title: Metabolism of systematically given corticosteroids.
abstract: In the metabolism of a systemically administered corticosteroid, one of three possible main pathways is determined by the position in the molecule of the substituents which are added in the drugs to the naturally occurring ones. (I) Chiefly, hydrogenation in ring A and/or the 20-position: cortisol, cortisoine, prednisolone, prednisone, and 6alpha-methylprednisolone (II) In the presence of a substituent in the 16-position mainly 6beta-hydroxylation: dexamethasone, betamethasone, and triamcinolone. (III) In the presence of a substituent in the 16-position, and fluorine in the 6alpha-position principally defluorination in the 6alpha-position and 6beta-hydroxylation: fluocortolone and paramethasone. Complete metabolism, in long-term use, can be expected in the case of the substances mentioned under II and III, but not of those under I. Enzyme induction, both actively and passively, is negligible in group I and marked in groups II and III.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000378:metabolism*; D001623:Betamethasone / Q000378:metabolism; D003348:Cortisone / Q000378:metabolism; D003907:Dexamethasone / Q000378:metabolism; D005448:Fluocortolone / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006865:Hydrogenation; D006900:Hydroxylation; D008775:Methylprednisolone / Q000378:metabolism; D010248:Paramethasone / Q000378:metabolism; D011239:Prednisolone / Q000378:metabolism; D011241:Prednisone / Q000378:metabolism; D014221:Triamcinolone / Q000378:metabolism
chemical_list: D000305:Adrenal Cortex Hormones; D014221:Triamcinolone; D005448:Fluocortolone; D003907:Dexamethasone; D001623:Betamethasone; D011239:Prednisolone; D003348:Cortisone; D011241:Prednisone; D010248:Paramethasone; D006854:Hydrocortisone; D008775:Methylprednisolone