glucocorticoide

Glucocorticoide (glucocorticoids) are a class of corticosteroids produced by the adrenal cortex and used clinically to reduce inflammation and modulate immune responses. They act by binding to the glucocorticoid receptor, altering gene transcription and suppressing inflammatory mediators. Endogenous glucocorticoids include cortisol; synthetic glucocorticoids vary in potency, duration of action, and mineralocorticoid activity.

Common synthetic agents include prednisone/prednisolone, methylprednisolone, dexamethasone, betamethasone, and hydrocortisone. They differ in anti-inflammatory strength and mineralocorticoid effects, which influence fluid and electrolyte balance. Some agents (eg, dexamethasone) have minimal mineralocorticoid activity, while others have more pronounced effects.

They are used for a wide range of conditions: acute and chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease; dermatologic disorders; asthma and COPD; allergic reactions; autoimmune diseases; prevention of organ transplant rejection; and certain cancers.

Adverse effects associated with systemic use include hyperglycemia, hypertension, edema, osteoporosis, myopathy, skin thinning, increased susceptibility to infection, peptic ulcers, and mood or behavior changes. Long-term therapy can suppress the hypothalamic-pituitary-adrenal axis, requiring gradual tapering to avoid adrenal crisis. Growth suppression in children and Cushing-like body changes may occur with prolonged use.

Safety considerations include using the lowest effective dose for the shortest feasible duration, monitoring for metabolic and infectious complications, and careful tapering on discontinuation. Pregnancy, vaccination status, and interactions with NSAIDs, anticoagulants, and drugs affecting glucose or bone health should be considered.