Allergic reaction cortisone. Cortisone (Cortone Acetate): Uses, Side Effects, and Precautions for Allergic Reactions
What are the primary uses of Cortisone (Cortone Acetate). How does it affect allergic reactions. What are the potential side effects and precautions to consider. Who should avoid using Cortisone.
Understanding Cortisone (Cortone Acetate) and Its Applications
Cortisone, also known by its brand name Cortone Acetate, is a corticosteroid medication used to treat a wide range of medical conditions. This powerful drug plays a crucial role in managing various inflammatory and autoimmune disorders.
Primary Uses of Cortisone
Cortisone is prescribed for numerous conditions, including:
- Adrenal insufficiency
- Allergic rhinitis
- Anaphylaxis
- Ankylosing spondylitis
- Atopic dermatitis
- Rheumatoid arthritis
- Psoriasis
- Ulcerative colitis
- Asthma
- Systemic lupus erythematosus
Can cortisone be used for less common conditions? Indeed, it’s also prescribed for rarer ailments such as Loeffler’s syndrome, nephrotic syndrome, and sarcoidosis.
Cortisone’s Role in Allergic Reactions
Cortisone plays a significant role in managing allergic reactions due to its potent anti-inflammatory properties. It can effectively reduce swelling, redness, and itching associated with various allergic responses.
Mechanisms of Action in Allergic Responses
How does cortisone work to alleviate allergic symptoms? Cortisone suppresses the immune system’s overreaction to allergens by:
- Inhibiting the release of inflammatory mediators
- Reducing the production of antibodies
- Decreasing the migration of white blood cells to affected areas
- Stabilizing cell membranes to prevent further inflammation
Is cortisone effective for all types of allergic reactions? While it’s beneficial for many allergic conditions, its use should always be under medical supervision, as it may not be suitable for all cases.
Side Effects and Precautions of Cortisone Use
Despite its therapeutic benefits, cortisone can cause various side effects, ranging from mild to severe. Understanding these potential risks is crucial for patients and healthcare providers.
Common Side Effects
What are the most frequently reported side effects of cortisone? Patients may experience:
- High blood pressure
- Muscle pain or weakness
- Sleep disturbances (insomnia)
- Mood changes
- Thinning skin, bruising, or discoloration
- Increased sweating
- Headaches and dizziness
- Stomach pain and bloating
- Slow wound healing
Severe Side Effects Requiring Immediate Medical Attention
When should a patient seek emergency medical help while taking cortisone? Urgent care is necessary if any of these symptoms occur:
- Signs of an allergic reaction (hives, difficulty breathing, swelling of face, lips, tongue, or throat)
- Blurred vision, eye pain, or seeing halos around lights
- Sudden unusual pain in bones or joints
- Severe headaches or pain behind the eyes
- Symptoms of stomach bleeding (bloody or tarry stools, coughing up blood)
- Signs of pancreatitis (severe upper stomach pain spreading to the back, nausea, vomiting)
- Indications of low blood potassium (leg cramps, constipation, irregular heartbeats, increased thirst or urination, numbness or tingling, muscle weakness)
Contraindications and Special Precautions
Certain individuals should avoid using cortisone or use it with extreme caution. Understanding these contraindications is essential for safe medication use.
Who Should Not Use Cortisone?
Cortisone is contraindicated for individuals with:
- Allergies to cortisone or similar medications
- Active fungal infections
- Recent or current infections, especially tuberculosis, herpes eye infections, or parasitic infections causing diarrhea
Conditions Requiring Special Precautions
Which medical conditions necessitate extra caution when using cortisone? Patients with the following should consult their healthcare provider before starting treatment:
- Liver disease, including cirrhosis
- Kidney disease
- Thyroid disorders
- Osteoporosis
- Muscle disorders like myasthenia gravis
- Glaucoma or cataracts
- Stomach ulcers, ulcerative colitis, or diverticulitis
- Depression or mental illness
- Congestive heart failure
- High blood pressure
Cortisone Use During Pregnancy and Breastfeeding
The use of cortisone during pregnancy and breastfeeding requires careful consideration and medical supervision.
Pregnancy Considerations
How does cortisone affect pregnancy? While some forms of cortisone can cross the placenta, the benefits of treatment may outweigh the risks in certain situations. However, prolonged or high-dose use during pregnancy may increase the risk of:
- Low birth weight
- Premature birth
- Adrenal suppression in the newborn
Pregnant women should always consult their healthcare provider before using cortisone.
Breastfeeding Considerations
Can cortisone be used while breastfeeding? Small amounts of cortisone can pass into breast milk. While occasional use is generally considered safe, prolonged or high-dose treatment may potentially affect the infant. Breastfeeding mothers should discuss the risks and benefits with their doctor.
Drug Interactions and Precautions
Cortisone can interact with various medications and substances, potentially altering its effectiveness or increasing the risk of side effects.
Common Drug Interactions
Which medications may interact with cortisone? Potential interactions include:
- Anticoagulants (blood thinners)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Certain antibiotics
- Antifungal medications
- Diabetes medications
- Diuretics
- Seizure medications
Patients should always inform their healthcare provider about all medications, supplements, and herbal products they are using.
Lifestyle Precautions
What lifestyle adjustments should be considered when taking cortisone?
- Avoid alcohol consumption, as it may increase the risk of stomach ulcers
- Maintain a balanced diet rich in calcium and vitamin D to support bone health
- Exercise regularly to prevent muscle weakness and osteoporosis
- Practice good hygiene and avoid close contact with individuals who have infections
- Monitor blood sugar levels closely, especially if diabetic
- Wear sunscreen and protective clothing, as cortisone can increase skin sensitivity to sunlight
Proper Dosage and Administration of Cortisone
Correct dosage and administration of cortisone are crucial for maximizing its benefits while minimizing potential risks.
Dosage Guidelines
How is the dosage of cortisone determined? The appropriate dose varies depending on:
- The specific medical condition being treated
- The patient’s age, weight, and overall health status
- The severity of symptoms
- The patient’s response to treatment
Dosages typically range from 25 to 300 mg per day, divided into multiple doses. However, exact dosing should always be determined by a healthcare professional.
Administration Tips
What are the best practices for taking cortisone?
- Take the medication exactly as prescribed
- Do not stop taking cortisone abruptly without medical supervision
- If a dose is missed, take it as soon as remembered, unless it’s almost time for the next dose
- Never double up on doses to make up for a missed one
- Keep regular follow-up appointments with your healthcare provider to monitor progress and adjust dosage if necessary
Long-term Effects and Monitoring
Long-term use of cortisone requires careful monitoring to prevent and manage potential complications.
Potential Long-term Effects
What are the possible consequences of prolonged cortisone use? Extended treatment may lead to:
- Osteoporosis and increased risk of fractures
- Cataracts or glaucoma
- Increased susceptibility to infections
- Adrenal suppression
- Cushing’s syndrome (characterized by weight gain, moon face, and skin changes)
- Diabetes or worsening of existing diabetes
- Muscle weakness
- Skin thinning and easy bruising
Monitoring and Prevention Strategies
How can the risks associated with long-term cortisone use be minimized? Healthcare providers may recommend:
- Regular bone density scans to monitor for osteoporosis
- Routine eye exams to check for cataracts and glaucoma
- Periodic blood tests to assess adrenal function and blood sugar levels
- Calcium and vitamin D supplementation to support bone health
- Gradual tapering of the medication when discontinuing treatment
- Use of the lowest effective dose for the shortest duration possible
Patients on long-term cortisone therapy should maintain open communication with their healthcare providers and report any new or worsening symptoms promptly.
Cortisone (Cortone Acetate) – Side Effects, Interactions, Uses, Dosage, Warnings
uses
What is Cortisone (Cortone Acetate) used for?
- Adrenal Insufficiency
- Allergic Rhinitis
- Anaphylaxis
- Ankylosing Spondylitis
- Atopic Dermatitis
- Bursitis
- Dermatitis Herpetiformis
- Idiopathic (Immune) Thrombocytopenic Purpura
- Loeffler’s Syndrome
- Nephrotic Syndrome
- Osteoarthritis
- Psoriasis
- Rheumatoid Arthritis
- Sarcoidosis
- Seborrheic Dermatitis
- Shock
- Systemic Lupus Erythematosus
- Ulcerative Colitis — Active
- Uveitis
- Anemia
- Asthma
- Iritis
- Gouty Arthritis
- Hemolytic Anemia
- Cardiogenic Shock
- G-6-PD Deficiency
- Pulmonary Impairment
- Tuberculous Meningitis
- Collagen Vascular Disease
- Thalassemia
- Keratitis
- Adrenogenital Syndrome
- Conjunctivitis
- Visual Defect/Disturbance
- Sepsis
- Sickle Cell Anemia
- Thrombotic Thrombocytopenic Purpura
- Infectious Posterior Uveitis
- Hemoglobinopathy
- Hemolytic Uremic Syndrome
- Herpes Simplex Iridocyclitis
- Herpes Zoster Iridocyclitis
- Adrenal Tuberculosis
- Allergic Asthma
- Autoimmune Disorder
- Autoimmune Hemolytic Anemia
- Infectious Anterior Uveitis
- Bone Marrow Depression/Low Blood Counts
- Pemphigus
- Felty’s Syndrome
- Psoriatic Arthropathy
- Rheumatoid Lung
- Adrenal Hemorrhage
- Waterhouse-Friderichsen Syndrome
- Syphilitic Uveitis
- Uveitis (Anterior)
- Panuveitis
- Uveitis (Posterior)
- Lymphoma
- Psoriatic Arthritis
- Dermatomyositis
- Epicondylitis
- Iridocyclitis
- Chorioretinitis
- Choroiditis
- Erythroblastopenia
- Berylliosis
- Serum Sickness
- Erythema Multiforme
warnings
What is the most important information I should know about Cortisone (Cortone Acetate)?
You should not use cortisone if you are allergic to it, or if you have a fungal infection anywhere in your body.
Steroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have. Tell your doctor about any illness or infection you had within the past several weeks, especially:
- tuberculosis;
- herpes infection of the eyes; or
- a parasite infection that causes diarrhea (such as threadworms).
Tell your doctor if you have ever had:
- cirrhosis or other liver disease;
- kidney disease;
- a thyroid disorder;
- osteoporosis;
- a muscle disorder such as myasthenia gravis;
- glaucoma or cataracts;
- stomach ulcers, ulcerative colitis, or diverticulitis;
- depression or mental illness;
- congestive heart failure; or
- high blood pressure.
Tell your doctor if you are pregnant or breastfeeding.
Side Effects
What are the side effects of Cortisone (Cortone Acetate)?
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- blurred vision, eye pain or redness, seeing halos around lights;
- swelling, rapid weight gain, feeling short of breath;
- unusual changes in mood or behavior;
- skin lesions;
- sudden unusual pain in a bone or joint;
- severe headaches, ringing in your ears, pain behind your eyes;
- stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
- pancreatitis–severe pain in your upper stomach spreading to your back, nausea and vomiting; or
- low blood potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.
Cortisone can affect growth in children. Tell your doctor if your child is not growing at a normal rate.
Common side effects may include:
- high blood pressure;
- muscle pain or weakness;
- sleep problems (insomnia), mood changes;
- thinning skin, bruising or discoloration;
- increased sweating;
- headache, dizziness, spinning sensation;
- stomach pain, bloating; or
- slow wound healing.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Pregnancy & Breastfeeding
Can I take Cortisone (Cortone Acetate) if I’m pregnant or breastfeeding?
Tell your doctor if you are pregnant or breastfeeding.
Interactions
What drugs and food should I avoid while taking Cortisone (Cortone Acetate)?
Ask your doctor before receiving a vaccine. The vaccine may not work as well while you are using cortisone.
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using cortisone.
Avoid drinking alcohol.
Dosage Guidelines & Tips
How to take Cortisone (Cortone Acetate)?
Use Cortisone (Cortone Acetate) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
What should I do if I missed a dose of Cortisone (Cortone Acetate)?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Overdose Signs
What happens if I overdose on Cortisone (Cortone Acetate)?
High doses or long-term use of steroid medicine can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.
If you think you or someone else may have overdosed on: Cortisone (Cortone Acetate), call your doctor or the Poison Control center
(800) 222-1222
If someone collapses or isn’t breathing after taking Cortisone (Cortone Acetate), call 911
911
What to Expect
The length of time you take cortisone will depend on your condition and your response to treatment.
If you take cortisone for a long time, you may be more likely to develop an infection. Be sure to wash your hands often and report any unusual symptoms to your healthcare provider.
Don’t stop taking cortisone suddenly without talking to your doctor.
Secondary Uses
Cortisone may be used for many other medical conditions that aren’t listed in this guide. For instance, cortisone is sometimes used to treat nausea and vomiting in people who receive chemotherapy or to stimulate appetite in certain patients.
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Allergic-type reactions to corticosteroids – PubMed
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Review
. 1999 Apr;33(4):451-60.
doi: 10.1345/aph.18276.
G L Kamm
1
, K O Hagmeyer
Affiliations
Affiliation
- 1 College of Pharmacy, University of Toledo, OH 43606, USA. [email protected]
PMID:
10332537
DOI:
10.1345/aph.18276
Review
G L Kamm et al.
Ann Pharmacother.
1999 Apr.
. 1999 Apr;33(4):451-60.
doi: 10.1345/aph.18276.
Authors
G L Kamm
1
, K O Hagmeyer
Affiliation
- 1 College of Pharmacy, University of Toledo, OH 43606, USA. [email protected]
PMID:
10332537
DOI:
10.1345/aph.18276
Abstract
Objective:
To review reported cases of suspected allergic reactions to various corticosteroids.
Data sources:
A MEDLINE search (January 1966-December 1997) was performed to obtain case reports and review articles on allergic-type reactions to corticosteroids. Further references were obtained from these publications.
Study selection:
Reports involving allergic or allergic-type reactions to systemic administration of corticosteroids were chosen for this review. An allergic-type reaction was defined as any reaction after administration of the drug that involved the appearance of adverse symptoms that are characteristic of unwanted immune responses. These symptoms include rash, sneezing, dyspnea, edema, bronchospasm, or death. Articles were excluded from the evaluation if they described reactions to topical, intraarticular, or ophthalmic corticosteroid administration.
Data synthesis:
Corticosteroids are medications that are often used to treat allergic reactions. However, it appears that patients can also have allergic-type reactions to these agents. The severity of the reaction can vary from a rash to anaphylaxis or death. Both immediate and delayed reactions can occur. Allergic-type reactions are reported to occur more frequently in asthmatic and renal transplant patients than other patient populations. However, it is questionable whether all of these are true allergic responses, as there is conflicting evidence regarding the mechanism of the reaction. The most commonly implicated corticosteroids are methylprednisolone and hydrocortisone, but reactions have also occurred with others. Intradermal skin testing can help determine cross-sensitivity, although its value has not been conclusively demonstrated.
Conclusions:
Clinicians should be aware that allergic reactions to corticosteroids are possible. Worsening of symptoms may not always mean treatment failure, but may indicate an allergic reaction. High doses of corticosteroids (> or = 500 mg) should be given over 30-60 minutes, and patients should be observed after administration for at least the same time period. Asthmatics, renal transplant patients, and hemodynamically unstable patients may be at higher risk for adverse events. If a patient is found to be allergic to one corticosteroid, intradermal skin testing may help identify another corticosteroid that can be tolerated.
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antihistamines and cortisone, how to use them correctly
However, antihistamines and cortisone are drugs with a certain degree of invasiveness.
As a result, they can be harmful, both directly and through side effects, if used incorrectly.
How do antihistamines work?
Antihistamines are drugs used to treat allergy symptoms by counteracting the action of histamine receptors, a substance released by immune system cells when the body comes into contact with common allergens such as dust mites, pollen, and food.
Antihistamines, taken as nasal sprays, eye drops, capsules, tablets, and creams, are ideal for controlling common reactions such as itching, swelling, runny nose, nasal congestion, sneezing, watery eyes, and hives.
How do corticosteroids work?
Cortisone drugs are drugs used for anti-inflammatory and immunosuppressive treatment of allergy symptoms.
These drugs modify the body’s response to immune stimuli, taking effect within a short time, and are therefore suitable for acute allergy attacks. The physician must carefully evaluate the benefit / risk ratio in relation to undesirable effects.
Antihistamines and Cortisone Side Effects
Antihistamines and corticosteroids should always be taken in the order and dosage recommended by your doctor to minimize side effects.
First generation antihistamines (currently used mainly in hospitals) have several side effects such as:
- drowsiness and decreased alertness and concentration
- insomnia, nervousness, anxiety
- increased appetite, urinary retention, constipation.
In contrast, second-generation antihistamines are less active on the central nervous system and have almost no side effects, but their use is associated with an increased risk of cardiac arrhythmias.
On the other hand, the undesirable effects of corticosteroids are mainly associated with their use, since over time they can cause:
- acne, redness and skin changes
- weight gain and edema due to water retention
- hyperglycemia and high blood pressure
- osteoporosis and muscle weakness.
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CORTISOL AND ITS RELATION TO IMMUNE REACTIONS
Cortisol and Allergy
Allergy is certainly a subject of immunology, because it is associated with hypersensitivity of the immune system. Immunity refers to the immunity of the body to antigens (foreign pathogens, infectious agents).
Glucocorticoids affect the immune system by inhibiting the phagocytic activity of lymphocytes and reducing their number in the blood. Therefore, synthetic analogues of cortisol are used to treat allergic diseases, as they can have anti-allergic and anti-inflammatory effects.
Mechanism of origin of allergic reactions
Allergic reactions can be immediate (E-dependent) and immunocytotoxic. An important role in the formation of an allergic reaction is played by mast cells, which are found in large numbers in the nasal cavity, upper and lower respiratory tract, and also in the skin. Mast cells have special receptors on their surface, with which they can bind to immunoglobulins E. When allergen molecules interact with immunoglobulin E antibodies, special substances – mediators – begin to be released from mast cell granules.
The first of them was discovered by scientists histamine (probably even people who are far from the world of medicine know the term “antihistamine drug” – a drug that suppresses allergic reactions). A consequence of the activity of mast cells is also the release of arachidonic acid, a precursor of prostaglandins and leukotrienes. Prostaglandins are active biological substances that are formed from fatty acids, they affect blood circulation, lung function, and regulate cell metabolism.
The most common allergic diseases are:
- allergic rhinitis – allergic disease of the nasal cavity
- bronchial asthma – allergic disease of the lower respiratory tract
- allergic dermatitis – allergic skin lesion
The best known synthetic analogues of cortisol are dexamethasone and prednisolone. They are an effective remedy against allergic diseases, as they have the ability to suppress the immune system. How are cortisol and the immune system related?
Glucocorticoids. Cortisol and the immune system.
Immunity can be innate (for example, all people are immune to canine distemper) and acquired (after scarlet fever, the chance of getting sick again is negligible). Acquired immunity can be natural (after an illness) or artificial (after a vaccine). Allergy is an immune reaction in which the human body produces immunoglobulins E, which serve as antibodies to certain proteins.
Immunity: | ||||
Antigen | ⇒ | Antibodies | ⇒ | Increasing the body’s resistance |
Allergy: | ||||
Antigen | ⇒ | Antibodies | ⇒ | Body sensitization |
The main cells of the immune system are leukocytes.
Man is surrounded by a huge number of unfavorable factors – without protection mechanisms, he simply could not resist a huge variety of viruses, bacteria and protozoa attacking his body. The human immune system protects the body from diseases by detecting and destroying potentially threatening substances.
Immunity is an integral system of protecting the body from various diseases and adverse environmental factors.
Adverse environmental factors:
- Bacteria
- Viruses
- Protozoa
- Somatic mutations: malignant transformation
Despite the fact that all these factors are very far from each other and have different origins, they have one thing in common – they are all genetically alien to the human body. Substances that threaten a person in science are called antigens. Antigen – a substance of a certain structure that is potentially dangerous for the body.
Main organs of the immune system:
- Bone marrow
- Spleen
- Lymph nodes
- Thymus (mammary gland)
Lymphocytes are one of the types of leukocytes, the main cells of the immune system. The main function of lymphocytes is participation in the work of immunity. We can safely say that lymphocytes form the backbone of the human immune system, because they are its defenders, destroying foreign structures.
Lymphocytes | Lymphocyte functions |
B-lymphocytes Ensuring humoral immunity (blood and body fluids) B-lymphocytes secrete immunoglobulins and interferons | They produce specific antibodies that are directed against potentially dangerous substances (antigens). Lymph cells synthesize immunoglobulins of the class IgG, IgM, IgA, IgD, IgE. Consider the most important classes of immunoglobulins. |
T-lymphocytes Develop in the thymus, the main function is to provide cellular immunity | Play an important role in cell-mediated immunity |
K-lymphocytes | Killer cells. Destroy viruses and bacteria |
NK lymphocytes | Active against tumor cells |
In the course of evolution, a universal mechanism for protecting a person from harmful environmental factors was formed – immunity. The main cells of the immune system are lymphocytes (one of the types of white blood cells).
Immune system functions:
- Recognition of foreign agents
- Neutralizing them with special protective proteins
A change in the number of lymphocytes in the blood indicates the beginning of an inflammatory process – the body fights against the “invader” by increasing the number of lymphocytes. Lymphocytes synthesize protective proteins-antibodies that are involved in providing immunity.
Antibodies are protective immunoglobulin proteins (lgG, lgM, lgA, lgD, lgE). Antibodies are produced by B-lymphocytes. In addition to immunoglobulins, the immune system also activates other biological substances: interferons, lysozyme, etc.
The main thing in the development of inflammation is phagocytosis, which is carried out by lymphocytes (biological theory of II Mechnikov). Cortisol has the property of suppressing immune responses by reducing phagocytosis, as a result of which the formation of protective antibodies slows down.