Betamethasone is a long-acting and systemic corticosteroid used to relieve inflammation in various conditions, including allergic states, dermatologic disorders, gastrointestinal diseases, and hematological disorders. It is available as a cream/ointment but also as an injectable solution. Corticosteroids bind to the glucocorticoid receptor to promote anti-inflammatory signals. As betamethasone is a glucocorticoid, its mechanism of action is that of the glucocorticoid response element (GRE) of influencing COX-2/prostaglandin G/H synthase 2 suppression and lipocortin/annexin induction. By binding to the glucocorticoid receptor, it influences transcription factors AP-1 and NF-kB to block the transcription of COX-2/prostaglandin G/H synthase 2 which reduces the amount of prostanoids being produced from arachidonic acid. Prostanoids such as PGI2 and thromboxane A2 influence the effects of inflammation through vasoconstriction/dilation, pain sensitivity, and platelet aggregation. Betamethasone also affects the promoter of annexin-1, an important inflammatory protein as it affects leukocytes and blocks phospholipase A2 which reduces the amount of arachidonic acid being cleaved from the phospholipid bilayer. Reducing the amount of arachidonic acid formed further decreases the concentrations of prostanoids mentioned calming inflammation. Betamethasone is administered in many different routes; eye drops, oral tablets, rectal enema, topical cream, and many others.

Betamethasone Pathway References