Corticosteroids

ROMEL Y. FELARCA,MD,DFM.
 Corticosteroids
are a class of steroid hormones that are
produced in the adrenal cortex.
Corticosteroids are involved in a wide
range of physiologic systems such as
– stress response
– immune response
– regulation of inflammation,
– carbohydrate metabolism
– protein catabolism
– blood electrolyte levels
– behavior.
Glucocorticoids such as cortisol control
carbohydrate, fat and protein metabolism
and are anti-inflammatory by preventing
phospholipid release, decreasing
eosinophil action and a number of other
mechanisms.
Mineralocorticoids such as aldosterone
control electrolyte and water levels,
mainly by promoting sodium retention in
the kidney.
Biosynthesis
 Classes of corticosteroids
Group A
(short to medium acting glucocorticoids)
– Hydrocortisone
– Hydrocortisone acetate
– Cortisone acetate
– Tixocortol pivalate
– Prednisolone
– Methyprednisolone
– Prednisone
 Classes of corticosteroids
Group B
– Triamcinolone acetonide
– Triamcinolone alcohol
– Mometasone
– Amcinonide
– Budesonide
– Desonide
– Fluocinonide
– Fluocinolone acetonide
– Halcinonide.
 Classes of corticosteroids
Group C
– Betamethasone
– Betamethasone sodium phosphate
– Dexamethasone
– Dexamethasone sodium phosphate
– Fluocortolone
 Classes of corticosteroids
Group D
– Hydrocortisone-17-butyrate
– Hydrocortisone-17-valerate
– Aclometasone dipropionate
– Betamethasone valerate
– Betamethasone dipropionate
– Prednicarbate
– Clobetasone-17-butyrate
– Clobetasol-17-propionate
– Fluocortolone caproate
– Fluocortolone pivalate
– Fluprednidene acetate
 Glucocorticoids-Action
The major glucocorticoids of the
adrenal cortex is Cortisol.
The hypothalamic-pituitary axis
regulates the secretion of cortisol by
increasing or decreasing the output of
CRF from the hypothalamus.
CRF stimulates the release of ACTH
from the pituitary gland ; ACTH then
stimulates the adrenal gland to secrete
cortisol
 Therapeutic outcomes
Glucocorticoids
– Reduced pain and inflammation
– Minimized shock syndrome and faster
recovery
– Reduced nausea and vomiting associated
with chemotherapy
 Types of Corticosteroids
Topical steroid for use topically on the
skin, eye, and mucous membranes.
Inhaled steroids for use to treat the
nasal mucosa, sinuses, bronchii, and
lungs
Oral forms - such as prednisone and
prednisolone.
Systemic forms - available in injectibles
for use intravenously and parenteral
routes
 MINERALOCORTICOIDS
Fludrocortisone
– Is an adrenal corticosteroid with potent
mineralocorticoid and glucocorticoid effects.
– Affects fluid and electrolyte balance by acting
on the distal renal tubules, causing sodium
and water retention and potassium and
hydrogen excretion.
– Used in combination with glucocorticoids to
replace mineralocorticoids activity in patients
who suffer from adrenocortical insufficiency
and to treat salt-losing adrenogenetal
syndrome.
 Therapeutic outcome
Fludrocortisone
– Control of blood pressure
– Restoration of fluid and electrolyte
balance
THANK YOU
God bless you