Help the development of the site, sharing the article with friends!

Glucocorticosteroids (corticosteroids) are steroid hormones produced by the body. Glucocorticosteroids are also drugs that replenish the deficiency of hormones as well as anti-inflammatory, antiallergic and immunosuppressive drugs. Glucocorticosteroids can be inhaled, oral, nasal, intravenous or in the form of ointments. Check what are the indications for the use of glucocorticosteroids and what are their side effects?

Glucocorticosteroids(glucocorticoids, corticosteroids) are hormones synthesized in the band layer of the adrenal cortex from cholesterol. Natural glucocorticosteroids affect various metabolic and defense processes as well as the secretion of other hormones and are essential for human life.

Glucocorticosteroids - hormones

Steroid hormones are divided into five classes, differing in structure and function. They are

  • mineralocorticoids - aldosterone is a particularly active representative of mineralocorticoids. Among other things, they regulate the distribution of water and sodium and potassium ions
  • glucocorticoids - the most active of them is cortisol, i.e. hydrocortisone. Glucocorticoids stimulate gluconeogenesis. They stimulate local lipolysis and at the same time lipogenesis in other parts of the body.
  • estrogens - are responsible for the maturation and the occurrence of menstruation. They facilitate the deposition of calcium in the bones, which prevents osteoporosis, increases blood clotting and the amount of good cholesterol
  • gestagens - progesterone is the main representative of gestagens. It is a procrastinating hormone. Its task is to prepare the uterus for implantation of the egg and then to maintain the pregnancy
  • androgens - testosterone is the most active androgen. Androgens kick off the maturation process. The appearance of the skin also depends on them - when their concentration in the blood is high enough, it is smooth and he althy. Androgens also affect the sex drive, promote the production of red blood cells in the bone marrow, have a positive effect on the body's calcium metabolism. They add energy and strength to action and ensure well-being

Glucocorticosteroids are hormones of the adrenal cortex, but also a group of synthetic drugs. Their common name is steroids.

Glucocorticosteroids - drugs

For a patternnatural hormones, drugs with the same name (GKS for short) were created, which are a chemical derivative of a natural human hormone: cortisol. Glucocorticosteroids are used to replenish the deficiency of hormones in the body and as anti-inflammatory, antiallergic and immunosuppressive drugs (weakening the immune system). Glucocorticosteroids can be oral, nasal or intravenous. Unfortunately, when administered in this way, they have numerous and serious side effects. For this reason, inhaled glucocorticosteroids have been developed - administered directly into the bronchi in doses thousands of times lower than the oral ones. As a result, the side effects are not perceived as such by the patient. Glucocorticosteroids have also been used as a means to accelerate the growth of muscle mass and strength in he althy people.

Glucocorticosteroids and asthma

Glucocorticosteroids are at the forefront in the treatment of bronchial asthma. By inhibiting the inflammatory response, glucocorticoids:

  • weaken the increased ability of the bronchi to respond with contractions to irritants, allergens
  • improve lung function
  • facilitate the regeneration of the respiratory tree epithelium
  • can prevent structural changes in the bronchial wall occurring in the course of asthma (remodeling).

Such action, however, appears only from a few to several hours after the drug administration.

Glucocorticosteroids - applicationin rheumatology

In some rheumatic diseases, GCS are the drugs of choice, in others they play an auxiliary role. They are most often administered in combination with other medications. The most commonly used preparation is prednisone. Other GCS are methyl derivatives such as methylprednisol (oral), methylprednisol succinate (intravenous), methylprednisol acetate (intraarticular and topical).

  • systemic lupus (active form)
  • antiphospholipid syndrome
  • rheumatic fever (heart involvement)
  • rheumatic polymyalgia
  • vasculitis (various forms)
  • polymyositis
  • eosinophilic fasciitis
  • Still's disease
  • mixed connective tissue disease
  • systemic scleroderma (severe inflammatory forms)
  • Sjögren's syndrome (in special situations)
  • seronegative spondyloarthropathies (in special situations)
  • rheumatoid arthritis (separate treatment principles)
Worth knowing

Glucocorticosteroids and pregnancy and breastfeeding

Although suspicions of teratogenic effects of corticosteroids in humans have not been confirmed, there aredata suggesting an increased risk of placental insufficiency, low birth weight and fetal death in women who received glucocorticoids during pregnancy. The general use of corticosteroids in women of childbearing age and pregnant women is acceptable only when the benefit of the drug outweighs the potential risk to the fetus.

It is believed that the treatment of a breastfeeding mother with a dose of up to 5 mg does not cause side effects in the child. However, the use of higher doses may cause growth retardation or inhibition of the secretion of endogenous hormones of the adrenal cortex in the child. If long-term use of the drug during feeding is necessary, it is advisable to stop feeding.

Are glucocorticosteroids really dangerous?

Source: x-news.pl/Dzień Dobry TVN

Glucocorticosteroids - application in dermatology

Skin diseases treated with topical glucocorticosteroids:

They are drugs of choice with:They are alternative or additional drugs with: can be used with a beneficial therapeutic effect

Eczema

  • contact eczema
  • atopic dermatitis
  • lichen planus
  • chronic lichen
  • papular urticaria
  • burns
  • keloidy
  • psoriasis
  • seborrheic dermatitis
  • lupus erythematosus
  • alopecia areata
  • annular granuloma
  • bullous pemphigoid
  • cutaneous mastocytosis
  • vitiligo

Glucocorticosteroids in the treatment of allergies

Nasal glucocorticosteroidsare highly effective in removing all symptoms of allergic rhinitis, such as runny nose, sneezing, itchy nose, and reduce nasal mucosa swelling, eliminating nasal obstruction.

Glucocorticosteroids - other uses

  • in other respiratory diseases - glucocorticosteroids should also be taken by patients with severe forms of chronic obstructive pulmonary disease (COPD).
  • with adrenal insufficiency

Glucocorticosteroids play an important role in the treatment of many inflammatory diseases.

  • in gout attacks
  • in kidney diseases - in the treatment of nephrotic syndrome
  • in neoplastic diseases - glucocorticosteroids are used in the treatment of malignant neoplasms, mainly systemic ones (acute lymphoblastic leukemia, chronic leukemialymphosarcoma, lymphosarcoma, lymphomas, Hodgkin's disease, brain tumors, breast cancer)
  • in hyperthyroidism
  • in inflammatory bowel diseases - ulcerative colitis, in Crohn's disease
  • in ophthalmology - incl. in macular degeneration
  • in transplantology (in the prevention of transplant rejection)

Glucocorticosteroids - drugs

Oral glucocorticosteroids include drugs such as prednisone (encortone), prednisolone, triamcinolone. Inhaled glucocorticosteroids include beclometasone, budesonide, ciclesonide, fluticasone, and mometasone. In turn, intranasal corticosteroids are e.g. beclometasone, budesonide, fluticasone, mometasone. Some of them are in the form of ointments and are also applied topically to the skin. Glucocorticosteroids used for the conjunctival sac are e.g. dexamethasone, fludrocortisone, fluorometolone, hydrocortisone.

Worth knowing

Glucocorticosteroids - drug interactions

  • glucocorticosteroids reduce the effect of non-steroidal anti-inflammatory drugs. Concomitant use of glucocorticoids, non-steroidal anti-inflammatory drugs or alcohol increases the risk of gastrointestinal ulceration and bleeding
  • simultaneous use of glucocorticosteroids and paracetamol increase: hypernatremia, edema, calcium excretion, risk of hypocalcemia and osteoporosis, risk of liver damage
  • the use of glucocorticosteroids with anticoagulants, coumarin derivatives, indadione, heparin, streptokinase, urokinase increases the risk of ulceration and bleeding from the duct
  • glucocorticosteroids weaken the antidiabetic effect of insulin and oral hypoglycaemic drugs. It may be necessary to change the dose
  • The use of glucocorticosteroids with antithyroid drugs, thyroid hormones may alter their effect on thyroid function. You may need to change your dose or stop taking your anti-thyroid medication or thyroid hormone
  • Oral contraceptives containing oestrogens may alter the metabolism of glucocorticosteroids and their protein binding, leading to a prolongation of the half-life and increased effects of glucocorticosteroids

Glucocorticosteroids - side effects

In the case of inhaled glucocorticosteroids, the possible occurrence is underlined:

  • fungal and bacterial infections of the oral cavity
  • dysphonia (voice weakening)
  • reflex cough and bronchospasm after inhalation of the drug
  • atrophic changes in the mucosa and the occurrence of respiratory infections

Short-term use of corticosteroids causes side effects only occasionally. The main risk of side effects is in patients receiving long-term medications.

Nasal glucocorticosteroids increase the possibility of local mucosal damage, fungal infections of the sinuses and mouth, and contact allergy.

In recent years, the possibility of systemic action of inhaled and intranasal forms of glucocorticosteroids has also been emphasized. They can be absorbed from the mucosa of the nose, mouth, throat and also from the intestines if swallowed.

The following local side effects include:

  • thinning of the epidermis and dermis
  • stretch marks
  • subcutaneous tissue atrophy
  • posteroid acne and worsening of the symptoms of acne vulgaris and rosacea
  • perioral inflammation
  • folliculitis
  • discoloration
  • hair growth
  • telangiectasia
  • fixed erythema
  • increased susceptibility to bacterial, viral, fungal and parasitic skin infections
  • impaired wound and ulcer healing
  • diaper rash of buttocks
  • contact allergy to GKS
  • severe relapse of the disease at an attempt to discontinue GCS

On the other hand, the topical application of glucocorticosteroids in the form of eye drops or ointment and in the form of ointments on the skin of the face may facilitate the formation of bacterial and fungal infections of the cornea and conjunctiva. They may also be responsible for the development of cataracts, increased intraocular pressure and glaucoma.

Systemic side effects:

  • hyperglycemia
  • Cushing's syndrome
  • hypertension
  • adrenal insufficiency
  • loss of muscle mass
  • feeling unwell
  • sleep disturbance
  • weight gain, increased appetite
  • osteoporosis
  • peptic ulcer disease
  • inhibition of the hypothalamic-pituitary-adrenal axis
  • mental disorders - symptoms of schizophrenia, mania or delirium may occur, they are dose dependent

Help the development of the site, sharing the article with friends!

Category:

Cardiology