Corticosteroids

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See also the following individual entries:

Beclomethasone dipropionate Fluticasone propionate Hydrocortisone Hydrocortisone acetate Prednisone

Triamcinolone acetonide Triamcinolone diacetate Action/Kinetics: The hormones of the adrenal gland influence many metabolic pathways and all organ systems and are essential for survival. These processes include carbohydrate metabolism, protein metab olism, fat metabolism), and water and electrolyte balance.

According to their chemical structure and chief physiologic effect, the corticosteroids fall into two subgroups, which have considerable functional overlap. First are those, like cortisone and hydrocortisone, that mainly regulate the metabolic pathways involving protein, carbohydrate, and fat. This group is often referred to as glucocorticoids. In the second group are those, like aldoste-rone and desoxycorticosterone, that are more specifically involved in electrolyte and water balance. These are often referred to as mineralocor-ticoids. Hormones, such as cortisone and hydrocortisone, although classified as glucocorticoids, possess significant mineralocorticoid activity. Therapeutically, a distinction must be made between physiologic doses used for replacement therapy and pharmacologic doses used to treat inflammatory and other disease states.

The hormones also have a marked anti-inflammatory effect and immunosuppresant effects. Uses

1. Replacement therapy. Acute and chronic adrenal insufficiency, including Addison's disease. For replacement therapy, drugs must possess both glucocorticoid and mine-ralocorticoid effects.

2. Rheumatic disorders, including rheumatoid arthritis (including juveniles), other types of arthritis, ankylos-ing spondylitis, acute and subacute bursitis.

3. Collagen diseases, including SLE.

4. Allergic diseases, including control of severe allergic conditions as serum sickness, drug hypersensitivity reactions, anaphylaxis.

5. Respiratory diseases, including prophylaxis and treatment of bronchial asthma (and status asthmaticus), seasonal or perennial rhinitis.

6. Ocular diseases, including se vere acute and chronic allergic and inflammatory conditions.

7. Dermatologic diseases, including angioedema or urticaria, contact dermatitis, atopic dermatitis, severe erythema multiforme (Stevens-Johnson syndrome).

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