Corticosteroids, also called adrenocortical hormones or corticoids, are a group of steroid hormones synthesized in the adrenal cortex. On the basis of their physiological function, they are didactically divided into three families, i glucocorticoids - so called for their importance in glucose metabolism - i mineralocorticoids - active in the balance of mineral salts, in particular sodium and potassium - and the sex hormones.
Corticosteroid drugs
Glucocorticoids
Cortisol is undoubtedly the best known glucocorticoid, despite the fact that several hormones, such as cortisone and corticosterone, belong to the same family. All these glucocorticoids act to raise blood sugar, increasing the production of glucose starting from some amino acids and decreasing its peripheral use; these hormones also stimulate the storage of glycogen in the liver. The increase in the concentration of glucose in the blood, called glycaemia, is important to ensure normal brain activity under stressful conditions.
The effects of these hormones at the metabolic, skin and bone level are essentially catabolic (they decrease bone mineralization, promote protein catabolism and stimulate the mobilization of fatty acids and glycerol from adipose deposits).
At the cardiovascular level, vascular tone and cardiac output increase (hypertensive effect).
Glucocorticoid - cortisone drugs
Glucocorticoids perform an "important activity on the immune system and have, on the whole, a" suppressed action on the body's defenses. This property is abundantly exploited in therapy to reduce inflammatory states (traumatic, asthmatic, arthritic, rheumatic, allergic, etc.).
Unfortunately, the use of these drugs, also known as cortisones, has a long series of side effects and this is the reason why, calculating the benefits and costs of the therapy, they are generally prescribed only in the presence of an important pathology, which is not resolved with the administration of other drugs with similar activity.
In therapy, a large number of synthetic compounds structurally related to glucocorticoids have been studied, with the aim of producing drugs with greater therapeutic activity and fewer side effects. Thanks to these researches, the methods of assumption are the most disparate and range from products to be administered intramuscularly or intravenously, useful in emergencies, to ointments, self-dosed sprays and eye drops.
Considering the countless bodily activities in which they are involved, the abuse of glucocorticoids implies important side effects, such as osteoporosis, swelling and tension, especially facial (due to water retention), hypertrichosis, hyperlipidemia, decreased secretion of GH, growth failure, increased and redistribution of adipose mass to the detriment of lean mass, menstrual abnormalities, electrolyte imbalances, arterial hypertension, glaucoma, gastric ulcers, psychosis, greater susceptibility to infections and injuries (reduce the synthesis of collagen, therefore the resistance of tendons and ligaments, and increase the risk of suffering fractures from repeated microtrauma.) Glucocorticoids also have important interactions with other drugs.
The appearance of these side effects, typical of cortisone drugs, is all the more probable the greater the dosage and duration of treatment; they are therefore more common in the case of systemic therapy (oral or injection) and rare for local therapies (with creams, ointments and eye drops), where they are generally used at low doses. Particular caution for those patients already suffering from diseases related to an abuse of glucocorticoids.
