Corticosteroids - drugs for the treatment of inflammatory diseases. They have powerful anti-inflammatory and anti-swelling effect, quickly relieve the patient from pain and fever. By its action the funds more effectively than their non-hormonal analogues - NSAIDs but have a number of side effects.
The content of the article:
- 1 What are corticosteroids? drugs function
- 2 The principle of operation of resources
- 3.1 weak
- 3.2 moderate
- 3.3 Strong
- 3.4 very strong
- 4 synthetic corticosteroids
- 5 hormonal corticosteroids
- 6 Local and systemic corticosteroids
- 7 Indications for admission
- 8 Contraindications
- 9 Possible side reactions
- 10 Form release agents
- 11 Types of corticosteroid therapy
- 12 List of effective nasal drops, corticosteroids
- 13 Table top ointments
- 14 Inhalants
- 15 Formulations for oral administration
- 16 The duration of the therapeutic course
- 17 Precautions for treatment with corticosteroids
- 18 Video of corticosteroids
What are corticosteroids? drugs function
Corticosteroids - a kind of hormones that are produced in the human body. The name they received because of the chemical structure (in their development plays an important role cholesterol) and place production (adrenal cortex). Another name for this group of hormones - glucocorticoids.
Their function in the body are manifold - the regulation of the activity of the immune system, maintain the level of glucose in the blood, increasing the adaptive capacities of the organism. In medicine they have been applied due to its anti-inflammatory and immunosuppressive effect.
They are appointed for a quick suppression of inflammatory reactions, including chronic kidney disease. Another area of application - complex therapy of autoimmune conditions, allergic reactions and antitumor treatment. The effect of increasing blood sugar is not used, but it has to be taken into account by assigning treatment.
The principle of operation of resources
The mechanism of action of drugs is based on interference in the biochemical basis of the inflammatory response. Drugs slow down the synthesis of phospholipase - an enzyme without which the inflammatory response is not possible. This makes them the most effective means against any group of inflammations, including allergic.
This same enzyme (phospholipase) is involved in a number of immune reactions and the formation of immune cells. Therefore, its synthesis slowdown results in a decrease of immunity and normalization condition in autoimmune aggression.
Corticosteroids are produced in the human body is normal. Their number is constantly fluctuating depending on the actual needs of the organism. Development of corticosteroid hormones regulated by the pituitary gland. When the doctor prescribes medication with corticosteroids, it has to take into account the natural level of these hormones in the patient.
Formulations that contain corticosteroids, are classified according to multiple features. Primarily secrete natural and synthetic hormones, i.e. isolated from animal tissues, similar in structure to the human and synthetic having desired properties.
In strength to emit a strong, very strong, medium and weak corticosteroids.
The need for administration to a patient of weak steroid constantly the subject of controversy among specialists - some believe that these drugs are best to replace NSAIDs.
By applying the method allocates system, i.e. applicable for the integrated exposure (oral and injectable drugs), as well as local (ointments and solutions) inhaled and that is administered via a nebulizer or as spray.
Classification of potency is mainly used in dermatology. It is important to determine the intensity of the impact of drugs on the affected area. Weak drugs include hydrocortisone and compounds.
Hydrocortisone demonstrates modest local effect and is used for the treatment of uncomplicated skin inflammations, in the form of eye drops and ear to combat inflammatory phenomena. Inside appointed rare. Most hydrocortisone active compounds are absorbed when applied topically, which creates the risk of unwanted side effects.
To get rid of them, use hydrocortisone butyrate - a compound is not absorbed into the blood from the skin and mucous membranes.
Corticosteroids - are drugs that are used for various purposes. Classification by force action taken mainly for topical preparations - ointments, creams and lotions.
The destination moderation corticosteroids - anti-inflammatory exacerbations of skin diseases (except fungi). For drugs of moderate strength are prednisolone and fluocortolone under various trade names. This is the most commonly used tools.
Strengths drugs include betamethasone, halometasone, Mometozon and Dexamethasone.
They have potent local anti-inflammatory action and are used when expressed allergic reactions, atopic dermatitis, bacterial inflammation. These ointments can be used only on prescription.
These preparations are struggling with such dangerous conditions as the exfoliative dermatitis, Lyell syndrome, etc. They are only used as part of combination therapy as a pathogenic agent (ie, violates the pathological process, but does not affect the cause of the disease). This group includes Clobetasol and halcinonide. Most often they are used in the hospital.
Formulations corticosteroid group divided by origin in natural and synthetic. The advantage of synthetic corticosteroids is that they are created in the laboratory. This makes their production simpler and cheaper, and therefore, drugs are available to the public.
Another, more important advantage - these drugs are created with predetermined properties. Synthetic drugs have fewer side effects than the natural hormones.
As can be seen from the list of most used drugs glucocorticoid series - synthetic.
This is due to the fact that they are cheaper and safer natural remedies. On the effectiveness they are only slightly inferior to the natural hormones, and situations in which this difference is critical, is extremely small.
Corticosteroids - a hormone drugs, so they all refer to the hormone drugs. This is due to their broad spectrum of activity and severity of side effects - effects of hormones always versatile.
Natural corticosteroids were the first in their group, which man has learned to use. Now natural hormones used cortisone and hydrocortisone. Their duration is very short - 2-3 hours, but the efficiency is slightly higher than that of synthetic hormones. Together with the above it and severity of side effects.
Drugs in this group are used in cases where important fast and powerful the effect and side reactions can be neglected, i.e. in extreme cases, when the patient's condition is very heavy, and there are threat to life. For continuous use, this group is not suitable.
Local and systemic corticosteroids
The division into local and systemic based on what effect longer needed in this situation. Systemic corticosteroids taken orally in tablets or intravenously. These drugs are administered for severe systemic pathologies - autoimmune responses, systemic inflammation, skin lesions widespread.
Appointment of systemic corticosteroids is always associated with the risk of side effects, so your doctor prescribes them only in those cases where a serious interference in the functioning of the organism.
The patient should be warned about the side effects and know how to reduce them. Also, systemic medications are used in states of emergency threatening the life of the patient - status asthmaticus, anaphylactic shock, sepsis, shock.
topical drugs have their effects are strictly in the field of application. They are used in the form of ointments and creams to combat skin lesions, as well as by inhalation for the treatment of bronchial asthma and other respiratory tract lesions. Local SCS system may be combined with or used as an independent element of treatment.
Indications for admission
Corticosteroids - are drugs with a broad list of indications for reception from minor to life-threatening.
Full list of indications for the use of SCS:
- chronic skin diseases accompanied by itch (ointments, systemic corticosteroids);
- acute inflammatory diseases of the skin (ointments);
- bronchial asthma (IGCC);
- allergic rhinitis (nasal drops);
- vasomotor rhinitis (nasal drops);
- chronic connective tissue disease (tablets);
- glomerulonephritis (tablets);
- autoimmune diseases (tablets);
- hormones adrenal insufficiency (tablets, injections);
- shock states, including anaphylactic shock (injection).
These drugs are used strictly on prescription, especially for system tools. Must be strictly observed Hour schedule - the effectiveness of this treatment depends.
Since hormonal agents have a significant impact on the body, their use should be carried out very carefully. The most effective drugs in this group are sold strictly on prescription.
When you can not use SCS:
- hyperfunction of the adrenal glands (the excess of its own GCS);
- diabetes (GCS raise blood sugar);
- mycosis, severe suppurative lesions, tuberculosis (GCS reduce immunity, stimulate the development of infection);
- immunodeficiency of any origin;
- high blood pressure (kgf raise him even more);
- clotting disorders (GCS increased tendency to thrombosis);
- glaucoma, corneal lesions (increase in intraocular pressure);
- digestive system diseases (impaired production of protective substances in the gastric mucosa);
- pregnancy, lactation (all the side effects of corticosteroids bad for the child).
Possible side reactions
Drugs in this group have a number of side effects, which are derived from their biological functions. Do cortisone and hydrocortisone are more pronounced in the synthetic hormones - is weaker.
GCS cause breakdown of glycogen and an increase in blood sugar levels. Normally, it is necessary to maintain blood glucose at a constant level, but the treatment of this side effect. Because of this, patients need to follow a diet, avoid fast carbohydrates.
Renal vasoconstriction, which causes rise in blood pressure. Normally - is part of the pressure regulation mechanism, during treatment - a dangerous side effect.
Effect on thrombosis. GCS regulate the coagulation system, but in cases where the tendency to thrombosis is increased, it is dangerous.
Cushing's syndrome. It is a condition that occurs when excess KGS. This changes the distribution of adipose tissue, the face is round and red, there is a "bull neck", while the limbs are disproportionately thin. Decreased immunity, which entails exposure to different diseases.
Form release agents
Corticosteroids are available in a variety of dosage forms. These are preparations for topical and systemic use.
They are available in the following dosage forms:
- solution for inhalation;
- powder for inhalation;
- nasal drops;
- solutions for intravenous injection.
Types of corticosteroid therapy
Depending on what goals the doctor by assigning GCS, identify several types of therapy with these drugs:
- substitution appointed by the shortage of own glucocorticosteroids. In this case, using natural hormones, their technique simulates the daily activity of the adrenal glands. Doses are selected individually, the criterion is the patient's well-being, normal blood sugar level, blood pressure, renal filtration.
- blocking used to suppress excessive secretion of hormones. The dosage and type of medication also selected individually. Performance indicator - the normalization of hormonal levels, good state of health of the patient.
- pharmacodynamic - a majority of the indications for Admission GCS. This uses their immunosuppressive or anti-inflammatory effect as well as a combination thereof. Dosage is selected, based on the patient's condition.
List of effective nasal drops, corticosteroids
Nasal drops with corticosteroids used for treatment of allergic and vasomotor rhinitis, rhinitis unclear etiology, nasal polyposis, inflammatory processes in the paranasal sinuses, if they have not purulent or fungal nature.
Trading names of drugs with corticosteroids:
In the composition of droplets used beclomethasone and mometasone, at least - and flunizalid flitkazon as independent agents or in combination with other drugs - antibiotics, antiviral agents. The drops are administered into each nostril 1-2 drops, the frequency of administration depends on the disease. Preparations with corticosteroids should not be taken for more than 2 consecutive weeks in order to avoid side effects.
Table top ointments
Ointment with corticosteroids - the most common dosage form of corticosteroids. They are prescribed for chronic skin diseases and acute inflammatory lesions.
|Title||testimony||Holiday from drugstores|
|dexamethasone||It is used for removal of pruritus, in the form of an eye ointment - for the treatment of conjunctivitis and corneal lesions||Without recipe|
|Glametazon||Atopic dermatitis, psoriasis, atopic dermatitis, eczema, seborrhea, ichthyosis||On prescription|
|Mazipredon||Chemical and thermal burns, severe allergic reaction on the skin, dermatitis ekfoliativny||On prescription|
|Polkortilon||Eczema, simple and Pink zoster, neurodermatitis, psoriasis, granuloma annulare, alopecia, keloid scars||Without recipe|
|methylprednisolone aceponate||Acute skin diseases accompanied by itching, burning, chemical skin lesions, severe manifestations of dermatitis||On prescription|
Corticosteroids - a drug for the treatment of bronchial asthma. They are used in combination therapy for the prevention of attacks. The destination - the stabilization of cell membranes. As a result, no longer secrete substances that provoke bronchospasm and response to the allergen is reduced. The patient may for a long time without seizures.
Features of the application of corticosteroids is that they are appointed strictly on time. They are unable to stop the attack, and they can not be used during an attack. They are used to prevent attacks.
The most effective drug - beclomethasone. Also using flunisolide, budesonide and fluticasone. The drugs used in the complex therapy. Basic methods of use - as a powder to a spacer or nebulizer solution. After inhalation of inhaled corticosteroids should be carefully rinse your mouth to avoid the development of fungal diseases.
Formulations for oral administration
Oral corticosteroids reception is prescribed for severe pathologies of the immune system - allergic diseases, autoimmune conditions, diseases of the joints and connective tissue. The list is big enough, it includes dexamethasone, prednisolone, fluticasone under various trade names.
Oral corticosteroids be appointed in the complex therapy. Dosage is adjusted individually. The first dose - the smallest possible, then it is increased if necessary. If the patient has significant side effects, your doctor will decide whether you need to reduce the dose, or appoint additional drugs that facilitate the patient's condition.
Medications prescribed courses, course duration determined by the physician depending on the patient's condition. The criterion of effectiveness - clinical improvement and reduced severity of complaints. Complete cure disease occurs infrequently.
The duration of the therapeutic course
corticosteroids cumulative effect, ie, it appears through any time of the regular reception, and held for a time after the course. Therefore, it is impossible to get from the GCS instant therapeutic effects and dosage always chosen the least.
The minimum duration of the course - week continuous use of the drug, the maximum - up to a month. More precise timing may indicate the doctor on the basis of survey data, Evaluation of the patient's state of health, as well as the results of therapy.
To obtain results, it is important to observe while taking drugs. The daily dose and the interval between receptions is calculated from the order to maintain the required dose the drug in the blood during the day, but the patient should be easy to comply with the interval between receptions the drug.
Precautions for treatment with corticosteroids
To avoid unwanted effects of GCS reception, you must follow the rules of admission drug:
- examination before appointment - if there are contraindications to take medicine can not be;
- strict adherence to dosage and time of reception;
- careful monitoring of their condition, when it is necessary to address the deterioration of the doctor;
- if necessary - receiving immunostimulatory agents;
- measures to maintain normal immune system - fresh air, balanced diet, physical activity;
- using inhalants - rinse the mouth after each procedure.
Corticosteroids are used to deal with a variety of pathologies. Are drugs that are effective both in pruritic dermatitis, and in life-threatening conditions.
Registration of the article: Lozinski Oleg
Video of corticosteroids
What are drugs and corticosteroids, which are: