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What is A patient with severe shoulder pain resulting from inflammation is not responding to treatment with naproxen. You staed a course of treatment with oral dexamethasone. What is the basis that the glucocoicoid will be more effective as an anti-inflammatory agent and explain in detail?
Inflammatory responses:- Mech of action:- Irrespective of the type of injury or insult, the attending inflammatory response is suppressed by glucocoicoids. The action is nonspecific and covers all components and stages of inflammation. This includes attenuation of--increased capillary permeability, local exudation, cellular infiltration, phagocytic activity and late responses like capillary prolife- ration, collagen deposition, fibroblastic activity and ultimately scar formation. This action is direct and can be restricted to a site by local administration. The cardinal signs of inflammation--redness, heat, swelling and pain are suppressed. Glucocoicoids interfere at several steps in the inflammatory respons but the most impoant overall mechanism appears to be limitation of recruitment of inflammatory cells at the local site and production of proinflammatory mediators like PGs, LTs, PAF through indirect inhibition of phospholipase A2. Ref:- kd tripathi; pg num:-285,286