corticosteroid

A large class of highly useful drugs similar to the human body's natural corticosteroid hormones used to treat many types of inflammation. They are also sometimes used to suppress the immune system (as is standard treatment following a transplant). Treatment for asthma and rheumatism has improved vastly since the introduction of corticosteroids.

Bad side effects include hypertension, fluid retention, and possibly even diabetes mellitus (with long-term treatment in high doses).

Since these drugs mimic the effects of hormones, the body's own production of them may cease. Sudden withdrawal of corticosteroid drugs after long-term treatment can therefore cause the symptoms of adrenal failure.

(Summarized from AMA literature)

Corticosteroids are medications used to decrease the immune response. They are analogues to the hormones that are naturally produced by the adrenal glands situated on top of the kidneys. Overuse of corticosteroids can lead to adrenal insufficiency, i.e. underproduction of adrenal hormones. Adrenal insufficiency, in turn, is treated by replacement of the lacking hormones, i.e. corticosteroids.

Corticosteroids, which are used for medical purposes, should not be confused with anabolic steroids. Anabolic steroids are the “steroids” which are often abused in the athletic world, and are more closely related to testosterone (note –“sterone”.. yes, testosterone is a type of steroid too).

Corticosteroids

Brand/Generic Drug Names

Celestone/betamethasone, Cortone/cortisone, Decadron/dexamethasone, Cortef/hydrocortisone, Medrol/methylprednisolone, Deltasone/prednisone, Aristocort/triamcinolone, Florinef/fludrocortisone, Entocort/ budesomide

Common uses

Glucocorticoids: decrease inflammation, immunosuppression, allergy, adrenal insufficiency, cerebral edema
Mineralocorticoids: adrenal insufficiency, adrenogenital syndrome

Pharmacology

Glucocorticoids: decrease inflammation by suppression of migration of polymorphonuclear leukocytes, fibroblasts, increased capillary permeability and lysosomal stabilization; varied metabolic effects, modify immune response to many stimuli
Mineralocorticoids: increase resorption of sodium by increasing hydrogen and potassium excretion in distal tubule

Class contraindications

allergy, systemic fungal infection, amebiasis, breastfeeding

Class precautions

diabetes mellitus, glaucoma, seizure disorder, peptic ulcer, impaired renal function, congestive heart failure, hypertension, ulcerative colitis, myasthenia gravis, children, elderly, pregnancy

Interactions

Decreased corticosteroid effect: barbiturates, rifampin, phenytoin
gastrointestinal bleeding: salicylates, indomethacin
Reduced salicylate levels
Decreased serum potassium: digitalis glycosides, amphotericin, potassium-depleting diuretics

Adverse Reactions

behavior change, insomnia, euphoria, gastrointestinal irritation, peptic ulcer, hypokalemia, hyperglycemia, carbohydrate intolerance, sodium and fluid retention

Additional Information

Assess intake and output, daily weight, mental status, blood and urine glucose
Assess for signs and symptoms of infection, adrenal insufficiency
Administer with food or milk to decrease gastrointestinal symptoms
Evaluate therapeutic response: decreased inflammation

Date of most recent Update

August 28, 2002

Further information is available in the writeup for the specific name(s) of this medication class