What is the mechanism of action of betamethasone?

 Betamethasone 

Betamethasone is a type of anti-inflammatory drug. It is used to treat rheumatologic diseases.It is also known as, Betadexamethasone, Flubenisolone, Betamethazone, Renderon, Visubeta, Betacorlan, Betacortril, Betamamllet, Betapredol, Betnelan, Alestene, Methazon, Bebate, Becort, Bedifos. It is an odorless, white crystalline powder which is solluble in water. It is sparingly solluble in aceton, methanol, alcohol and dioxane. Very slightly solluble in chloroform and ether. The moleculer weight of betamethasone is 392.5gm/mol. The melting point and boiling point is 178⁰c and 568.2⁰c. 

Structure-

The moleculer formula of betamethasone is,

                                     [C22H29FO5]

The IUPAC name of betamethasone is,

9-fluro-11,17-dihydroxy-17-(2-hydroxyacetyl) -10,13,16-trimethyl-6,7,8,11,12,14,15,16-octahydrocyclopentaphenanthren-3-one.

Mechanism of action-

Betamethasone can work through genomic and non genomic pathways. The genomic pathway is slower and occurs when drug activates glucocorticoid receptor. It also initiate downstream effect that promote transcription of anti-inflammatory genes including phosphoenolpyruvate carboxykinase.

                     On the other hand the nongenomic pathway is able to elicit a quicker responses by modulating T-cell, platlet and monocyte activity through the use of existing membren bond receptors and second messenger. 

                      The drug is bind to glucocorticoid receptor and binds to DNA to modify the gene expression. It synthesized anti-inflammatory protiens, which occur while the synthesis of certain inflammatory mediators inhibits.

Dosage-

For the treatment of endocrine disorder, the initial dose is 0.6-7.2mg orally devided twice daily/ four times daily or 0.6to9mg per day IM each day devided twice daily. 

For the treatment of inflammatory condition,the initial dose is0.6-7.2mg orally devided twice daily/ four times daily or 0.6to9mg per day IM each day devided twice daily. 

For children under 12 years old the initial dose is,0.0175-0.25mg per killo per day IM/orally devided every 6-12 hours.

For the treatment of Rheumatoid Arthritis,  the initial dose is for intrabursal, intra-articular,intradermal is 0.25 to 2 ml (6gm/ml) per day. Foe the treatment of very large joint 1-2ml.For the treatment of large and medium joint 1ml and 0.5to1 ml.For the treatment of small joints 0.25to0.5ml per day.

Uses-

It is used in the treatment of, 

• Itching.
• Redness, dryness.
• Crusting.
• Scaling.
• Inflammation. 
• Psoriasis. 
• Eczema. 

Side-effects-

The major Side-effects are, 

• Burning skin.
• Itching.
• Irritation. 
• Red and dry skin.
• Acne.
• Unwanted hair growth. 
• Skin color changes.
• Shiny skin.
• Red bumps on skin.
• Tiny red bumps and rash around mouth.

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