Corticosteroids Systemic (Oral and Injectable)Glucocorticoids GCs are a class of corticosteroidswhich are a class of steroid hormones. Glucocorticoids are corticosteroids that bind to the glucocorticoid receptor GR that is present in almost corticosteroids and glucosteroids vertebrate animal cell. A less common gluclsteroids is glucocorticosteroid. GCs are part of the feedback mechanism in the immune system corticosteroids and glucosteroids reduces certain aspects of immune function, such as inflammation. They are therefore used in medicine to treat diseases caused by an overactive immune system, such as allergies, asthma, glucosterolds diseasesand sepsis.
Glucocorticoids – Knowledge for medical students and physicians
Glucocorticoids are a group of drugs with various anti-inflammatory and immunosuppressant as well as metabolic and endocrine effects. These drugs are structurally and pharmacologically similar to the endogenous hormone cortisol.
Glucocorticoids have immediate effects that do not depend on DNA interaction e. However, they exert their main anti-inflammatory and immunosuppressive actions by binding to glucocorticoid receptors, which, in turn, causes complex changes in gene transcription. These genomic effects only begin to manifest after several hours.
Similarly, glucocorticoids bind to mineralocorticoid receptors, but for most glucocorticoid drugs, high doses are required for a significant mineralocorticoid effect. Systemic glucocorticoids are used for hormone replacement therapy e. Local glucocorticoids are used to treat conditions like dermatoses, asthma , and anterior uveitis. Side effects include metabolic and endocrine disturbances, weight gain, skin reactions, hypertension , and psychiatric disorders.
Contraindications for systemic glucocorticoids include systemic fungal infections and, in the case of dexamethasone , cerebral malaria. Status asthmaticus is a contraindication for inhalative glucocorticoids. Topical and ophthalmic glucocorticoids are usually contraindicated if there are pre-existing local infections. Do not confuse cortisol and cortisone!
Both acute and long-term effects lead to inhibition of inflammatory processes and to immunosuppression! Glucocorticoid toxicity depends on the dose that is administered over a certain period of time. Therefore even low doses can have toxic effects if administered long-term. If glucocorticoids are administered once or only briefly e.
Many of the side effects listed above are also features of iatrogenic Cushing's syndrome! Local side-effects of inhaled glucocorticoids can be avoided by reducing the dose to the lowest effective amount, rinsing with mouthwash after each puff, improving the inhalation technique and compliance, and keeping vaccinations up to date! We list the most important adverse effects. The selection is not exhaustive.
We list the most important contraindications. If the Cushing threshold is exceeded over a longer period of treatment, the glucocorticoid dose should be gradually decreased to minimize the risk of adrenocortical insufficiency! An intratendinous injection carries the risk of bacterial spread and iatrogenic bacterial arthritis! Clinical science Glucocorticoids are a group of drugs with various anti-inflammatory and immunosuppressant as well as metabolic and endocrine effects.
General Glucocorticoids are a type of corticosteroid These are hormones , based on cholesterol, originally derived from the adrenal cortex Synthetic derivatives of cortisol are used in a variety of conditions Routes of administration: Systemic glucocorticoids Glucocorticoid toxicity depends on the dose that is administered over a certain period of time.
Local glucocorticoids Topical glucocorticoids Inhaled glucocorticoids Local effects Skin manifestations as in systemic glucocorticoids Allergic dermatitis Oral candidiasis Lung infections Hoarseness Allergic dermatitis Eyes As in systemic glucocorticoids Ocular reactions Other - Growth inhibition Osteoporosis Adrenal suppression Local side-effects of inhaled glucocorticoids can be avoided by reducing the dose to the lowest effective amount, rinsing with mouthwash after each puff, improving the inhalation technique and compliance, and keeping vaccinations up to date!
Oral candidiasis Lung infections Hoarseness Allergic dermatitis. Growth inhibition Osteoporosis Adrenal suppression.