CORTICOSTEROIDS
DR UMAIR

CORTICOSTEROIDS
Steroid hormones produced by the adrenal cortex.
1-Glucocorticoids
2-Mineralocorticoids
3-Androgens

CORTICOSTEROIDS
1. SHORT ACTING (t ½ 8-12 hrs)
Cortisone
Cortisol
2. INTERMEDIATE ACTING (t ½ 12-36 hrs)
Prednisolone
Methylprednisolone
Triamcinolone
3. LONG ACTING (t ½ 36-72 hrs)
Paramethasone
Betamethasone
Dexamethasone

CORTICOSTEROIDS
Inhalational corticosteroids:
Beclomethasone
Budesonide
Fluticasone
Triamcinolone
Mometasone

CORTICOSTEROIDS
Mechanism of action:
1-Corticosteroids enter the cell and bind to cytosolic receptors( bound
with Hsp90)
2-Binding of steroids with receptor releases Hsp90
3-Receptor dimerization Receptor activation
4-Steriod receptor complex moves into nucleus and binds with GRE
5-Transcription of mRNA  Regulatory Proteins are formed

CORTICOSTEROIDS
Pharmacological effects:
1-Metabolic effects:
Stimulate gluconeogenesis Hyperglycemia
Catabolism of muscle protein
Increased Insulin secretion
Increased lipolysis and lipogenesis  increase of fat deposition in face ,
shoulders and back.

CORTICOSTEROIDS
Pharmacological effects:
2-Catabolic effects:
Muscle protein catabolism
Lymphoid and connective tissue, fat, and skin undergo wasting
Catabolic effects on bone osteoporosis.
Growth inhibition  Children
3-Immunosuppressive effects
Inhibit cell mediated immunity

CORTICOSTEROIDS
CLINICAL USES:
Adrenal uses: (Replacement therapy)
1-Acute adrenal insufficiency
2-Chronic adrenal insufficiency
3-Congenital adrenal hyperplasia
Non-Adrenal uses:
Rheumatoid arthritis
Systemic lupus erythematous
Polyarteritis Nodosa

CORTICOSTEROIDS
Non-Adrenal uses:
Glomerulonephritis
Allergic disorders
Urticaria
Bee sting
Drug reactions
Bee stings
Contact dermatitis
Anaphylaxis
Serum sickness

CORTICOSTEROIDS
Non-Adrenal uses:
Bronchial asthma
Eye inflammations
Malignancies
Cerebral edema
Transplant rejection

CORTICOSTEROIDS
Adverse effects of corticosteroids:
1-Iatrogenic Cushing Syndrome
2-Acne
3-Weight gain & Visceral fat deposition
4-Myopathy & muscle wasting
5-Thining of skin with striae & brusing
6-Hyperglycemia Diabetes
6-Osteoprosis & necrosis of the hip
7-Impaired wound healing
8-Peptic Ulcers

CORTICOSTEROIDS
Adverse effects of corticosteroids:
9-Clinical findings of Bacterial & Mycotic Infections are masked
10-Hpomania
11- Acute Psychosis
12-Depression
13-Posterior Cataracts
14-Glaucoma
15-Growth retardation in children
16-Adrenal suppression