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Corticosteroids

Corticosteroids are a class of chemicals that includes steroid hormones produced in the adrenal cortex and synthetic analogues. They include glucocorticoids like cortisol which control metabolism and have anti-inflammatory effects, and mineralocorticoids like fludrocortisone which regulate electrolyte and fluid balance. Corticosteroids are used clinically as hormone replacement therapy, to reduce inflammation, suppress the immune system, and treat tumors and nausea from chemotherapy.

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2K views8 pages

Corticosteroids

Corticosteroids are a class of chemicals that includes steroid hormones produced in the adrenal cortex and synthetic analogues. They include glucocorticoids like cortisol which control metabolism and have anti-inflammatory effects, and mineralocorticoids like fludrocortisone which regulate electrolyte and fluid balance. Corticosteroids are used clinically as hormone replacement therapy, to reduce inflammation, suppress the immune system, and treat tumors and nausea from chemotherapy.

Uploaded by

AkuMrW
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Corticosteroids are a class of chemicals

that includes steroid hormones naturally


produced in the adrenal cortex of
vertebrates and analogues of these
hormones that are synthesized in
laboratories.
CORTICOSTEROIDS
GLUCOCORTICOIDS
Glucocorticoids such as cortisol control
carbohydrate, fat and protein metabolism and
are anti-inflammatory by preventing
phospholipid release, decreasing eosinophil
action and a number of other mechanisms.
Glucocorticoids
Clinical uses
replacement therapy
(e.g. Addisons disease)
anti-inflammatory
(e.g. asthma, eczema)
immunosuppressive
(e.g. severe allergic reactions, RA, IBS)
anti-tumour
(e.g. combination with cytotoxic drugs in ALL)
anti-emetic
(e.g. conjunction with chemotherapy)
Hydrocortisone, Prednisolone, Dexamethasone
Mineralocorticoids
Maintain water & electrolytes balance
increase Na+ reabsorption in distal tubules
=> hypernatreamia, increase plasma volume, hypertension
increase K+ & H+ efflux into distal tubules
=> hypokalaemia, metabolic alkalosis
Clinical use
replacement therapy
Fludrocortisone
CORTICOSTEROID GROUPS
SYSTEMIC
Hydrocortisone
Methyprednisolone
Prednisolone
Triamcinolone
Dexamethasone
TOPICAL
Betamethasone
Clobetasol
Triamcinolone
Hydrocortisone
Mometasone
INHALE STEROIDS
Fluticasone
Beclomethasone

DOSAGE & ADMINISTRATION
Corticosteroids Dosage Administration
Hydrocortisone 10mg
(Solu-Cortef)
20 30 mg daily PO, after food
100 300mg tds qid IM, IVB, IVI
- Dilute in D5% or NS, over 30sec
Methylprednisolone
500mg, 1g
(Solu-Medrol )
10 500mg IM, IVB, IVI
-Recostitute with WFI, further dilute in D5% or
NS
-Infuse: 250mg: 5min, >250mg: 30min
Prednisolone 5mg Up to 60mg daily PO, after breakfast
Triamcinolone
10mg/ml, 40mg/ml
(Kenacort)
40mg (max
100mg/dose)
IM
Dexamethasone
0.5mg, 4mg
(Decadron)
0.5 10mg daily PO, after food
0.5 24mg/dose IM, IVB, IVI
Bethamethasone
0.5mg
0.5 5mg daily PO, after food
Fludrocortisone 0.1mg
(Flotinef)
50 300mcg daily PO, after food
*daily once daily
Side effects of
corticosteroids

- Gastric ulcer
- Electrolytes imbalance
- Hyperglycaemia
- Growth retardation in
children
- Adrenal cortical atrophy
(dont stop abruptly)

USE IN GASTROENTEROLOGY
Acute IBD
Hydrocortisone, Prednisolone, Methylprednisolone
Treatment of choice for, use IV in severe disease.
Administer higher/stress doses for patient already on
steroids.
Do not use to maintain remission because lack of efficacy &
potential complications
Act as potent anti-inflammatory

UC & Proctitis
Hydrocortisone enema 0.1%
Adjunctive treatment

Alcoholic hepatitis
Methylprednisolone preferred over prednisolone because
hepatic metabolism is not required
Decrease inflammation & autoimmune reactions

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