Synthetic glucocorticoid therapy--recent progress]

Synthetic glucocorticoids are administered systematically in the treatment of a large number of nonendocrine and endocrine diseases. Efforts have been made to reduce the side effects and to increase the pharmacological effects of these glucocorticoids. To avoid complications compartmental administration(topical, inhaled, suppository, ophthalmic, intra-articular) and alternate-day administration of intermediate acting glucocorticoids are recommended. Careful monitoring of the patients under therapy and gradual reduction of glucocorticoids should be performed to avoid adrenal insufficiency or reactivation of the disease. The understanding of molecular mechanisms of glucocorticoid actions may lead to the development of novel glucocorticoids, which are more active in anti-inflammatory actions than endocrine and metabolic actions(adverse effects of glucocorticoids).