Kortikosteroidia

Kortikosteroidia (corticosteroids) are a class of steroid hormones produced by the adrenal cortex and their synthetic analogues used as medicines. They are broadly categorized into glucocorticoids, which primarily affect metabolism and inflammation, and mineralocorticoids, which regulate electrolyte and fluid balance.

Glucocorticoids exert their effects by binding to the glucocorticoid receptor, altering gene expression to reduce production of inflammatory cytokines, suppress immune cell activity, and stabilize lysosomal membranes. This yields potent anti-inflammatory and immunosuppressive actions. Mineralocorticoids influence renal sodium reabsorption and potassium excretion, affecting blood pressure and fluid balance.

Medically, corticosteroids substitute for deficient hormones (as in Addison disease) and treat a wide range of conditions, including asthma and COPD, allergic and inflammatory diseases, dermatologic disorders, rheumatoid and autoimmune diseases, inflammatory bowel disease, and prevention of transplant rejection. They can be given systemically (oral or intravenous), or locally via inhalation, nasal spray, topical applications, intra-articular injections, or rectal forms.

Common adverse effects from systemic use include hyperglycemia, hypertension, weight gain, osteoporosis, myopathy, mood changes, and increased infection risk. Growth suppression can occur in children; Cushingoid features may develop with prolonged therapy. Long-term use requires tapering to prevent adrenal insufficiency, and caution is advised in patients with diabetes, peptic ulcers, or osteoporosis.

Contraindications include active systemic fungal infections and certain hypersensitivity conditions. Interactions may occur with nonsteroidal anti-inflammatory drugs, oral anticoagulants, and antidiabetic agents, and vaccination responses may be blunted by immunosuppressive doses.