N116, inflammation 3, 2025

Glucocorticoids

• Definition: Steroid hormones produced in the adrenal cortex, critical for various bodily functions.

• Function: Involved in metabolism, immune response regulation, and stress response.

• Uses:

  • Treat allergic reactions, inflammation, and autoimmune conditions.

  • Manage diseases like asthma and rheumatoid arthritis.

Allergy Overview

• Symptoms:

  • Rash, lacrimation, runny nose, sneezing, red eyes, itching.

• Types of Treatment:

  • Local allergy: Use topical antihistamines (e.g., Benadryl cream).

  • Systemic exposure: Prefer non-drowsy antihistamines (e.g., Reactin).

  • Eye symptoms: Topical antihistamines (e.g., Patanol drops).

  • Prophylaxis: Use leukotriene modifiers like Singulair before high doses of allergens.

Anaphylaxis

• Description: Severe allergic reaction leading to systemic inflammatory response.

• Symptoms:

  • Evidence of allergy, bronchoconstriction, hypotension.

• Treatment Focus:

  • Maintain Airway, Breathing, and Circulation (ABCs).

  • Medications: Epinephrine IM, dexamethasone IV, antihistamines IV, and IV fluids.

Epinephrine

• Classification: Endogenous neurotransmitter and non-selective adrenergic agonist (acts on alpha and beta receptors).

• Administration: Routes include IV and IM with rapid onset (20 mins duration).

• Trade Names: Epipen, Adrenalin.

Glucocorticoids Side Effects and Usage Caution

• Minimal Side Effects:

  • Safe for acute treatment (e.g., anaphylaxis) via local route.

• Long term Risks:

  • Higher chances of adverse effects with systemic route.

  • Negative Feedback: Long-term use can suppress adrenal glucocorticoid synthesis.

Conditions Associated with Chronic Inflammation

• Chronic Conditions:

  • Allergic rhinitis, dermatitis, psoriasis, arthritis, IBD, asthma, COPD.

  • Treatment includes evaluating clinical efficacy and balancing risks.

Chronic Inflammation and Tissue Changes

• Stages: Initial acute inflammation is followed by chronic inflammation, characterized by:

  • Lymphocyte and macrophage proliferation, tissue growth factors, and destruction.

  • Leads to scar formation and changes in tissue properties, increasing susceptibility to abnormal growth.

Allergic Rhinitis

• Prevalence: Up to 40% of the population.

• Triggers: Inhaled allergens like pollen and dust.

• Symptoms: Nasal discharge, conjunctivitis, sneezing.

• Lab Findings: High eosinophil count.

• Treatment: Antihistamines and intranasal corticosteroids (e.g., Flonase, Nasonex).

Atopic Dermatitis (Eczema)

• Description: Common chronic inflammatory skin disease associated with allergies.

• Characteristics: Itchy skin, potential for bacterial/viral super-infections.

• Treatment: Moisturizers, topical glucocorticoids, and antihistamines.

Psoriasis

• Characteristics: Chronic inflammatory skin condition characterized by dry, scaly patches, often on extensor surfaces.

• Treatment: Glucocorticoids (local/mild or systemic during flare-ups), DMARDs, and UV light therapy.

Osteoarthritis (OA)

• Definition: A degenerative disorder affecting articular cartilage.

• Risk Factors: Mechanical stress, obesity, age.

• Pathophysiology: Causes chronic inflammation leading to cartilage destruction and pain.

• Treatment: NSAIDs and glucocorticoids, including intra-articular injection when necessary.

Rheumatoid Arthritis (RA)

• Overview: Chronic autoimmune disease causing joint inflammation and systemic symptoms.

• Affected Areas: Joints, heart, lungs, kidneys, eyes.

• Signs and Symptoms: Inflammation, pain, limited function, systemic fatigue.

• Main Treatments: NSAIDs, glucocorticoids, biologic response modifiers (e.g., Infliximab, Methotrexate).

Summary of Key Differences: OA vs RA

• OA: Degenerative, fewer joints affected, cartilage loss, and joint space narrowing.

• RA: Inflammatory, typical swelling of synovial membranes, and potential for bone erosion.