Corticosteroids or corticosteroids are very potent drugs that can only be administered with a prescription. Therefore, despite the fact that many people know this, this type of medication cannot be acquired, let alone consumed, without an indication of a health professional.
These drugs are a variety of hormones that belong to the group of steroids, produced by the cortex of the adrenal glands. Corticosteroids are involved in a wide range of physiological mechanisms. Among them we can mention the following:
- Inflammation processes.
- Immune system.
- Carbohydrate metabolism.
Corticosteroid drugs are artificially synthesized for therapeutic purposes, for example, in the treatment of Crohn’s disease or for joint pain.
Types and indications of corticosteroid drugs
This type of medication is only indicated with a medical prescription, so in no way and in no case can it be self-medicated.
Since these drugs can be synthesized artificially, they can be created in different ways according to indication and requirement.
Therefore, we can find medicines with steroids, for example, for inhalations. This formula is used in the case of asthmatic patients or those suffering from chronic obstructive pulmonary disease (COPD).
However, they are also used specifically in some cases of acute bronchitis, although the two previous indications are long-term and under medical control.
There are also oral steroids in pill form. The main indication of this type is the treatment of inflammatory diseases such as Crohn’s disease or ulcerative colitis.
On the other hand, corticosteroids also have a topical presentation, indicated in cases of eczema, atopic dermatitis or psoriasis. Local inflammation may also be a cause of administration of topical corticosteroid medications.
Finally, there are injectable steroids. They are those that are administered intravenously and are used in some systemic diseases of the autoimmune type. When administered intramuscularly, they are reserved for the treatment of joint pain.
Mechanism of action and pharmacological effects
A characteristic consequence is the risk of osteoporosis, due to the effect on calcium, among others.
Corticosteroid drugs must enter the cell’s cytoplasm where they bind to receptors. Once a bond is formed between the hormone and the receptor, it goes to the cell’s nucleus and there interacts with the DNA.
The result of this interaction is the synthesis of the specific protein that will perform the desired function.
As we mentioned at the beginning of the article, corticosteroids play many roles in the body. Below, we explain each of them in more detail:
- Carbohydrate and protein metabolism: stimulate gluconeogenesis, glycogenesis. Elevates blood glucose and pyruvate levels. It also allows the balance of nitrogen and calcium to be negative, thus generating osteoporosis and myopathies.
- Lipid metabolism: intervenes in the redistribution of fat and increases appetite.
- Water and electrolyte metabolism: Retain sodium and water, but excrete potassium and hydrogen and reduce intestinal calcium absorption.
- Cardiovascular actions: retain fluid, thus causing the formation of edema.
- Hematopoietic actions.
- Anti-inflammatory action: reduces the inflammatory tetrad, that is, redness, heat, pain and edema. They also inhibit histamine secretion.
Adverse reactions of corticosteroid drugs
Due to the increase in minerals such as sodium and water retention, edema and an increase in blood pressure can occur.
As for the immunological effects, it increases the susceptibility to infections as it is an immunosuppressive agent. It also causes adverse effects on the skeletal muscle, thus, myopathy, osteoporosis and bone necrosis may appear.
It is possible to produce gastrointestinal effects, such as pancreatitis and peptic ulcer. These two adverse reactions are the most common. In addition, hypertension can be caused by fluid retention as an adverse cardiovascular effect.
On the other hand, within the adverse reactions of corticosteroids we can mention:
- Stretch marks.
The changes in mood, a feeling of euphoria, insomnia, depression and psychosis are neuropsychiatric character reactions that can also occur during treatment with corticosteroid medications. Although in this case, they are less frequent and likely.
In fact, eye problems such as cataracts and glaucoma may also appear, as well as endocrinological and metabolic problems.
Among the last ones we mention, we can mention glucose intolerance, diabetes, overweight, hyperlipidemia, growth suppression due to its relationship with growth hormone and suppression of the hypothalamic-pituitary-adrenal gland axis, among others.