Corticosteroids

Corticosteroid released from adrenal cortex

Anatomic Position of Adrenal Gland
Anatomically, the adrenal glands are located
in the thoracic abdomen situated 'on' top
of the kidney one on each side,
specifically on their anterosuperior aspect.
In humans, the adrenal glands are found at
the level of the 12th thoracic vertebra.
 Adrenal Gland

Medulla Cortex
Epinephrine Gluco-corticoid
Norepinephrine Minerocorticoid
Sex Hormone

Gluco-corticoid and minerocorticoid together terms as Corticosteroid

Adrenal Medulla Response
:Fear and Flight Condition
-Corticosteroid made in adrenal cortex by cholestrol ,
under the influence of ACTH

-Two main hormones are made

Gluco-corticoids group : Hydrocortisone
Mineralocortcoid group : Aldosteron
-Secretion
Hydrocortisone :10-20mg daily
Aldosteron : 0.125 mg daily
 Effects of:
Gluco-corticoid:
Carbohydrate, Fat and Protien Metabolism

Minerlocorticoid :
Na+,k+ and fluid balance
 1.Minerlaocorticoid Action
- Increase Na+ reabsorption in the kidney
- Increased K+ and H+ excretion
Mechanism of action

Corticosteroid

PENETRATE

Cell Wall
 2. Gluco-corticoids Action
Carbohydrate Deposition of glycogen in Liver
(including bringing glycogen from
tissues)
Fat Lypolysis

Calcium Decreased absorption by intestine

and increased by renal excretion

Water excretion Maitain normal GFR with

aldosteron(by excreting excess water)
CVS Restrict capillary permeablity (leads to
vaso constriction and myocardial
contractility)
CNS Maintain the level of sensory
perception, maintain normal level of
excitability of neuron

Stomach Increase gastric secretion

Blood cells Increase number of RBC,

Platelate,neutrophil.
Decrease number of Lymphocyte,
Eosinophil, Basophil
Inflammation Suppressed by it

Immunological Suppress all types of hyper

sensitization and allergic pheromone
 Pharmacokinetics
- All natural and synthetic corticoids are absorbed
and effective by oral route.

- Hydrocortisone undergoes high first pass effect

- Corticosteroid generally metabolised by liver

 Corticosteroid used in:

2. Repalcement therapy

4. Nonendocrine diseases
 A.Replacement Therapy in
1]. Acute adrenal insufficiency

2]. Chronic adrenal insufficiency (Addision’s

disease)

3]. Congenital adrenal hyperplasia

(adrenogenital syndrome)
 B].For Nonendocrine disease
1. Arthritis
2. Collegen disease
Glomerulo nephritis, nephrotic syndrom, polyartritis nodosa
4. Severe allergic reactions
5. Autoimmune disease
Autohaemolytic anaemia, idiopathic thrombocytopaenic ,active chronic
hepatitis
5. Bronchail asthma
6. Lungs
Aspirational pneumonia,
7. Infective disaese
Tuberculosis , bacterial meningitis,
8. Eye disease
allergic conjunctivitis ,iritis, keratitis,
9. Skin diseases(Eczema)
10. Intestinal disease
Ulcerative disease, Crohn’s disease,chronic inflammatory disease
11. Cerebral oedema
-Malignancy
Lymphatic leukaemia, Hodgkin’s disease

-In organ and skin transplant

-Septic shock

-Hyperthyroidism
 Corticosteroid drugs
Compound Available in Type Indicated in
name market with
name of
Hydrocortisone(co Lycortin-S,Efcorlin Gluco-corticoid Replacement
rtisol) (inj) therapy, status
asthmaiticus,
ulcerative colitis
Prednisolone Deltacortiril,Hosta same Allergies,
cortin, Nucort(tab) inflammation,
autoimmune
disease
Methyleprednisolo Solu-medrol, same Rheumatoid
ne Methylprednisolon arthritis, renal
e(inj) transplant,
ulcerative colitis
Triamcinolone Kenacort,Tricort Pure
glucocorticoid
-
Dexamethosone Decadron, Pure Shock, Cerebral
dexona(tab) Glucocorticoid edema,

Betamethasone Betnesol, same Cerebral oedema

Betacortril,

Desoxycorticoster Docabolin PURE Addision’s

on MINERALOCORT disease
acetate(DOCA) ICOID
Fludrocortisone Fluricot mineralocorticoid Addision’s
disease, adrenal
hyperplasia
Aldosteron - same Low availbility of
drug
 Adverse effects of Corticosteroids
1. Minerlocorticoids
Sodium and water retention,edema,
hypokalemia , Rise in Bp
 2. Glucocorticoids adverse
effects
1. Cushing’s habitus
2. Fragile skin , purple stria
3. Easy bruising, hirsutism
4. Hyperglycaemia(precipitation of diabetes)
5. Muscular weakness
6. Delayed healing,
7. Osteoporosis
8. Glaucoma
9. Growth retardation
10. Foetal abnormilities :Neonatal death, mental
retardation, gestational daibetes (if given pregnant
women)
11. Psychiatric

Mild euphoria, lead to maniac psychosis, mood changes.

12. Suppresion of hypothalmo-pitutary-adrenal axis:

Causes atrophy of adrenal gland leads to withdrawal symptom like

anorexia, ,mailaise, fever, hypotension, weakness
 Contraindication
1. Peptic ulcer
2. Diabetes mellitus
3. Hypertension
4. Viral and fungal infections
5. Osteoporosis
6. Herpes simplex keratitis
7. Psychosis
8. Epilepsy
9. CHF
10. Renal failure