Glucocorticoids are a class within the corticosteroid family. Glucocorticoids are chemically and functionally similar to endogenous cortisol. There are a wide array of indications, which primarily benefit from the antiinflammatory and immunosuppressive effects of this class of drugs. These medications are also used for conditions requiring physiologic glucocorticoid replacement. Despite their extensive use, glucocorticoids can produce many and varied adverse effects and should be used judiciously. Because of their immunosuppressive effect, these medications may predispose individuals to infection and should be avoided in those with uncontrolled infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease. In addition, long-term therapy can lead to suppression Suppression Defense Mechanisms of the hypothalamic- pituitary Pituitary A small, unpaired gland situated in the sella turcica. It is connected to the hypothalamus by a short stalk which is called the infundibulum. Hormones: Overview and Types-adrenal (HPA) axis Axis The second cervical vertebra. Vertebral Column: Anatomy, so discontinuation of therapy should be done carefully to avoid adrenal insufficiency Adrenal Insufficiency Conditions in which the production of adrenal corticosteroids falls below the requirement of the body. Adrenal insufficiency can be caused by defects in the adrenal glands, the pituitary gland, or the hypothalamus. Adrenal Insufficiency and Addison’s Disease.
Last updated: 30 Mar, 2022
The chemical structure of cortisol
Image: “Structure of Cortisol” by NEUROtiker. License: Public DomainThe chemical structure of prednisone Prednisone A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. Immunosuppressants, which appears similar to cortisol.
Image: “Structure of Prednisone Prednisone A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. Immunosuppressants” by Bryan Derksen. License: Public Domain Flowchart showing the hypothalamic-
pituitary
Pituitary
A small, unpaired gland situated in the sella turcica. It is connected to the hypothalamus by a short stalk which is called the infundibulum.
Hormones: Overview and Types–
adrenal cortex
Adrenal Cortex
The outer layer of the adrenal gland. It is derived from mesoderm and comprised of three zones (outer zona glomerulosa, middle zona fasciculata, and inner zona reticularis) with each producing various steroids preferentially, such as aldosterone; hydrocortisone; dehydroepiandrosterone; and androstenedione. Adrenal cortex function is regulated by pituitary adrenocorticotropin.
Adrenal Glands: Anatomy
axis
Axis
The second cervical vertebra.
Vertebral Column: Anatomy:
Stresses may be physical (e.g., exercise), mental (e.g., fear), or biochemical (e.g.,
low blood glucose
Low blood glucose
Hypoglycemia is an emergency condition defined as a serum glucose level ≤ 70 mg/dl (≤ 3. 9 mmol/l) in diabetic patients. In nondiabetic patients, there is no specific or defined limit for normal serum glucose levels, and hypoglycemia is defined mainly by its clinical features.
Hypoglycemia). Biologic rhythms include circadian rhythms as well as longer rhythms associated with growth and development.
ACTH:
adrenocorticotropic hormone
Adrenocorticotropic hormone
An anterior pituitary hormone that stimulates the adrenal cortex and its production of corticosteroids. Acth is a 39-amino acid polypeptide of which the n-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotropic activity. Upon further tissue-specific processing, acth can yield alpha-msh and corticotropin-like intermediate lobe peptide (clip).
Adrenal Hormones
CRH:
corticotropin-releasing hormone
Corticotropin-releasing hormone
A peptide of about 41 amino acids that stimulates the release of adrenocorticotropic hormone. Crh is synthesized by neurons in the paraventricular nucleus of the hypothalamus. After being released into the pituitary portal circulation, crh stimulates the release of acth from the pituitary gland. Crh can also be synthesized in other tissues, such as placenta; adrenal medulla; and testis.
Hypothalamic and Pituitary Hormones
Systemic glucocorticoids can be divided into:
Topical steroids Steroids A group of polycyclic compounds closely related biochemically to terpenes. They include cholesterol, numerous hormones, precursors of certain vitamins, bile acids, alcohols (sterols), and certain natural drugs and poisons. Steroids have a common nucleus, a fused, reduced 17-carbon atom ring system, cyclopentanoperhydrophenanthrene. Most steroids also have two methyl groups and an aliphatic side-chain attached to the nucleus. Benign Liver Tumors are classified as classes I–VII based on their potency.
The following summarizes the pharmacokinetics Pharmacokinetics Pharmacokinetics is the science that analyzes how the human body interacts with a drug. Pharmacokinetics examines how the drug is absorbed, distributed, metabolized, and excreted by the body. Pharmacokinetics and Pharmacodynamics for systemic glucocorticoids:
Systemic glucocorticoids are commonly used for the short- and/or long-term management of a variety of conditions, including:
System | Indications |
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Allergic conditions |
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Dermatologic |
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Endocrine |
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GI |
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Hematologic |
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Neurologic |
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Ophthalmic |
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Respiratory |
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Rheumatologic |
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Topical glucocorticoids can be used for a number of dermatologic conditions, including (list is not exhaustive):