Facts about Corticosteroids

What are Corticosteroids?

Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiological systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Corticosteriods are also synthesized pharmaceutically by various methods of synthesis. Corticosteroids are classified in various groups and classes depending upon their potency, chemical structure and also by rout of administration of the drug such as Topical, inhaled, oral and injectable means.

Uses of Cortisone:

Synthetic pharmaceutical drugs with corticosteroid are used in a variety of conditions, ranging from brain tumors to skin diseases, enhancing the potency of certain medication, to bring sudden relief. Corticosteroids like Dexamethasone and its derivatives are almost pure glucocorticoids; drug like prednisone and its derivatives have some mineralocorticoid action in addition to the glucocorticoid effect. Fludrocortisone (Florinef) is a synthetic mineralocorticoid. Hydrocortisone (cortisol) is available for replacement therapy, e.g. in adrenal insufficiency and congenital adrenal hyperplasia.

Synthetic glucocorticoids are widely used in the treatment of joint pain or inflammation (arthritis), temporal arteritis, dermatitis, allergic reactions, asthma, hepatitis, systemic lupus erythematosus, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), sarcoidosis and for glucocorticoid replacement in Addison’s disease or other forms of adrenal insufficiency. Topical formulations are also available for the skin, eyes (uveitis), lungs (asthma), nose (rhinitis), and bowels. Corticosteroids are also used supportively to prevent nausea, often in combination with 5-HT3 antagonists (e.g. ondansetron).

Damage caused by Cortisone:

For several years since its discovery, it was considered to be the boon medication and even doctors did not realize the extent of the side effects until the past decade or so. Many sports specialists now say they administer only two or three cortisone shots per year in a joint and only as a last resort when rest, ice and other pain relievers fail to contain suffering. “Cortisone is one of the most powerful anti-inflammatory that can be given to humans,” said Dr. Michael Reilly, a Fort Lauderdale surgeon who was a team doctor for the U.S. Olympic swimming team. Long-term misuse of the man-made steroid can cause extensive damage throughout the body, leading to extensive and severely torn tendons, infections, dead bones in joints and high blood pressure. A syringe of cortisone can quickly silence the screaming joints of an injured athlete though it offers a big short-term relief, while risking the future.

Cortisone was introduced in 1949, a synthetic version of the hormone cortisol that is made out of cholesterol by the adrenal glands. The body cannot survive without cortisol, as cortisol helps maintain the blood pressure and kidney function and plays a vital part in injuries by regulating swelling and pain. During stress, cortisol boosts glucose to help the body cope with the abnormality.

Sports embraced cortisone as a way to delay the effects of injuries that sideline players. It suppresses antibodies and other defender cells that combat injury by causing swelling and pain. The shots can last for a few hours to a few weeks. Some dangers of cortisone were obvious. Specialists say, by masking injuries, players stretch beyond their limits and may get injured further and hurt worse. Also, reducing antibodies risks infection in the injured area. Later studies found more problems. Repeated cortisone shots can weaken “crosslinks,” chemicals that bind the parallel fibers in a tendon, making the tendon more likely to rupture, and resulting in a tear. Cholesterol-based cortisone also leaves fatty deposits in blood vessels. In areas with tight circulation, such as the ball joints of the hip and shoulder, reduced blood flow can kill the bone and force the need to implant artificial joints.

Side effects of Corticosteroids:

Various clinical and experimental evidences indicate that extensive and long term use of corticosteroids has several severe side effects which result in certain drug related abnormalities and diseases such as hyperglycemia, insulin resistance, diabetes mellitus, osteoporosis, anxiety, depression, gastritis, colitis, hypertension, ictus, erectile dysfunction, hypogonadism, hypothyroidism, amenorrhoea, also can cause permanent eye damage by inducing central serous retinopathy. Typical undesired effects of glucocorticoids present quite uniformly as drug-induced Cushing’s syndrome. Typical mineralocorticoid side effects are hypertension (abnormally high blood pressure), hypokalemia (low potassium levels in the blood), hypernatremia (high sodium levels in the blood) without causing peripheral edema, metabolic alkalosis and connective tissue weakness, There may also be impaired wound healing or ulcer formation because of the immunosuppressive effects.

It is advisable to refrain form continuously consuming medications using the same doctor’s prescription for a long period of time. Consult the doctor at regular intervals or as advised by the medical practitioner.

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