Steroid induced pancreatitis in dogs

PLACENTAL TROPHOBLAST DEVELOPMENT AND VASCULARIZATION During human and nonhuman primate pregnancy, the placenta simultaneously accesses the maternal blood and develops a vascular network for the transport of nutrients to and waste products from the fetus across the syncytiotrophoblast to ensure fetal growth and development. Both processes depend on the ability of the primordial stem-cell cytotrophoblasts to take either the villous pathway where they remain in the fetal compartment and differentiate morphologically into the syncytiotrophoblast or the extravillous pathway where they proliferate, aggregate into cell columns of the anchoring villi, and invade the endometrial stroma (Fig. 6). 105 The syncytiotrophoblast covers the floating chorionic villi that become highly vascularized, whereas the extravillous cytotrophoblasts infiltrate the walls of the spiral arterioles to facilitate the process of placentation.

Depending on the number and character of their functional groups, steroid molecules may show diverse reactivities. Moreover, the reactivity of a functional group varies according to its location within the molecule (for example, esters are formed readily by 3-OH groups but only with difficulty by the 11β-OH group). An important property of steroids is polarity —., their solubility in oxygen-containing solvents (., water and alcohols ) rather than hydrocarbon solvents (., hexane and benzene ). Hydroxyl, ketonic, or ionizable (capable of dissociating to form electrically charged particles) groups in a steroid molecule increase its polarity to an extent that is strongly influenced by the spatial arrangement of the atoms within the molecule.

Physicians need to be aware of the danger of topical steroids. Only mild steroids should be applied to the face. The use of the topical steroid should be limited to the condition. Alternate week therapy or 3 consecutive days a week therapy is better than continuous therapy in preventing steroid-induced rosacea. Only the mildest topical steroid should be used on the face if a condition warrants such use. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) does not necessary prevent steroid induced rosacea. Similar conditions have been seen with both Elidel and Protopic, possibly from immunosuppression and Demodex or bacterial growth.

During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.

Steroid induced pancreatitis in dogs

steroid induced pancreatitis in dogs

During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. Although it has been shown that there is considerably less adrenal suppression following a single morning dose of prednisolone (10 mg) as opposed to a quarter of that dose administered every six hours, there is evidence that some suppressive effect on adrenal activity may be carried over into the following day when pharmacologic doses are used. Further, it has been shown that a single dose of certain corticosteroids will produce adrenal cortical suppression for two or more days. Other corticoids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered to be short acting (producing adrenal cortical suppression for 1¼ to 1½ days following a single dose) and thus are recommended for alternate day therapy.

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