Calming the Storm: A review of corticosteroid use in severely ill COVID-19 patients on mechanical ventilation

The importance of corticosteroids in the therapy of COVID-19 has been controversial. However, as the world develops a better understanding regarding the pathophysiology of COVID-19, we are realizing that suppressing the host immune response may reduce lung inflammation preventing further complications. In addition, more high-quality randomized controlled trials, meta-analysis, and review articles are being published discussing the role of corticosteroids. Majority of these studies concluded that corticosteroids are beneficial for hospitalized severely ill COVID-19 patients requiring supplemental oxygen. To date, therapeutic guidelines for COVID-19 patients recommend dexamethasone or other alternative corticosteroids, including methylprednisolone, hydrocortisone, or prednisone, as a treatment choice for severely ill COVID-19 patients. This review will discuss the pharmacology, mechanism of action, pharmacodynamics, pharmacokinetics, and benefits of corticosteroids in COVID-19 patients, and review current published clinical evidence on corticosteroids. Keywords: Corticosteroids, COVID-19, ARDS

Penggunaan Kortikosteroid pada Pasien Anak dengan Perikarditis Tuberkulosis.

Tuberculous pericarditis (TB pericarditis) is a disease that still frequently occurs in developing countries. The mortality rate due to TB pericarditis is still quite high, reaching 17-40%. Death due to tuberculous pericarditis is influenced by adequate or not treatment. The use of additional corticosteroid therapy is still a matter of debate in the treatment of tuberculous pericarditis. Writing this case aims to see the outcome of the use of corticosteroids in patients with tuberculous pericarditis. Literature searches were carried out through Pubmed and Google Scholar. From the results of literature search, two meta-analyzes were obtained that discussed the use of corticosteroids in tuberculous pericarditis. In children with tuberculous pericarditis, the use of corticosteroids does not reduce mortality, but can reduce complications due to tuberculous pericarditis. Keywords: corticosteroids, tuberculous pericarditis, outcome.

Designing, Cytotoxic Evaluation, Molecular Docking and in Silico Pharmacokinetic Prediction of New Hydrocortisone Derivatives as Anti-Asthmatics Drugs

A series of new 20 corticosteroids were subjected to molecular property prediction. The Molecular, Physicochemical, and Biological properties were determined using Molinspiration Cheminformatics software. These compounds were further subjected to Toxicity Predictions using the Osiris Software. The calculated drug-related properties of the designed molecules were similar to those found in most marketed drugs. Amongst the proposed molecules, fourteen promising candidates can be considered as promising structures for the synthesis of new and more effective anti-asthmatic drugs. Result indicates that the derivatives are orally active molecules. In-silico ADME and toxicity prediction was accomplished with the help of Swiss-ADMET tool provides the latest and most inclusive for diverse chemicals associated with known Absorption, Distribution, Metabolism, Excretion and Toxicity profiles. furthermore, BBB (Blood brain barrier) penetration, HIA (Human intestinal absorption), Caco-2 cell permeability and Ames test were calculated using ADMET web-based query tools incorporating a molecular build in interface enable the database to be queried by Smiles and structural similarity search. According to molecular docking results, derivatives No 4, 10 and 11 showed better docking Scores values compared to other derivatives and also dexamethasone and hydrocortisone. Keywords: Corticosteroids, Drug-likeness, Lipophilicity, Anti-asthmatic, ADME.