Corticosteroids

• Adrenal Cortex produces glucocorticoid and mineralocorticoids.They both are termed as corticosteroids.
• Produced from cholesterol
• At the time of stress,adrenaline is released directly from adrenal medulla.At the same time stress and adrenaline also stimulate higher centers, hypothalamus and anterior pituitary to releases releasing factors,which acts on adrenal cortex provoking the production of coticosteroids.Its must to understand that adrenaline manage stress for short time,where as corticosteroids manage it for longer terms.
• Glucocorticoid increases blood glucose level
• Also causes protein break down, muscle wasting is seen
• Glucocorticoid increases myocardial contractility,maintain tone of arterioles and restrict membrane permeability.They have permissive effect on pressor action of adrenaline and angiotensin.In a cyclic manner glucocorticoid stimulates kidney to release angiotensin & this angiotensin acts on adrenal cortex to release coticosteroids.Angiotensin causes sodium retention and has a vasopressor action.
• Inflammatory Responses-Causes reduction of:capillary permeability,local exudation,cellular infiltration,phagocytic activity,scar formation and healing.Cardinal signs of inflammation are suppressed.
• Corticosteroids favour spread of infections as capacity of defensive cells to kill microorganisms is impaired.
• Coticosteroids suppress all types of allergic and hypersensitivity reactions.
• Steroids are powerful drugs.They can be life saving and at the same time they can be life threatening

1. Single dose is not harmful.can be used in mortal crisis
2. Short courses of heavy doses are not harmful,in the absence of contraindications
3. Don't withdraw immediately,can lead to adrenal insufficiency
4. In cases where fast action is needed like that in case of anaphylactic shock adrenaline must be preferred over steroids as they take 1 to 2 hours to show the effect.
5. If they are used in cases of high infectivity than it should be administered only when proper antibiotic coverage has been maintained.

• Should be cautiously used in cases of hypertension and Cardiac disorders.
• Dexamethasone- Anti inflammatory & allergic dose 0.5-5 mg/day oral

                                     Shock 4-20 mg/day i.v/i.m 

                                     Brand name-Dexona 0.5 mg tab, 4 mg/ml for i.v. i.m. inj.

• Betamethasone- Dose 0.5-5 mg/day oral

                                             4-20 mg/day i.v/i.m for inj.

                                    Brand name-Betnesol

• Prednisolone- Dose 5-60 mg/day oral

                                        10-40 mg i.m/i.v