to fight
diseases, overcome trauma and cope with emotional upsets. In the
mammalian adrenal gland there is a central zone, derived from the
ectodermal neural crest, which produces catecholamines. This is
sur- rounded by a peripheral zone, the adrenal cortex, derived from
the mesodermal co- elomic epithelium, which synthesizes steroids.
The fetal adrenal gland is already cap- able of synthesizing
corticosteroids and by the middle trimester of pregnancy a two- way
diaplacental transfer exists.
General
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