Glucocorticosteroids - what is it? Preparations of glucocorticosteroids: indications, contraindications

Glucocorticosteroids - what is it? The hormones synthesized by the adrenal cortex, as well as a group of synthetic drugs with great potential in therapy, bear this name. In everyday life they are defined as steroids. The possibility of topical application of these hormones significantly reduced the risk of common side effects. Synthetic glucocorticosteroids inhibit the development of the inflammatory process in the body.

Types of glucocorticosteroids

Glucocorticoids, such as cortisol, cortisone and corticosterone, are natural steroid hormones from the adrenal cortex. Their main production is carried out in accordance with the daily rhythm. A greater amount is allocated with an increased need of the organism in these hormones. They arise from progesterone in the bundle and reticular layer of the adrenal cortex. The blood is transported through transcortin. Glucocorticoids act through intracellular receptors. They affect the metabolism of carbohydrates, proteins and fats. These hormones also inhibit inflammatory processes, therefore they are called anti-inflammatory steroids. They are necessary for overcoming severe stressful situations in the human body.

Synthetic types of hormones

Synthetic glucocorticosteroids - what is it? As therapeutic agents, glucocorticosteroids (corticosteroids) are used, called steroids in common parlance. They have a greater anti-inflammatory effect than natural compounds.

In pharmacological therapy - mainly as anti-inflammatory drugs, less often - as an antiallergic or immunosuppressive drug glucocorticosteroids are used. Their use in therapy is widespread with insufficiency of the adrenal cortex. Their main action consists in inhibition of inflammatory reactions, i.e., in blocking phospholipase A ₂ , which leads to a decrease in the production of inflammatory mediators.

As a rule, standard doses of the drug are used in hormone therapy, which does not cause serious side effects. It is best to take these medicines in the same dosage and according to the physiological rhythm of the secretion of cortisol in the body, that is, in the morning. Glucocorticosteroid therapy includes a gradual reduction in the dose of hormones administered at the last stage of treatment (for avoiding the adrenal cortex atrophy).

Steroids can be used orally, and in acute conditions (in the presence of a life threat) - in the form of injections or infusions intravenously. The use of them should be under control, that is, apply only when there are clearly defined indications, taking into account possible side effects. Doses should be selected individually for each patient, they should be changed depending on the severity of the disease.

Glucocorticosteroids used in dermatology

Hormones of the adrenal cortex have anti-inflammatory, immunosuppressive and antipruritic effect. They are widely used in dermatology for skin diseases. Topical glucocorticosteroids are the drugs that are the most commonly used drugs for the treatment of dermatological diseases. They can be used, in particular, in the treatment of:

• Eczema;
• Dermatitis;
• Erythema.

Ointment with glucocorticosteroids is used in the treatment of psoriasis. Also for the removal of the symptoms of inflammation and itching of the skin, gels, creams, lotions are used. Fluids containing steroid hormones are recommended for use on the scalp. As with continuous treatment, and in rare cases of using steroid agents, the use of weaker drugs (to prevent side effects) is preferable.

Steroids in the treatment of the respiratory system

Hormonal remedies from all the drugs used to treat bronchitis have the strongest effect. After their introduction, the edema of the mucous membrane and the secretion of mucus decrease, the normal epithelium of the bronchi is restored. The introduction of steroids into the body inhibits the late phase of allergies, as well as an increased response of the bronchi. Distinguish:

1. Glucocorticosteroids in the form of inhalational anesthetics. They are the most preferred form of medication for use in the treatment of all forms of bronchial asthma.
2. Glucocorticosteroids, used in the form of systemic infusions into the blood. This species is used only in severe forms of bronchial asthma, when other therapeutic methods do not yield results.
3. Steroids for oral administration can also be used for short-term treatment during periods of exacerbation of the disease.

Steroids in the treatment of rheumatoid diseases

The drugs used in the fight against rheumatism include glucocorticosteroids. What is it, and what drugs are used to treat rheumatism, we will consider in more detail. Rheumatoid disease has limitations in the treatment process. Steroid drugs can only be used for a short period of time. However, they are often used in the fight against fever (during the activation of the disease). Preparations of this group are also used in the treatment of inflammation of the joints of the spine. Glucocorticosteroids with the most frequent use in the treatment of rheumatoid diseases:

• Prednisone, prednisolone, less often - dexamitazone (orally);
• Methylprednisone, betamethasone.

Glucocorticoids and their significance in hematological diseases

Glucocorticosteroids (cortisone, prednisone, prednisolone, dexamethasone) are among the most commonly used immunosuppressive drugs in diseases of the hematopoietic system. In its pathogenesis, inflammatory reactions and autoimmune phenomena are possible. Prednisolone, and in severe cases - methylprednisone, is administered intravenously in the therapy of anemia associated with thrombocytopenia. Steroids can be used with a tendency to bleeding, as they lead to an increase in the number of platelets.

Steroid drugs with insufficiency of the adrenal cortex

In the case of the disease "hypofunction of the adrenal glands," synthetic glucocorticosteroids are used. What is it, what are the symptoms of the disease? It is primarily associated with a decrease in the production of corticoid hormones (Addison's disease). Corticosteroids are used in the treatment of acute or chronic adrenal insufficiency. Of the drugs used - cortisol (or hydrocortisol).

Glucocorticosteroids in allergic reactions

In the treatment of allergic manifestations, glucocorticosteroids are also used. Such treatment can be performed with mild symptoms of seasonal allergic rhinitis, conjunctivitis, as well as with hives or inflammatory reactions associated with insect bites. To prevent the recurrence of anaphylactic reactions , as a rule, hydrocortisone (200 mg intravenously) or prednisolone (20 mg intravenously) is used. And of the most popular medicines taken for a cold caused by an allergy are: flunisolide and fluticasone, which contribute to a faster removal of nasal congestion.

Side effects from the use of steroids

Different reactions arise because of the action on the nervous system and metabolism in the body, when hormones are taken of the adrenal cortex. The risk of side effects increases when the drugs of this group are used for a long time or in large doses. Their type, frequency and severity depend to the greatest extent on the type of preparation.

Of the side effects from the use of corticosteroids can be identified:

• Increased blood glucose (steroids can weaken the action of insulin);
• Increased risk of diabetes;
• Increased risk of developing gastric and duodenal ulcer;
• Osteoporosis and slowing the growth of children;
• Cushing's syndrome;
• Mental disorders (insomnia, mood changes, manic-depressive states, schizophrenia);
• Seizures in patients with epilepsy;
• Adrenal insufficiency;
• hypertension.

Also, the use of glucocorticoid drugs in large doses promotes the development of candidiasis of the oral cavity and nasal sinuses, dry mouth, hoarseness, coughing, bleeding of the mucous membranes.