CORTICOSTEROIDS (GLUCOCORTICOIDS)

 

OBJECTIVES OF THE DISCUSSION:  By the end of this discussion the learner/medical student will be able to;

1.  Describe the role of corticosteroids in management of pain

2.  Explain the effect of corticosteroids on the human body

3.  List the possible side and adverse effect encountered with use of corticosteroids

INTRODUCTION:  Corticosteroids have numerous therapeutic applications. One of their most useful properties is the ability to suppress severe inflammation. Because of potentially serious adverse effects, however, systemic corticosteroids are reserved for the short-term treatment of severe disease. Corticosteroids are often referred to as glucocorticoids.

TREATING ACUTE OR SEVERE INFLAMMATION WITH CORTICOSTEROIDS:  Corticosteroids are natural hormones released by the adrenal cortex that have powerful effects on nearly every cell in the body. When corticosteroids are used as drugs to treat inflammatory disorders, the doses are many times higher than the amount naturally present in the blood. The uses of corticosteroids include the treatment of neoplasia, asthma, arthritis, and corticosteroid deficiency.  Asthma 

PHARMACODYNAMICS:  Like the NSAIDs, corticosteroids inhibit the biosynthesis of prostaglandins. Corticosteroids, however, affect inflammation by multiple mechanisms. They have the ability to suppress histamine release and can inhibit certain functions of phagocytes and lymphocytes. These multiple actions markedly reduce inflammation, making corticosteroids the most effective medications available for the treatment of severe inflammatory disorders.  Inflammation 

ADVERSE EFFECTS:  When given by the oral or parenteral routes, corticosteroids have a number of serious adverse effects that limit their therapeutic utility. These include suppression of the normal functions of the adrenal gland a condition known as adrenal insufficiency, hyperglycemia, mood changes, cataracts, peptic ulcers, electrolyte imbalances, and osteoporosis.  Peptic ulcers

Because of their effectiveness at reducing the signs and symptoms of inflammation, corticosteroids can mask infections that may be present in a patient. This combination of masking signs of active infection and suppressing the immune response creates a potential for infections to grow rapidly and remain undetected. In that regard therefore, active infection is usually a contraindication for corticosteroids therapy. 

Because the appearance of these adverse effects is a function of the dose and duration of therapy, treatment is often limited to the short-term control of acute disease. When longer therapy is indicated, doses are kept as low as possible and alternate-day therapy is sometimes implemented; the medication is taken every other day to encourage the patient’s adrenal glands to function on the days when no drug is given.

RELATED;

1.  OPIOID ANALGESICS

2.  OPIOID ANALGESICS

3.  MORPHINE

4.  INFLAMMATORY CONDITIONS OF THE HUMAN BODY

REFERENCES