Specific Sources / Comments / Reports
Some corticosteroids such as prednisone and prednisolone do not readily cross the placenta and can be safely used during pregnancy as immunosuppressive drugs. Maternal complications related to corticosteroids may occur and close monitoring is therefore mandatory. – Drug Saf 1998 Nov;19(5):389-410 — Treatment of inflammatory rheumatic disorders in pregnancy: what are the safest treatment options? — Ostensen M, Ramsey-Goldman R.
Bone loss in patients taking systemic corticosteroids. Patients being started on corticosteroids should receive prophylactic therapy with calcium and vitamin D.- Cochrane Database Syst Rev 2000;(2):CD000952 — Calcium and vitamin D for corticosteroid-induced osteoporosis. — Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells G, Tugwell P.
Supplementation of vitamin D plus calcium is effective in corticosteroid-induced osteoporosis management.- Clin Exp Rheumatol. 2000 Jan-Feb;18(1):3-4. — Supplementation of vitamin D plus calcium is effective in corticosteroid-induced osteoporosis management. — Bijlsma JW.
This study suggests that glycyrrhizin found in licorice increases the plasma prednisolone concentrations by inhibiting the metabolism of prednisolone and that it potentiates pharmacological effects of prednisolone.- Endocrinol Jpn 1990 Jun;37(3):331-41 — Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. — Chen MF, Shimada F, Kato H, Yano S, Kanaoka M.
Data demonstrates that corticosteroid treatment increases chromium losses and that steroid-induced diabetes can be reversed by chromium supplementation.- Diabet Med 1999 Feb;16(2):164-7 — Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. — Ravina A, Slezak L, Mirsky N, Bryden NA, Anderson RA.
Glucocorticoids elevate blood pressure.- Biol Res Nurs 2002 Jul;4(1):16-21 — Impaired vasodilation and nitric oxide synthase activity in glucocorticoid-induced hypertension. — Mitchell BM, Webb RC.
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Corticosteroids: What They Are And What They Do
Corticosteroids are a group of drugs that are derived from the naturally occurring hormone cortisol, produced by the adrenal gland. Over the years, these steroids have become indispensable in the medical community for their potent anti-inflammatory and immunosuppressive properties. Whether it’s an asthmatic trying to breathe easier or an individual trying to combat the swelling caused by arthritis, corticosteroids play a vital role in many treatment regimens. This article delves into the world of corticosteroids to understand what they are and how they function.
1. The Origin: The Adrenal Gland
Corticosteroids are synthetic versions of cortisol, a hormone that our adrenal glands, located on top of each kidney, naturally produce. Cortisol plays a critical role in various functions in the body including regulating metabolism, reducing inflammation, and controlling the body’s sleep-wake cycle.
2. Types of Corticosteroids
Broadly, corticosteroids can be classified into two primary categories:
- Glucocorticoids: These are the most frequently prescribed corticosteroids. Prednisone, prednisolone, and dexamethasone fall under this category. They mainly deal with inflammation and are used in conditions like asthma, rheumatoid arthritis, and lupus.
- Mineralocorticoids: Aldosterone is a primary mineralocorticoid that helps control blood pressure by maintaining a balance of sodium and potassium in the blood. Fludrocortisone is a synthetic mineralocorticoid used to treat conditions where the body doesn’t produce enough aldosterone.
3. How Do They Work?
Corticosteroids, specifically glucocorticoids, exert their effects in multiple ways:
- Anti-inflammatory: They reduce the production of chemicals that cause inflammation. This action is beneficial in conditions like asthma where inflammation of airways can lead to breathing problems.
- Immunosuppression: Corticosteroids can suppress the immune system, making it less active. This property is useful in autoimmune diseases, where the body’s immune system attacks its tissues, or after organ transplantation to prevent organ rejection.
4. Application Methods
Corticosteroids can be administered in various ways:
- Orally: As tablets or liquid solutions.
- Topically: As creams, gels, or ointments for skin conditions.
- Inhalation: For asthma or chronic obstructive pulmonary disease (COPD).
- Injection: Directly into joints, muscles, or the bloodstream.
5. Potential Side Effects
While corticosteroids offer significant benefits, they also come with potential side effects, especially when used in high doses or for prolonged periods. Some common side effects include:
- Weight gain and increased appetite.
- Osteoporosis (weakening of bones).
- Mood changes, including irritability or depression.
- Increased blood pressure.
- Increased blood sugar levels, which can worsen or even trigger diabetes.
- Thinning of skin and easy bruising.
It’s essential to work closely with a healthcare provider to manage potential side effects and to adjust dosages or switch medications as needed.
Corticosteroids remain an invaluable tool in the world of medicine, providing relief for countless individuals with various conditions. As with any drug, it’s essential to understand their benefits and risks. When used responsibly under the guidance of a medical professional, corticosteroids can improve quality of life and treat various conditions effectively.