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Corticosteroids: Classification, Mechanism, and Uses
1. Oral Corticosteroids
- Examples: Prednisolone, Dexamethasone, Methylprednisolone
- Mechanism of Action: Inhibit inflammation by binding to glucocorticoid receptors and modulating gene transcription.
- Therapeutic Uses:
- Acute inflammation (e.g., rheumatoid arthritis)
- Chronic inflammatory diseases (e.g., asthma, COPD)
- Allergic conditions (e.g., allergic rhinitis, eczema)
- Organ transplantation
- Adverse Effects:
- Weight gain, fluid retention
- Hyperglycemia
- Osteoporosis with prolonged use
- Cataracts and glaucoma
- Gastrointestinal ulcers
- Contraindications:
- Active infections (e.g., tuberculosis, fungal infections)
- Severe hypertension
- Peptic ulcer disease
2. Parenteral Corticosteroids
- Examples: Hydrocortisone (IV), Methylprednisolone (IV), Dexamethasone (IV)
- Mechanism of Action: Rapid anti-inflammatory action through binding to glucocorticoid receptors and modulating gene transcription.
- Therapeutic Uses:
- Acute exacerbations of autoimmune diseases
- Severe asthma attacks
- Shock and adrenal insufficiency
- Anaphylaxis and severe allergic reactions
- Adverse Effects:
- Increased risk of infection
- Hyperglycemia
- Cardiovascular issues
- Gastrointestinal disturbances
- Contraindications:
- Active infections
- Uncontrolled hypertension
3. Inhaled Corticosteroids
- Examples: Beclometasone, Fluticasone, Budesonide
- Mechanism of Action: Acts locally on the airways to reduce inflammation and inhibit inflammatory cell activation.
- Therapeutic Uses:
- Chronic asthma
- Chronic obstructive pulmonary disease (COPD)
- Allergic rhinitis
- Adverse Effects:
- Oral thrush
- Hoarseness
- Coughing and throat irritation
- Growth retardation in children (with prolonged use)
- Contraindications:
- Hypersensitivity to corticosteroids
- Active respiratory infections
4. Topical Corticosteroids
- Examples: Hydrocortisone, Betamethasone, Clobetasol
- Mechanism of Action: Reduces inflammation by binding to glucocorticoid receptors in the skin, inhibiting inflammatory cytokines and reducing vasodilation.
- Therapeutic Uses:
- Dermatological conditions (e.g., eczema, psoriasis, contact dermatitis)
- Inflammatory skin disorders
- Adverse Effects:
- Skin thinning (atrophy)
- Striae (stretch marks)
- Systemic absorption and Cushing’s syndrome
- Contact dermatitis
- Contraindications:
- Skin infections
- Active acne or rosacea
- Perioral dermatitis