The role of glucocorticoid
This kind of hormone drugs are used in clinic, mainly for anti-inflammatory and immunosuppression. Especially in emergency or critical situations, glucocorticoid is often the first choice, which can prevent excessive immune inflammatory reaction and is effective for almost any type of excessive immune response diseases.
Glucocorticoid is secreted by human body, and regulating the metabolism of sugar and protein is a continuous process every day. Therefore, it is impossible to show anti-inflammatory effect at physiological dose, and only when it is greater than this dose will it gradually show anti-inflammatory effect. This article focuses on the anti-inflammatory and immunosuppressive effects of these hormones.
This kind of hormone drugs can resist inflammation because it can not only inhibit the production of inflammatory mediators (leukotrienes, prostaglandins, etc.). ), but also inhibit or even destroy inflammatory cells, so that the site of inflammation will not produce too many inflammatory cytokines. In addition, when using these drugs, people's immune function will also be inhibited. Using these acupoints, when people are infected by some exogenous pathogenic microorganisms, they will not be excessively damaged and life-threatening due to problems such as cytokine storms.
Therefore, these drugs are usually used to treat some inflammatory diseases, such as systemic lupus erythematosus, rheumatoid arthritis, synovitis with edema, pyelonephritis, ophthalmia and some nervous system diseases.
Glucocorticoid drugs also played an important role in the treatment of SARS in 2003, saving many lives. However, it is undeniable that improper use of such drugs will also produce side effects and even leave permanent sequelae.
Side effects of glucocorticoid application
At present, the role of glucocorticoid drugs is irreplaceable. When some acute inflammation is life-threatening, it should be used as a life-saving medicine, considering the risks and benefits. As for the side effects, minimize them. The application of glucocorticoid has three noticeable side effects, which should be remedied in time:
1, osteoporosis
Mainly because the application of these hormone drugs affects the absorption of calcium, but also increases the discharge of calcium, and the loss of calcium in the body will be more serious. If glucocorticoid drugs are used without paying attention to calcium supplementation, the probability of osteoporosis will greatly increase. So the solution is, as long as you remember one thing, as long as you use glucocorticoids, you should take calcium tablets at the same time, and it is best to eat compound preparations of calcium and vitamin D, which is the first choice for preventing and treating osteoporosis.
Short-term high-dose use, or long-term use, may also lead to femoral head necrosis. Once the femoral head necrosis is usually irreversible, it usually occurs in clinical treatment. For example, some SARS patients are saved by short-term high-dose glucocorticoid treatment, but femoral head necrosis is a serious side effect.
However, there is no need to worry too much about daily use of paints such as dexamethasone. This kind of local, small dose and short-term use generally does not produce serious side effects.
2. Central obesity
Can be understood as? Hormone fattening? In fact, it is not obesity, but the accumulation of fat in the face, back and other parts, while the fat in the limbs and other parts decreases, so the total amount of fat in the human body may not change. This condition is called centripetal obesity.
This kind of obesity caused by hormones is usually reversible, so don't worry too much. It only temporarily affects the appearance. When you get well, stop taking hormone drugs and your body will naturally recover.
3, easy to be infected
This is easy to understand, because people's immunity is suppressed, which also gives opportunities for other pathogenic microorganisms to infect. Because some symptoms after infection are suppressed, it is easy to be found, which leads to untimely treatment and serious and difficult consequences. Therefore, we should pay close attention to whether there is infection after 1~2 weeks of high-dose use of such drugs.
what do you think?
There are three points: first, look at blood routine, white blood cell value and C-reactive protein value; Second, look at the respiratory tract, digestive tract and urethra for redness, swelling and tingling; Third, look at the infection performance of common bacteria. For example, staphylococcal infection is a common infectious bacteria after using this kind of drugs, which should be paid attention to.
The above three are three side effects that should be paid attention to in clinical treatment of critically ill patients. This kind of hormone drugs are also commonly used in life, such as allergic diseases, asthma, eczema and so on. What should I pay attention to?
In addition to possible osteoporosis, inducing and aggravating infection, the use of such drugs in life has three side effects, which need special attention: 1, increasing blood sugar. Hormones mainly affect the metabolism of sugar and protein, and blood sugar tends to fluctuate violently. When using this kind of drugs, it is recommended to pay attention to the changes of blood sugar so as not to cause undue harm to the body. 2, hypertension, these drugs mainly cause water and sodium retention, and activate the sympathetic nerve, leading to increased blood pressure. When using these drugs, we should also pay attention to the monitoring of blood potassium level to avoid hypokalemia. 3, pay attention to fundus lesions, whether systemic or local eye diseases, when hormone drugs are needed for treatment, it may cause glaucoma, so it is called hormonal glaucoma in clinic. In fact, this is also related to high blood pressure. After taking the medicine, the intraocular pressure will increase by about10mmhg, and it will return to normal after stopping taking the medicine, but about 20% people will have glaucoma changes in their fundus.
Hormones can be used, but they can't be used indiscriminately.
Some people regard hormones as a panacea for skin diseases and apply them externally without a dermatologist's diagnosis, especially on the face. For some infectious skin diseases, external use of these drugs is not only ineffective, but also reduces local resistance, aggravates the condition, and even leads to drug-dependent dermatitis (hormone-dependent dermatitis). Itching, desquamation and pustules will occur if you don't use it. Just use it once. In order to avoid the pain after drug withdrawal, patients rely entirely on the application of hormones.
Some skin diseases cannot be cured by hormone drugs.
Give a few very common examples that may happen to you. Next time you encounter such a situation, stop the wrong medication behavior quickly:
1, acne (whelk)
It is caused by the exuberant activity of sebaceous glands in adolescence. If hormone drugs are used, it will be harmful and useless, the skin will shrink and thin, accelerate aging, and produce pigment spots.
2, herpes simplex
This kind of medicine is not suitable for herpes simplex that grows beside the mouth and lips. Because these herpes are mostly caused by herpes virus, hormone drugs have no effect on killing and inhibiting the virus, and indiscriminate use of drugs will only aggravate the infection of the affected area.
3. Seborrheic dermatitis
The etiology is complex, usually related to hyperandrogenism, but it is useless to use hormonal drugs. Even if a small area is rubbed with glucocorticoid for a long time, it can lead to systemic side effects.
Because of SARS, the side effects of hormones have really entered the public's field of vision, and they have gradually been taken seriously. In fact, sometimes, side effects can be completely avoided. Hormone is a double-edged sword, and correct use is the key. Academician Zhong Nanshan said that the use of hormones has a premise, that is? Is it reasonable? That is, the right patient, the right time and the right dose.
I hope that when you use this hormone, you can ask your doctor first, because of your skin problems, whether it is suitable to use this hormone, how long it should be used and how much it should be used each time. To reduce side effects.
Brief introduction of Dr. Yao
Doctors, licensed pharmacists, senior nutritionists, protect life and health, reject fake health, and personally care for a healthy you!