Corticosteroids

 Overdosage or prolonged use can exaggerate some of the normal physiological actions of corticosteroids leading to mineralocorticoid and glucocorticoid side - effects. Mineralocorticoid side-effects  include hypertention, sodium and water retention, and potassium and calcium loss . They are most marked with fludrocortisone , but are significant with hydrocortisone, corticotropin, and tetracosactide. Mineralocorticoid actions are negligible with the high potency gucocrticoids, betamethasone and dexamethasone, and occur only slightly with methlprednisolone, prednisolone, and tiamcinolone.   Glucocorticoid side-effects   include diabetes and oesteoporosis , which is a danger, paticulaly in the elderly , as it can result in osteoporotic fractures for example of the hip or vertebrae; in addition high doses ae associated with avasculat necrosis of the femora head. Muscle wasting (proximal myopathy) can also occur. coticosteroid therapy is also weakly linked with pe...

 Dosages of corticosteroids very widely in different disease and different patients. If the use of a corticosteriod can save or prolong life, as in exfoiative dermititis, Pemphigus, Acute Leukamia or Acute Transplant rejection, High doses may need to be given, because the complications of therapy are likely to be less serious than the effects of the disease itself. When long-term corticosteroid therapy is used in some chronic diseases, the adverse effects or treatment may become greater than the disabilities caused by the disease. To minimise side-effects the maintenance dose should be kept as low as possible. when potentialy ess harmful measures are ineffective corticosteroids are used topically for the treatment of inflammatory conditions of the skin. Corticosteroids ahould be avoided or used only under specialist supervision in psoriasis. Notes; Psoriasis is a  skin disease marked by red, itchy, scaly patches. Corticosteroids are used both topically and systemically...

In comparing the relative potencies of corticosteroids in terms of their anti-inflammatory (glucocorticoid) effects it should be borne in mind that high glucocorticoid activity in itself is of no advantage unless it is accompanied by relatively low mineralocorticoid activity. The mineralocorticoid activity of fludrocortisone is so high that its anti-inflammatory activity is of no clinical relevance. The below shows equivalent anti-inflammatory doses. Prednisolone 5 mg = Betamethasone 750 micro-grams = Deflazacort 6 mg = Dexamethasone 750 micrograms = Hdrocortisone 20 mg = Methylprednisolone 4 mg = Prednisone 5 mg = Triamcinolone 4 mg The relatively high minrelocoticoid activity of hydrocortisone , and the resulting fluid retention, makes it unsuitable for disease suppression on a long-term basis. However, hydrocortisone can be used for adrenal replacement therapy. Hydrocortisone is used on short-term basis by intravenous injection for the emergency management of some co...

The adrenal cortex normally secrets hydrocortisone ( cortisol ) which has glucocorticoid activity and weak mineralcocorticoid activity. It also secretes the mineralocorticoid aldosteone. Notes; The  adrenal cortex —the outer part of the gland—produces hormones that are vital to life, such as cortisol (which helps regulate metabolism and helps your body respond to stress) and aldosterone (which helps control blood pressure) . In deficiency states, physiological replacement  achieved with a combination of Hydrocortsone and mierallocorticoid fludrocortisone;            hydrocortisone alone does not usually provide sufficient mineralocorticoid activity for complete replacement. In addison's disease o following adrenalectomy, hydrocotisone 20 to 30 mg daily by mouth is usually reqiured. This is given in two doses, the larger in the morning and the smaller in the evening, mimicking the normal diurnal rhythm of cortisol secretion. The o...

Synthetic corticosteroids   Synthetic corticosteroids   mimic the actions of naturally occurring corticosteroids and may be used to replace corticosteroids in people with adrenal glands that are unable to produce adequate amounts of corticosteroids , however, they more often are used in higher-than-replacement doses to treat diseases of immunity, inflammation or salt and water balance .   Examples of synthetic corticosteroids include: bethamethasone, (Celestone) Prednisone (Prednisone Intensol) Prednisolone (Orapred, Prelone) Triamcinolone (Aristospan Intra-Articular, Aristospan Intralesional, Kenalog) Methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol) Dexamethasone (Dexamethasone Intensol, DexPak 10 Day, DexPak 13 Day, DexPak 6       Day). Fludrocortisone  ( Florinef ) Relative potencies Glucocorticoid Mineralocorticoid Hydrocortisone 1 1 Cortisol 1.25 1 Prednisolone 4 0.8 Methylprednisolone 5 minimal Dexame...

Corticosteroid any of a group of steroid hormones produced in the adrenal cortex or made synthetically . There are two kinds: glucocorticoids and mineralocorticoids . They have various metabolic functions and some are used to treat inflammation. Systemic corticosteroids   Systemic corticosteroids  refer to corticosteroids that are given orally or by injection and distribute throughout the body . It does not include corticosteroids used in the eyes, ears, or nose, on the skin or that are inhaled, although small amounts of these corticosteroids can be absorbed into the body.   Naturally occurring corticosteroids   Naturally occurring corticosteroids, hydrocortisone (Cortef ) and Cortisone , are produced by the outer portion of the Adrenal Gland  known as the  C ortex  (hence the name, corticosteroid). Corticosteroids are classified as either: glucocorticoids (anti-inflammatory) which suppress inflammation and immunity and assist in the bre...