Corticosteroids: what it is and why it is used
What are corticosteroids? This is the collective name of a whole group of hormones produced by the adrenal cortex. Preparations based on them are actively used in modern medicine. They are divided into two groups, the first - glucocorticoids, which include in particular cortisone (oral glucocorticosteroid, used in chronic adrenal insufficiency) and hydrocortisone. The second group - mineralocorticosteroids - regulators of the exchange of water and sodium in the body.
The first time doctors and scientists began to talk about their advantages and importance for the human body in 1886. Corticosteroids are necessary for the person for normalization of a metabolism, control of function of kidneys, and also puberty.
Classification of corticosteroid hormones
In modern medicine, natural hormones are not used, they are superseded by synthetic substitutes that affect people in a similar way.Doctors classify them by activity level:
- Steroid hormones produced exclusively by the adrenal cortex with reduced activity ("Hydrocortisone" and "Prednisolone").
- Steroid hormones with medium activity, these include "Flumetazon" and "Fluocortolone".
- Hormones with strongly pronounced activity are the most common steroids in the present ("Betamethasone" and "Mometasone").
- Hormones with very high activity, they include "clobetasol" and "Halcinonide".
So what is it - “corticosteroids” - and what effect do they have on the human body? Those drugs that are sold in a pharmacy are synthetic compounds, they can be produced under different trade names, but the active substance in each group is the same. The action of corticosteroids is manifested in the following:
- anti-inflammatory effect without affecting the infectious agent and pathogens;
- the ability to influence all forms of metabolism: water-electrolyte, lipid, protein and carbohydrate;
- anti-allergic effect;
- effects on the cardiovascular system, an increase in the sensitivity of the vascular walls and heart muscles to adrenergic and epinephrine, the effect on blood pressure;
- the ability to stimulate the formation of platelets, fragments of megakaryocytes and red blood cells;
- the ability to suppress the production of sex hormones, as well as reduce the sensitivity of organs and tissues to steroids, which are produced by the thyroid gland.
Indications for use
Corticosteroids are used where conventional drugs (anti-inflammatory, painkillers, antiallergic) are powerless. Between themselves, glucocorticoids and mineralocorticoids differ in the nature of their effects on the body. The first ones are most relevant in the treatment of bronchial asthma, rheumatism, pancreatitis, viral hepatitis, rheumatoid arthritis, etc. They have a pronounced anti-inflammatory effect. Mineralocorticoids are used for diseases whose occurrence is associated with impaired mineral metabolism.
Glucocorticoids - what is it?
Corticosteroids produced by the adrenal cortex. This type of hormones most effectively affects carbohydrate metabolism. Steroid hormones are named for their ability to raise blood sugar and lymph levels by enhancing the glucose pooling process in the liver.They also affect the metabolism of fats and proteins. The most effective of these is cortisol (a biologically active glucocorticoid hormone of a steroid nature, that is, it has a steran core in its structure).
Containing drugs prescribed in the presence of the following diseases:
- all forms of arthralgia (joint pain);
- salt deposition in chronic metabolic diseases characterized by a failure of the purine metabolism and the inability of the kidneys to excrete uric acid;
- chronic systemic diseases of the joints with primary localization of the inflammatory process in the spine.
Important!Doctors prescribe steroids in the case if within fourteen days the use of other anti-inflammatory drugs did not give a positive result.
In addition to painful deviations from the normal state in the joints, corticosteroids are often prescribed for disorders in the work of other organs and tissues (autoimmune diseases, bronchial asthma, severe allergic reactions).
Finding out what it is - corticosteroids, it is not superfluous to learn about their classification.This group includes adrenal cortex hormones that affect mineral metabolism, mainly on the exchange of sodium and potassium. These steroids are responsible for ordering the water-salt balance. Unlike other corticosteroids, this type is not in special demand in medicine. Mineralcorticoid is prescribed for:
- chronic insufficiency of the adrenal cortex, or hypocorticism (a rare endocrine disease, as a result of which the adrenal glands lose their ability to produce a sufficient amount of hormones, especially cortisol);
- syndrome of severe weakness of the muscles, accompanied by a significant decrease or complete cessation of motor activity;
- Addison disease.
Despite the high activity of many drugs with corticosteroids, there are no certain contraindications. However, there are conditions in which health workers prescribe them with caution. These diseases and disorders include:
- Diabetes mellitus (a disease of endocrine origin that develops due to the lack or absence of insulin in the body).
- Ulcer of the gastrointestinal tract during exacerbation.
- Heart failure.
- High blood pressure.
- Acute renal or hepatic failure.
- Glaucoma (an eye disease that is characterized by a constant or periodic increase in intraocular pressure).
- Cataract (physiological condition associated with clouding of the lens of the eye and causing varying degrees of visual impairment, up to its complete loss).
- Chickenpox (acute viral infection transmitted by airborne droplets).
- Tuberculosis (an infectious disease, the occurrence of which provoke Mycobacterium tuberculosis).
- Epilepsy (common chronic neurological disease of a person, manifested in the body's susceptibility to the sudden onset of convulsive seizures).
- Mental illness.
The explication of undesirable reactions when taking corticosteroids is due to which class they belong to. Glucocorticosteroids of the first type ("Cortisone") provoke side effects more often than newer, more modern drugs ("Mometasone" and "Betamethasone").In addition, the strength of the effect is directly dependent on the dose and duration of administration. The higher the dosage and duration of the course, the higher the likelihood of adverse reactions. In most cases, such medications cause:
- Swelling caused by sodium retention.
- Increased blood pressure and increase in blood glucose concentration.
- Inflammatory disease of the gastric mucosa, leading to its dystrophic changes.
- Dermatitis, acne, and in severe cases - atrophy of the skin.
- An inflammatory lesion of the skin resulting from exposure to damaging factors of a chemical, physical or biological nature.
- Depression, stress, mental disorders.
- Malfunction of the adrenal glands.
Important! To prevent the occurrence of adverse reactions, it is necessary to adjust the dose and duration of steroid hormones in time.
Corticosteroids are recommended to be taken from six in the morning until twelve in the afternoon. These conditions are as close as possible to the physiological production of adrenaline and noradrenaline (adrenal hormones) in the body. As a rule, the medication should be taken during a meal or after it.
Treatment with corticosteroids, especially with long courses, must be supplemented with calcium intake to protect against its deficiency, as well as food rich in protein.
Synthetic steroid hormones are produced in several forms:
- tablets or capsules;
- injection solutions in ampoules;
- topical corticosteroids, which are used externally (ointments, creams);
- solutions for inhalation.
Corticosteroids: Drug List
The most popular steroids in the form of tablets are:
"Prednisolone" is a drug that has a strong anti-allergic and anti-inflammatory effect. The drug is prohibited to take with a stomach ulcer and intestines, with vaccination and persistent high blood pressure. The cost of "Prednisolone" (100 tablets) is about one hundred and fifty rubles. The drug is also available in the form of a solution for injection.
Celestone is an anti-inflammatory medicine that includes betamethasone, prescribed tablets after a heart attack, at high pressure, diseases of the endocrine system, glaucoma, osteoporosis, and venereal diseases.
"Kenacort" - pills to stabilize the cell membrane, eliminate the symptoms of inflammation and allergies. Contraindicated in psychosis (pronounced impairment of mental activity, in which mental reactions roughly contradict the real situation), as well as in neuritis (inflammatory disease of the peripheral nerves, in which, along with pain, symptoms, so-called loss, ie loss or decrease in sensitivity, paralysis and paresis) and fungal infections. The cost of packing tablets (50 pieces) is about two hundred and fifty rubles.
"Methylprednisolone" - a hormonal drug, refers to glucocorticosteroids. The only contraindication is individual intolerance. In emergency situations, prescribed to pregnant women, with psychosis and diseases of the endocrine system, as well as disorders of the gastrointestinal tract. The cost of "Metiprednisolone" varies from 160 to 300 rubles.
"Lemod" - a drug that is effective in combating abnormalities that have endocrine, allergic, musculoskeletal, oncological nature.It is not recommended to take for herpes cornea (a viral disease with a characteristic rash of grouped vesicles), tuberculosis (an infectious infectious disease, the main cause of which is an infection of the body with Koch sticks), as well as for diabetes mellitus and fungal diseases. The cost of the drug is about 500 rubles.
The list of corticosteroids is extensive, hormones are also available in the form of injections:
“Hydrocortisone” is a hormonal steroid medicine. The drug suppresses inflammatory, allergic and immune reactions. The price of "Hydrocortisone" (10 ampoules) is about 150 rubles.
“Diprospan” is a hormonal drug, which by its pharmacological action belongs to the group of glucocorticoids. Betamethasone acts as an active ingredient. Injections are effective in the following cases:
- pathological process, manifested by excessive accumulation of fluid in the cells of the brain or spinal cord;
- adrenal insufficiency.
- excessive sensitivity to one of the components;
- infectious lesion;
- diseases of the digestive system;
- high blood pressure;
- diseases of the kidneys and liver.
The cost of one ampoule of "Diprospana" is approximately 210 rubles.
"Kenalog" - a drug to relieve inflammation and severe allergy attacks. The active ingredient of the drug is triamcinolone. "Kenalog" is characterized by a slight effect on the human body. Does not affect the functioning of the pituitary and metabolism. Five vials of the drug cost about 450 rubles.
"Flosterone" is an anti-inflammatory, anti-toxic, desensitizing, immunosuppressive drug. The active ingredient in the composition is betametazol (it has a prolonged action). The price of five ampoules of "Flosteron" is about 250 rubles.
"Depot-Medrol" - what is this corticosteroid drug? The drug belongs to the group of glucocorticosteroids (hormones of the adrenal cortex), used in the treatment of diseases of almost all internal organs, including the spinal column. Available in suspension. The cost of the Belgian drug is about 500 rubles.
The most common corticosteroid ointments are:
- "Lorinden With."
- "Fucidin G".
- Sinflan (Flucinar).
“Lokid” is a synthetic glucocorticoid ointment for external use, widely used for the treatment of psoriasis, dermatitis and eczema. The drug has anti-inflammatory, antipruritic action. The cost of "Locoid" - within 350 rubles.
"Lorinden C" - an external drug with antimicrobial, anti-allergic and anti-inflammatory effects. The price of the medicine "Lorinden C" varies from 350 to 600 rubles.
Steroids in the form of inhalations reduce the permeability of cell membranes, and also limit the release of protease beyond the limits of cellular organoids. Inhaled corticosteroids are:
- "Beklamitozon" (analogs: "Alcedin", "Bekotid", "Beklokort").
- "Flunisolid" (analog: "Ingakort").
"Beklokort" - the active ingredient of the drug inhibits the process of separating chemical compounds from the group of physiologically active lipids, which are formed in the body by enzymatic means. As well as the drug reduces the production of pathological fluid released in the tissue or cavity from the small blood vessels during inflammation.The drug is contraindicated in children up to six years, as well as with individual intolerance. The cost of "Beklamitozona" varies from 300 to 450 rubles.
"Baconase" is an anti-allergic agent that reduces the swelling of the epithelium and the secretion of mucus by the bronchial glands. Used as a nasal corticosteroid. The price of the drug is about 350 rubles.
“Flunisolid” is an anti-inflammatory medicine, effective for chronic respiratory disease, obstructive bronchitis and rhinitis. The drug is not recommended for use in the first trimester of pregnancy, children under five years of age, with tuberculosis.