kortikosteroidale

Kortikosteroalele are a class of steroid hormones produced by the adrenal cortex and synthetic analogues used as medicines for their anti-inflammatory and immunosuppressive properties. They are grouped into glucocorticoids, which influence metabolism and immune responses, and mineralocorticoids, which regulate electrolyte and water balance. Common therapeutic glucocorticoids include prednisone/prednisolone, methylprednisolone, dexamethasone, and budesonide or fluticasone for local effects; common mineralocorticoids include fludrocortisone for replacement therapy.

Mechanism: Corticosteroids act by binding to intracellular receptors that alter gene transcription, reducing production of pro-inflammatory mediators and immune cell activity while promoting anti-inflammatory proteins. Mineralocorticoids primarily affect epithelial sodium transport in the kidney.

Medicinal uses: They are employed to treat many inflammatory and autoimmune conditions (asthma and COPD, eczema and psoriasis, rheumatoid arthritis, inflammatory bowel disease), prevent transplant rejection, and replace deficient hormones in adrenal insufficiency. Local forms (inhaled, nasal, topical) are used to limit systemic exposure while targeting specific tissues.

Administration and dosing: Corticosteroids can be given orally, intravenously, intramuscularly, inhaled, topical, or rectal. The lowest effective dose is preferred, and gradual tapering is important when stopping long-term therapy to avoid withdrawal and adrenal suppression.

Adverse effects and safety considerations: Short-term use may cause mood changes, increased appetite, and sleep disturbances; long-term use can lead to osteoporosis, hyperglycemia, weight gain, hypertension, cataracts, skin thinning, poor wound healing, increased infection risk, and growth suppression in children. Caution is needed in diabetes, peptic ulcers, hypertension, or active infection; vaccination and drug interactions should be reviewed.