ABSTRACT
The historical breakthrough of glucocorticoids as a pharmacological agent can be traced back to 1929. At the time, Dr. Philip S. Hench developed the concept that steroids could alleviate symptoms of rheumatoid arthritis (Glyn, 1998). During 1930-1938, Drs. Edward C. Kendall and Tadeus Reichstein independently isolated and identified the adrenal steroids. Following the ground-breaking discovery of cortisone as an effective therapeutic agent against rheumatoid arthritis in 1949 (Hench et al., 1949), a variety of synthetic glucocorticoids (GCs) have been made with different potency, half-life, and administering methods. Among the most commonly used synthetic GCs for therapeutic purposes are dexamethasone, prednisone, and methylprednisolone. While dexamethasone has a long half-life and therefore is long acting, both prednisone and methylprednisolone exhibit an intermediate half-life resembling endogenous GCs. These synthetic GCs can be administered topically, orally, intramuscularly, or intravenously. Methylprednisolone can also be administered intralesionally, intraarticularly, and via nasal spray or inhalation. Like cortisone, which is a prodrug of cortisol, prednisone is a prodrug being converted to prednisolone rapidly in the body.
