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paramethasone fluorinated glucocorticoid anti-inflammatory immunosuppressant 3d hormone hormonal therapy replacement function action endocrine endocrinology level prohormone analogue mineralocorticoid corticosteroid glucocorticosteroid steroid glucocorticoid receptor inflammation immune system autoimmune disease stress response carbohydrate metabolism protein catabolism steroid steroidal endogenous synthetic semisynthetic molecule molecular structural structure formula skeletal geometry ball stick bioactive cell biochemistry biology biomolecule