Corticosteroids are substances which belong to a subclass of steroid hormones, in the normal state of an organism are developed by human adrenal glands. In this article we will in detail understand what is corticosteroids what their versions exist as they are accepted in the form of synthetic medicines and for what amount of time are acquired whether collateral reactions of an organism are possible.
What is it?
These substances are divided into two types: mineralokortikoida and glucocorticoids. To the first type substance aldosteron, concerns the second — a hydrocortisone and a cortisone.
Natural
Biologically healthy adrenal glands of the person are capable to synthesize glucocorticoids regularly. They have necessary therapeutic effect at various inflammatory processes in a human body. Besides, without normal quantity of glucocorticoids there will not be able to be a regulation of proteinaceous, fat and carbohydrate exchanges.
The cortisone and hydrocortisone promote the most correct functional course of all processes during pregnancy, support normal work of kidneys, control hormonal maturing and brain reaction to stressful situations. Components of glucocorticoids in a liver break up, and then are removed through kidneys together with urine.
Whether you know? For the first time mineralokortikoid it was artificially synthesized from bark of adrenal glands in 1937.
Corticosteroids are the vital hormones, one of key functions of which is played by mineralokortikoida. Aldosteron who is a basis of mineralokortikoid regulates exchange processes of potassium and sodium. Aldosteron provokes a delay in an organism of ions of Na+, but at the same time promotes the accelerated removal of ions of K+.
Synthetic
Researchers in the field of biology and medicine synthesized corticosteroids for a long time, found for them application in the field of therapeutic treatment of infectious diseases.
But the thing is that corticosteroid medicines have no curing effect (they do not kill causative agents of an infection and do not suppress the reason of the infectious beginning). Hormonal corticosteroids are capable to suppress temporarily processes in the center of inflammatory reactions, but no more than that.
These substances, as well as many other hormones of adrenal glands, are capable to increase sensitivity of an organism to external irritations. Corticosteroids provoke appearance of a stress that directly influences decrease in immune protection of an organism, much know that protective forces of an organism are most viable only at moderate and quiet life.
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As these steroid substances are capable to block regeneration processes, the use of such hormones leads to a long course of disease.
At frequent intake of synthetic hormones the adrenal glands relax and cease to develop norm of an aldosteron, sufficient for an organism, cortisone and hydrocortisone, and after the termination of intake of synthetic steroids the adrenal glands can return to the normal former state any more never.
When do accept corticosteroids?
Glucocorticoids and mineralokortikoida are issued as the different drugs, respectively, are taken at various diseases. The hydrocortisone together with a cortisone is shown at such diseases:
- rheumatoid arthritis and its other manifestations;
- rheumatism;
- some types of good-quality and malignant new growths;
- collagenases;
- autoimmune diseases (dermatomiozit, the sklerodermiya, nodular periarteriit, system red a wolf cub);
- allergic diseases and bronchial asthma;
- skin diseases (red flat deprive, psoriasis, an eritrodermiya, seboreyny dermatitis, diskoidny of a wolf cub, eczema, neurodermatitis, atopic dermatitis);
- glomerulonefrit;
- fibroziruyushchy alveolita, pneumonia and bronchitis;
- sharp pancreatitis and ulcer colitis;
- disease Krone;
- external otitis (chronic and sharp);
- viral diseases (viral hepatitis, infectious mononukleoz);
- hemolytic anemia;
- infectious diseases in ophthalmology (sklerit, Irit, uveit, iridotsiklit, keratit);
- prevention and treatment of shock;
- for suppression of rejection of transplanted organs;
- neuralgic diseases (neuritis of an optic nerve, sharp injury of a spinal cord, multiple sclerosis).
It is much less indications to use of substances on the basis of an aldosteron, but after all they are:
- myasthenia (muscle weakness against the background of autosomal diseases);
- Addison's disease (it is shown in cases chronically of misoperation of adrenal glands);
- adinamiya;
- violations of mineral exchange.
At any of the above-stated diseases the treatment is shown by synthetic corticosteroid medicines. But be careful, do not self-medicate at all as these hormones should be accepted with extra care.
Forms of release and feature of application
Forms of release of corticosteroids are different, they are appointed depending on what disease became the reason of necessary intake of hormones.
Tablets and capsules
Medicines on the basis of corticosteroids have quite extensive list. In the market such corticosteroid medicines are the most popular and most demanded: Kenakort, Tseleston, Medrol, Kenalog, Lemod, Florinef, Prednisolonum, Urbazon, Kortineff and many others.
Medicines in the form of capsules and tablets are accepted at an interval of 8 hours. Such mode of intake of synthetic hormones is connected with their natural receipt in blood from bark of adrenal glands.
Important! At long-term treatment by corticosteroid medicines it is necessary to carry out regular surveys regarding electrolytic composition of blood, an indicator HELL, conditions of digestive tract, quantitative ratio of glucose in urine and blood.
There are cases that the tableted drugs are taken on 3-4 times for 16-18 hours (in cases of a sharp course of a disease). Such mode of reception can be appointed only by the doctor, otherwise dangerous consequences for health are possible. Corticosteroid hormones right after meal are accepted or during food. Tablets or capsules need to be washed down with a glass of water.
Injections
As the most known glucocorticoid and mineralokortikoidny medicines for intravenous administration are considered: Metilprednizolon, Diprospan (Betametazon), Medrol, Prednisolonum, Flosteron, Kenalog, Dexamethasone. In most cases such injections are appointed only at threat of life for the person. Medicines are appointed and entered only by experienced specialists of medical institutions.
At intensive therapy of some diseases the patient is on treatment in a hospital, corticosteroid drugs are injected by it intravenously in the dosages specified by doctors after inspection. Intensive therapy by these hormones is appointed in very short terms, and at achievement of acceptable effect, treatment also quickly stops.
Alternative therapy means in itself minimization of the oppressing action on normal functioning of intra secretory glands. In cases of such therapy often use Prednisolonum, each two days enter it into the period from 6 to 8 in the morning.
In pulse therapy use the medicine Metilprednizalon. Enter it intravenously, quickly and in big dosages (not less than 1 g). Pulse therapy it is shown only in case of emergency, for example, for patients of resuscitation.
Inhalations
Inhalation corticosteroids are applied at sharp forms of bronchial asthma and HOBL of various degrees of severity. Inhalations are performed as additional resources at treatment and simplification of a course of various allergic diseases, pneumonia, bronchitis.
Also inhalations are shown at infectious damages of a mouth and airways. The most popular inhalers of this type are: Ingakort, Pulmikort, Bekotid, Beklomet, Azmakort. All listed aerosols can differ in ways of dosages and existence of speyser.
Whether you know? Dexamethasone reduces inflammatory activity of the center by 40 times!
Any types of inhalation medicines differ in high local anti-inflammatory effect, a fast inactivation, low system bioavailability and high affinity to group of companies receptors.
Intake of these medicines by strictly experienced staff of the medical centers is appointed. Independent reception can be hazardous to health of the patient. Dosages of reception of inhalation means depend on type of a disease and a step of its weight.
Ointment and cream
Topichesky medicines of local influence (ointment or cream-gel with corticosteroids) have a wide range of indications at various skin diseases. As the most popular of them are considered: Lokoid, Ftorokort, Afloderm, Flutsinar, Dermoveyt, Klobetazol, Prednisolonum.
Topichesky corticosteroid medicines classify depending on activity degree: slaboaktivny (Korteyd, Prednisolonum), moderately active (Ftorokord, Latikord), highly active (Sinalar, Kuterid, Flutsinar) and superhighly active (Klobetazol).
All above-mentioned synthetic hormonal medicines are very widely applied by medical employees in the field of dermatology. They are excellent assistants in fight against non-infectious damages of skin (red flat deprive, atopic dermatitis, psoriasis, eczema).
These medicines on the basis of corticosteroids are capable to eliminate the naggers, to have positive effect on the centers of infectious defeats. Besides, it should be noted that these cream medicines with difficulty get through epidermis of dry skin.
Important! Therapeutic courses with application of glucocorticoids for 1.5 years and more lead to steroid diabetes and a subkapsulyarny cataract.
In the therapeutic purposes apply these medicines only after consultation with the doctor. He has to register a course of treatment with intervals of putting ointment on integuments. It is also worth noticing that sharp cancellation of intake of corticosteroid hormones can lead to aggravation of a course of disease and cause so-called superinfection.
Side effects
At the long and uncontrollable use of these hormonal substances there can be various side effects. Mineralokortikoida sodium salts in an organism are capable to detain, water in full degree will not be removed that will cause unpleasant consequences (increase HELL, hypostases, potassium loss).
In rare instances there can be steroid diabetes which is caused by a long hyperglycemia. Some other side effects is also possible:
- hemorrhagic pancreatitis;
- aggravation of course of chronic stomach ulcer;
- oppression of processes of regeneration of fabrics;
- the risk of thrombosis caused by hyper coagulation;
- obesity, appearance of eels and deterioration in the general condition of skin;
- decrease in level of activity of protective forces of an organism (in this regard developing of various new diseases);
- the increased risk of development of a cataract and glaucoma;
- hyperactivity of growth of indumentum of the person.
Sometimes against the background of reception of corticosteroids there is osteoporosis which in the most part is connected with the increased conclusion of ions of calcium from an organism. For prevention of a disease together with intake of hormones take vitamin D and various mineralized chemical drugs on the basis of calcium.
Pain in joints is symptoms of developing of aseptic necrosis of bones which arises against the background of the excessive use of a cortisone and a hydrocortisone. Specialists of medical institutions are obliged to warn the patients about various by-effects and to appoint a therapeutic course towards minimization of their manifestations.
Whether you know? Natural glucocorticoids contact protein molecules for 92-98%, and synthetic — only for 45-55%.
Glucocorticoids are capable to change the chemical composition of blood in this connection there can be an eozinopeniya, a limfopeniye, decrease in level of basophiles, increase in quantity of erythrocytes. From mental and nervous functions can appear: euphoria, insomnia, psychosis.
In more hard cases the atrophy of bark of adrenal glands is possible. For considerable decrease in frequency and degree of side effects the intake of corticosteroid substances has to be strictly controlled. Frequent medical examinations and consultations of the doctor are necessary.
Contraindications
These hormonal medicines are forbidden to application at a current such diseases:
- pronounced form of an endocarditis;
- ulcer damages of a duodenum and stomach;
- various mental disorders;
- nephrites and osteoporosis;
- diabetes;
- tuberculosis in actively expressed form;
- insufficiency of blood circulation of the third stage;
- Itsenka-Cushing's disease;
- during pregnancy;
- allergic reactions to a cortisone, hydrocortisone and aldosteron;
- syphilis;
- recently postponed surgical interventions.
Children are recommended to apply these medicines only in extreme cases after consultation with the doctor as corticosteroids in the increased quantity are capable to oppress processes of growth and development of a young organism.
Inhalations and ointments are forbidden to application at virus damages of skin and an eye (can cause appearance of ulcers, are appointed only in specific cases together with medicines which support functions of a cornea of an eye and epidermis of skin). Some of the making glucocorticoids can provoke appearance of arrhythmia and a gipokaliyemiya that will harmful affect normal functioning of a cardiac muscle.
Important! Alcohol intake together with corticosteroid medicines increases risk of formation of ulcer damages of a stomach and duodenum.
In conclusion there is a wish to note that corticosteroid substances are difficult chemical and molecular connections, the full nature of their impact on an organism is still not described.
Scientists continue to study chemical and biological properties of these hormones that puts them in one row with some of the most complex chemical structures. Proceeding from all this, it is important to understand that independent application of corticosteroids in any of forms of release can negatively affect your health therefore before a course of treatment the obligatory consultation of the doctor is necessary.