![GI system
Increased appetite
Peptic ulcers and gastrointestinal hemorrhage
CNS and psyche
Mood disorders
Cognitive disorders
Psychosis
Eyes
Cataract
Glaucoma
Other
Adrenocortical atrophy
Acute adrenal insufficiency
Avascular bone necrosis [17]
Glucocorticoid-induced osteoporosis, osteopenia
Immunosuppression](https://image.slidesharecdn.com/steroids-221111145935-e8383baa/85/Steroids-pptx-13-320.jpg)
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Steroids .pptx
- 1. By : Sabir Abdulrahman Steroids (H.C, prednisolone, methyl prednisolone, dexamethasone ) UOD - college of medicine
- 2. Glucocorticoids are predominantly involved in metabolism and have immunosuppressive, anti-inflammatory, and vasoconstrictive effects. Adrenal gland Corticosteroids
- 3. Mechanism of action Anti-inflammatory and immunosuppressive Acute effects (within minutes) Vasodilation and capillary permeability Leukocyte migration to inflammatory foci Long-term effects (within hours) : Glucocorticoids bind to cytoplasmic glucocorticoid receptors (GRs) Inhibition of neutrophil apoptosis and demargination neutrophilic leukocytosis Inhibition of phospholipase A2, production of leukotrienes and prostaglandins Suppression of B cells and T cells (T cell apoptosis) Inhibition of histamine release from mast cells
- 4. Mechanism of action Mineralocorticoid properties Cortisol can bind to mineralocorticoid receptors at high concentrations . Effects include, e.g., reduced sodium excretion, increased potassium excretion Anti proliferative: triggers cell apoptosis, and inhibits fibroblast proliferation . Anabolic-androgenic effects with steroid abuse : increase in muscle mass and strength .
- 5. Replacement therapy Adrenocortical insufficiency Systemic symptomatic treatment Allergic reactions and anaphylactic shock Asthma Acute exacerbation of COPD Thyroid storm: Rheumatic diseases (e.g., sarcoidosis, Sjogren syndrome) Malignancy (e.g., CLL, non-Hodgkin lymphoma) Local symptomatic treatment: anterior uveitis, dermatoses, Prophylactic :Organ transplant Preterm delivery: Glucocorticoids are given to the mother prenatally to induce fetal lung maturity. Indications
- 6. Hydrocortisone Inflammation Status asthmatics Congenital adrenal hyperplasia Palliative management of acute leukemia Drug hypersensitivity reaction Congenital hypo- plastic anemia Hydrocortisone is the synthetic equivalent of endogenous cortisol and its glucocorticoid and mineralocorticoid potency is considered to be 1
- 7. Inflammation Acute asthma Nephrotic syndrome Prednisolone Prednisolone is one of the most commonly used glucocorticoids
- 8. Croup Inflammation Meningitis Spinal cord compression Dexamethasone Cerebral edema associated brain tumor Dexamethasone is a potent glucocorticoid with very little, if any, mineralocorticoid activity.
- 9. Inflammation Status asthmatics Pneumocystis jiroveci pneumonia in AIDS Severe lupus nephritis Methylprednisolone Methylprednisolone is a systemic synthetic corticosteroid, which, just as the naturally occurring gluco
- 10. Duration of action Drug Common route of administration Short acting (8- 12 hours) Hydrocortisone Oral Injectable Topical Intermediate acting (12-36 hours) Prednisone Oral injectable Methyprednisolone Oral injectabe Long acting (36-72 hours) Dexamethasone Oral injectable Topical
- 11. Contraindications General: hypersensitivity Systemic Systemic fungal infections Intrathecal administration Cerebral malaria Concomitant live or live attenuated virus vaccination Topical Dermatological: bacterial, viral or fungal infection of the mouth or throat Ophthalmic: Fungal or mycobacterial ocular infections, viral conjunctivitis, or keratitis Inhalation: status asthmaticus or acute asthma episode requiring intensive measures
- 12. Organ/System of organs Effects Skin Poor wound healing, skin atrophy, and stretch marks due to impaired fibroblast activity and thus, impaired collagen synthesis Purpura Steroid acne Hypertrichosis Increased risk of squamous and basal cell carcinomas Cardiovascular system Hypertension Metabolism, electrolytes and endocrine system Weight gain, buffalo hump, and moon face (Cushingoid appearance) Hyperglycemia and insulin resistance glucocorticoid-induced diabetes Hypocalcemia PTH activation secondary osteoporosis
- 13. GI system Increased appetite Peptic ulcers and gastrointestinal hemorrhage CNS and psyche Mood disorders Cognitive disorders Psychosis Eyes Cataract Glaucoma Other Adrenocortical atrophy Acute adrenal insufficiency Avascular bone necrosis [17] Glucocorticoid-induced osteoporosis, osteopenia Immunosuppression
- 14. Tapering to avoid toxicity: Short-term administration ( 3 weeks): usually no tapering necessary Long-term administration (> 3 weeks): tapering regimen based on patient age and condition and on duration/dose of prior glucocorticoid administration. Additional considerations ?
- 15. Any comments ?