This video deals with Quick n easy way to memorise about Corticosteroid drugs.Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones. Two main classes of corticosteroids, glucocorticoidsand mineralocorticoids, are involved in a wide range of physiologic processes, including stress response, immune response, and regulation of inflammation, carbohydratemetabolism, protein catabolism, blood electrolyte levels, and behavior.Synthetic pharmaceutical drugs with corticosteroid-like effects are used in a variety of conditions, ranging from brain tumors to skin diseases. Dexamethasone and its derivatives are almost pure glucocorticoids, while prednisone and its derivatives have some mineralocorticoid action in addition to the glucocorticoid effect. Fludrocortisone(Florinef) is a synthetic mineralocorticoid. Hydrocortisone (cortisol) is typically used for replacement therapy, e.g. for adrenal insufficiency and congenital adrenal hyperplasia.
Medical conditions treated with systemic corticosteroids:
Allergy and respirology medicineAsthma (severe exacerbations)Chronic obstructive pulmonary disease(COPD)Allergic rhinitisAtopic dermatitisHivesAngioedemaAnaphylaxisFood allergiesDrug allergiesNasal polypsHypersensitivity pneumonitisSarcoidosisEosinophilic pneumoniaInterstitial lung diseaseDermatologyPemphigus vulgarisContact dermatitisEndocrinology (usually at physiologic doses)Adrenal insufficiencyCongenital adrenal hyperplasiaGastroenterologyUlcerative colitisCrohn’s diseaseAutoimmune hepatitisHematologyLymphomaLeukemiaHemolytic anemiaIdiopathic thrombocytopenic purpuraMultiple MyelomaRheumatology/ImmunologyRheumatoid arthritisSystemic lupus erythematosusPolymyalgia rheumaticaPolymyositisDermatomyositisPolyarteritisVasculitisOphthalmologyUveitisKeratoconjunctivitisOther conditionsMultiple sclerosisOrgan transplantationNephrotic syndromeChronic hepatitis (flare ups)Cerebral edemaIgG4-related diseaseProstate cancerTendinosisLichen planus
Topical formulations are also available for the skin, eyes (uveitis), lungs (asthma), nose (rhinitis), and bowels. Corticosteroids are also used supportively to prevent nausea, often in combination with 5-HT3 antagonists (e.g.ondansetron).
Typical undesired effects of glucocorticoids present quite uniformly as drug-induced Cushing's syndrome. Typical mineralocorticoid side-effects are hypertension (abnormally high blood pressure), hypokalemia (low potassium levels in the blood), hypernatremia (high sodium levels in the blood) without causing peripheral edema, metabolic alkalosis and connective tissue weakness. Wound healing or ulcer formation may be ibhibited by the immunosuppressive effects.
Clinical and experimental evidence indicates that corticosteroids can cause permanent eye damage by inducing central serous retinopathy (CSR, also known as central serous chorioretinopathy, CSC). A variety of steroid medications, from anti-allergy nasal sprays (Nasonex, Flonase) to topical skin creams, to eye drops (Tobradex), to prednisone have been implicated in the development of CSR.
Corticosteroids have been widely used in treating people with traumatic brain injury. A systematic review identified 20 randomised controlled trials and included 12,303 participants, then compared patients who received corticosteroids with patients who received no treatment. The authors recommended people with traumatic head injury should not be routinely treated with corticosteroids.
Use of corticosteroids has numerous side-effects, some of which may be severe:
Neuropsychiatric: steroid psychosis, and anxiety, depression. Therapeutic doses may cause a feeling of artificial well-being ("steroid euphoria"). The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina.Cardiovascular: Corticosteroids can cause sodium retention through a direct action on the kidney, in a manner analogous to the mineralocorticoid aldosterone. This can result in fluid retention and hypertension.Metabolic: Corticosteroids cause a movement of body fat to the face and torso, resulting respectively in "moon face" and "buffalo hump". and away from the limbs. Due to the diversion of amino-acids to glucose, they are considered anti-anabolic, and long term therapy can cause muscle wastingEndocrine: By increasing the production of glucose from amino-acid breakdown and opposing the action of insulin, corticosteroids can cause hyperglycemia, insulin resistance and diabetes mellitus.Skeletal: Steroid-induced osteoporosis may be a side-effect of long-term corticosteroid use. Use of inhaled corticosteroids amon