Most common uses of Corticosteroids

 

Corticosteroids are very popular and effective type of medications which represent a very close copy of cortisol, a hormone that our adrenal glands produce naturally. Beside this term- they are also called just steroids! There are some good things and some bad things that we should know about these Corticosteroids. First, the two worse things about them is that they can cause several serious side effects and that they have been abused for many years by top athletes all around the globe. Good thing about them is that corticosteroid medications have great potential in the treatment of a variety of conditions, from rashes to lupus to asthma.  The corticosteroid family of medications is extremely large, but the most commonly used are:

 

·         Prednisolone (Prelone)

·         Cortisone (Cortone)

·         Dexamethasone (Decadron Betamethasone (Celestone))

·         Budesonide (Entocort EC)

·         Hydrocortisone (Cortef)

·         Methylprednisolone (Medrol)

·         Prednisone (Deltasone)

·         Triamcinolone (Kenacort, Kenalog)

 

Well, the main thing that we should know about their mechanism of work is that they in fact mimic the effects of cortisone and hydrocortisone. These two are hormones that our body produces naturally in our adrenal glands. Adrenal glands are two small glands found on the top of our kidneys. They are extremely hormonally active and produce three different types of hormones: mineralocorticoid,  glucocorticoid and sex hormones. Although all of these hormones have their own specific functions- important thing to point is that these hormones help control three important aspects of our health:

·         Stress of illness and injury

·         Immune function

·         Inflammation

So the fact is that, by taking these medications, we in fact duplicate the effects of our body's natural steroids. They are most commonly used in the situations where the inflammation response of our body is to strong! Therefore, you can assume that their main effects is suppression of inflammation, which can reduce the symptoms of inflammatory conditions such as arthritis and asthma. Not only that this effect can be helpful but it can be life-saving! You see, when inflammation threatens to damage critical body organs, steroids can save a life of a patient! In many disease such as in lupus or vasculitis, these medications can significantly reduce kidney inflammation which could lead to kidney failure! In cases of rheumatoid arthritis, corticosteroids can provide significant relief from pain and stiffness in joints!

How they do it? Well, to be honest with you- nobody really knows! Experts don't fully understand how corticosteroids suppress inflammation but most of them suggest the theory that they deactivate a protein associated with inflammation.  

 

Like we have already mentioned- corticosteroid medications are extremely useful in treatment of variety of conditions in which the body’s defense system malfunctions and causes tissue damage. Some of those conditions are:

• Systemic vasculitis - This is one very serious disorder which is characterized by the generalized inflammation of blood vessels in our body

• Myositis - This is also considered to be one autoimmune disorder in which our immune system attacks our muscles

• Rheumatoid arthritis – Almost everyone has heard about this condition because it is present mostly in older people and it is characterized by chronic and very painful inflammatory arthritis occurring in joints all around the body

• Systemic lupus erythematosus – An autoimmune disorder where our immune system targets several body systems, especially skin 

• Sjögren’s syndrome-This is one serious disorder where the target tissues are eyes and a mouth, and which is characterized by dryness of eyes and mouth

Beside these conditions they are also being used in the treatment of many other conditions such as:

·         temporal arteritis

·         dermatitis

·         allergic reactions

·         asthma

·         hepatitis

·          inflammatory bowel disease (ulcerative colitis and Crohn's disease)

·         sarcoidosis

·         for glucocorticoid replacement in Addison's disease

·         treatment of different skin conditions

·         eye diseases (uveitis)

·         prevention of nausea

 

Typical undesired effects of glucocorticoids present quite uniformly as drug-induced Cushing's syndrome. It is also important to point out that all of these corticosteroids have their own specific side effects of which the most commons are: hypertension (conditions characterized by abnormally high blood pressure), hypokalemia (complications because of abnormally low potassium levels in the blood), hypernatremia (high sodium levels in the blood), permanent eye damage by inducing central serous retinopathy and many other…  

 

Well, it could be difficult to answer this question shortly because there are almost hundreds different corticosteroid medications today and everyone of them has its own characteristic administration rules, dosage etc…  However, depending on their type of administration, we could divide all corticosteroid medications into next groups:

·         Oral corticosteroid medications

These medications come in forms of tablets, capsules or syrups! They are usually made to help treat the inflammation and pain associated with certain chronic conditions such as arthritis and lupus.

·         Inhalational corticosteroids

Most commonly they come in forms of intranasal sprays which usually help control inflammation associated with allergy and asthma.

·         Topical corticosteroid medications

They come in forms of different creams, ointments and roll-ons that can help relieve symptoms mostly from skin conditions associated with strong immune response!  

·         Injectable corticosteroids 

These represent one very effective from of corticosteroids which usually used to treat such signs and symptoms as the pain and inflammation of tendinitis, severe musculoskeletal pain or serious rashes.

Corticosteroid drugs can also be used as ingredients contained in:

·         Various eye products

·         inhalers

·         nasal drops and sprays 

·         topical creams, ointments, etc…

 

It is even unnecessary to repeat that, like all other medications, corticosteroids can cause several possible side effects some of which can be even life-threatening! That’s why- we should know more about these unwanted effects! Every type of corticosteroids have its own characteristic side effects, depending mostly on their administration!

Big problem with these oral medications is that they affect our entire body instead of a particular area. That’s why- the side effects caused by these medications are usually the worse! Some of the most common side effects caused by oral corticosteroids are:

·         Mood swings

·         Elevated pressure in the eyes, condition called the glaucoma

·         Slow wound healing

·         Cataracts

·         High blood sugar

·         Increased risk of infections

·         Increased blood pressure

·         Fluid retention, causing edema on legs

·         Weight gain

·         Menstrual irregularities

·         Suppressed normal adrenal gland hormone production

·         Thin skin

·         Loss of calcium in bones

 

Like with all other medications which target the specific point on our body, these medications may deposit in our mouth and throat instead of making it to our lungs. Studies have proven that this can cause coughing, hoarseness, dry mouth and sore throat. What should you do? Well, experts are suggesting that the best thing to do is that, after the inhalation, you should gargle and rinse your mouth with water and spit it out. This should reduce the chance of experiencing the side effects of this kind! 

Several researches done in the past have proven that prolonged usage of topical corticosteroids can cause severe skin lesions, thickness of the skin and acne! Similar to these, injected corticosteroids can cause side effects near the site of the injection. Most common side effects include pain, infection, shrinking of soft tissue and loss of color in the skin. There is one rule about all these side effects:  The side effects grow in severity if the treatment is continued for a long period of time. This is because, with prolonged use, the drug inhibits the communication between the pituitary gland and the adrenals.  

How can the side effects of steroids be minimized?

Is it possible to minimize the side effects of steroids? The answer is simple- YES! Experts are saying that some of the following advices can be extremely useful:

• First, you should use steroids only when necessary.

• If it is possible, local steroids should be used in the treatment of local problems.

• Only the minimal dose required should be used to gain control of the disease.

• Reduce the dose gradually as long as the disease remains under control.

• every patient should monitor its own blood pressure during the usage of corticosteroids

• During the corticosteroid treatment, every patient should use some calcium supplements to prevent osteoporosis and maintain normal bone density.