Corticosteriods

• Corticosteroids


  Hormones secreted by the adrenal cortex of the adrenal gland
• Types of corticosteroids

  • Mineralocorticoids (e.g. fludrocortisone, aldosterone)
  • Glucocorticoids (e.g. cortisone, hydrocortisone, prednisone)
• Mineralocorticoids


  Maintain fluid and electrolyte balance, used to treat adrenal insufficiency
• Glucocorticoids


  Regulate carbohydrate, protein, and fat metabolism, have anti-inflammatory, antiallergenic, and immunosuppressant activity
• Synthetic polymers


  • nylon, polyethylene, polyester, Teflon, epoxy
• Enzymes


  • They increase the rate of chemical reactions without themselves being consumed or permanently altered by the reaction
  • They increase reaction rates without altering the chemical equilibrium between reactants and products
• Fludrocortisone


  An adrenal corticosteroid with potent mineralocorticoid and glucocorticoid effects, affects fluid and electrolyte balance
• Cortisol


  The major glucocorticoid of the adrenal cortex, regulated by the hypothalamic pituitary axis
• Alternate-day therapy


  Corticosteroids are usually given between 6 and 9 AM on alternate days to minimize suppression of normal adrenal function
• Common and serious adverse effects of corticosteroids


  • Fluid and electrolyte disturbances
  • Immune system effects
  • Psychological effects
  • Metabolic effects (hyperglycemia)
  • Gastrointestinal effects (peptic ulcer)
  • Integumentary effects (delayed wound healing)
  • Sensory effects (visual disturbances)
  • Musculoskeletal effects (osteoporosis)
• Diuretics and corticosteroids


  Corticosteroids may enhance the loss of potassium, check potassium levels and monitor for hypokalemia
• Warfarin and corticosteroids


  Steroids may enhance or decrease the anticoagulant effects of warfarin, monitor prothrombin time and adjust warfarin dose as needed
• Rifampin and corticosteroids


  Rifampin may enhance the metabolism of corticosteroids, reducing their therapeutic effect