Corticosteroids - Corticosteroids Side Effects And Work Mechanism Of Corticosteroids

Corticosteroids - Corticosteroids Side Effects And Work Mechanism Of Corticosteroids

9 The Effects Of Corticosteroids

1. corticosteroids play a role in the metabolism of carbohydrates, fats, proteins, nucleic acids, fluids and electrolytes, as well as bones and calcium.

2. corticosteroids required to maintain numerous physiological functions such as blood pressure and volume, muscle function, blood sugar, and glycogen he-par, corticosteroid increases protein synthesis and decrease degradation in many tissues. in addition corticosteroid lose trans-for glucose into the cells and peripheral glucose consumption increases.

3. another effect of corticosteroids is a bitter taste and immunosuppression. 

4. corticosteroids work simultaneously on different inflammatory process in cascade, i.e. production, deployment, and activation of effect or function.

5. against the production of and function's especially IgG, IgA, and IgE, corticosteroids have the effect of suppression that occur a maximum of 2-4 granting and pasca week back after corticosteroid stopped. production and loses the histamine on cells and basophils mask is also inhibited by corticosteroid.

6. this hormone also worked on many stages with final effect reduces inflammatory symptoms, signs and local damage by inflammatory. nitric oxide is inhibited so that products with decreased this compound will reduce edema joint with erythema and inflammation.

7. against leukocytes, corticosteroids able to change cells in the circulation of traffic. corticosteroid injection at once in intravenous, the number of sudden neutrofit rise while other cells such as lymphocytes, monocytes, eosinophils and basophils thus decreased. a decrease in lymphocytes due to redistribution of lymphoid tissues and cells to the bone marrow.

8. corticosteroids decrease the number of cells in the circulation, reduce migration to the network, and reduces inflammatory cell response against various cytokines.

9. other effects of carticosteroid is inhibiting activity and lymphocytes polyester, platelet aggregation, and arakidonat acid metabolism and vascular endothelial fibroblast.

The Working Mechanism Of Corticosteroids

after in absorption, corticosteroids across a cell membrane receptors, tied to specific targets in the cytoplasm and forming a complex of corticosteroid receptors. the complex is in translation to the nucleus to be bound GCRE (Glucocortikoid Response Element) specific in chromatic. this incident raises the transcription of DNA that from new proteins.

corticosteroid receptors found in many types of cells such as lymphocytes, mocytes, macrophages, osteoblast, the cells of the liver, muscle, fat and fibroblast, this explains why carticosteroid gives biological effects against so many cells.

5 Corticosteroids Side Effects

1. corticosteroid can cause various side effects complex that many doctors fear giving corticosteroids and settled : increasing disturbance of emotion, impaired wound healing, increased risk of infection, hiperurikaria, catabolism protein increases.

2. at high cumulative dosing : posterior capsule cataracts, osteoporosis, otropu skin, impaired growth (child), ateroskerosis.

3. exacerbation due to therapy with corticosteroids (depending on dose) : glucose intolerance, hypertension, peptic ulcers, acne vulgarism. 

4. sometimes a dose sometime dependent : necrotizing myopathy, avaskular, fat on heart.

5. rarely seen, unpredictable : psychosis, pancreatitis, lypomatosis, glucoma, pseudotimor serebri, allergy corticosteroid.

3 General Principles The Use Of Corticosteroids

1. in granting a systemic corticosteroids to note several phases of treatment, i.e. induction, consolidation, tapering off, and a dose of the treatment.

2. on the induction phase, to stop inflammatory given the initial dose of 1 mg per kg/day, divided into 3 times a day. in case the repair is referred to as a phase of consolidation, the dose can be made into a single morning dose.

3. if the improvements persist or symptoms disappear, further reduced dose (tapering off), when possible. some doctors do not tapering off, but with the sudden stop can cause inflammatory back so that doses should begin again as begin. the use of less than a week need not be tapering off.

for less than a month, dosage needs to be lowered more slowly, for example 2.5 mg 2-3 every week when you've reached the 7 mg, a decline much smaller, for example 1 mg 2-3 every week.

in some cases, corticosteroids may not be stopped because it will cause in advice to recurrence, then give the dose treatments, namely the effective doses as small as possible, one time every morning.

Separate Substances Corticosteroids :

1. Corticotropin 

pituitary hormone was obtained from pigs and is polypeptide with a 39 amino acids, because it is broken down by proteolytic enzymes then this remedy was used only in the form of injection.

Corticotropin Usage

in ancient times corticotropin used on non-specific therapy in lieu of prednison (asthma, etc.) because of the lack of risk of osteoporosis and muscle atropia, but because of serious side effects is now only used to determine the function of the cortex the adrenals, for example when the alleged presence of addison's disease.

Dose : as a diagnostic corticotropin granting sc 4 x 10 UI

2. Desocsicorton 

this natural mineral corticosteroid been created synthetically in 1937, mainly used on adrenal insufficiency such as in addison's disease which has a sign : missing energy, fatigued, weak muscles, generally used with hydrocortisone 

Use Of Desocsicorton

the use of desocsicorton can sublingual or parental, due to low bio avaliable per oral due to be resorption less well.

Dose : sublingual : 4-10 mg a day.

IM : 25 mg every week 2-3

3. Hydrocortisone

effects of hydrocortisone primarily on carbohydrate metabolism, protein and fat, as well as very mild mineral metabolism and against water. resorption in the gut are less well, then used as an injection (im and intra articular) also locally (ointment or cream)

The Usage Of Hydrocortisone

the use of hydrocortisone is locally used in creams (1-2% acetate), also in eye drops (1%)

Dose :

IM/iv : 100-300 mg aqueous solution

rectal : 2x a day 25 mg (hemorrhoids).

4. Prednisolone

synthetic substances is 5 times stronger than cortisol with the mineral corticosteroid effect of the lighter regarding the properties, then the prednisolone and perdnison is regarded as gluecorticotiroids first choice for systematic therapy.

Dosage :

oral : 5-60 mg a day morning, lowered 5-10 mg per day

IM or iv : 25-75 mg a day

A Derivative Prednisolone

1. prednison
2. metilprednisolon
3. budisonida 

5. Medrison

have this corticosteron has the effect of glucocorticois similar to cortisol. especially used in eye drop 1%, at an inflammation of mucous membranes and membrane.

fluormetolon is to have power anti inflammatory with fluorine-30 times more powerful, also rarely cause increased pressure intra ocular, especially used in eye drops 0,1%.

6. The Flucorticoida

a derivative prednisolone has power glucocorticoid 6-7 time more powerful than prednisolone, while power the mineral corticoid vanished altogether.

Use Of Flucorticoida

local : widely used in ointments, because it is more potent than hydrocortisone

The Flucorticoida :

1. betametasone
2. dexametasone 
3. fluocortolon
4. fluosinolon
5. parametason
6. triamsinolon.

Share this post