1. Corticosteroids

2. Corticosteroids
Corticosteroids suppress immune responses and reduce inflammation.
available as natural or synthetic steroids.
Natural corticosteroids are hormones produced by the adrenal cortex;
Natural and synthetic corticosteroids are classified according to their biological activities:
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3. • Glucocorticoids, such as cortisone acetate and dexamethasone,affect carbohydrate and protein metabolism.
• Mineralocorticoids, such as aldosterone and fludrocortisone acetate,regulate electrolyte and water balance.
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4. Glucocorticoids
Most glucocorticoids are synthetic analogues of hormones secreted by the adrenal cortex:
• beclomethasone
• betamethasone
• cortisone
• dexamethasone
• hydrocortisone
• methylprednisolone
• prednisolone
• prednisone
• triamcinolone.
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5. Pharmacokinetics
Glucocorticoids are well absorbed when administered orally.
After I.M. administration, they’re absorbed completely.
Glucocorticoids are metabolized in the liver and excreted by the kidneys.
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6. Pharmacodynamics
Glucocorticoids suppress hypersensitivity and immune responses through a process that isn’t entirely understood.
Researchers believe that glucocorticoids inhibit immune responses by:
• suppressing or preventing cell-mediated immune reactions
• reducing levels of leukocytes, monocytes, and eosinophils
• decreasing the binding of immunoglobulins to cell surface receptors
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7. …Pharmacodynamics
- Glucocorticoids suppress the redness, edema, heat, and tenderness associated with the inflammatory response. - prevent the leakage of plasma from capillaries, suppress the migration of polymorphonuclear leukocytes (cells that kill and digest microorganisms), and inhibit phagocytosis (ingestion and destruction). - decrease antibody formation in injured or infected tissues .
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8. Pharmacotherapeutics
replacement therapy for patients with adrenocortical insufficiency,
glucocorticoids are prescribed for immunosuppression and reduction of inflammation.
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9. Adverse reactions to corticosteroids
• insomnia
• increased sodium and water retention
• increased potassium excretion
• suppressed immune and inflammatory responses
• osteoporosis
• intestinal perforation
• peptic ulcers
• impaired wound healing.
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10. Endocrine system reactions may include:
• diabetes mellitus
• hyperlipidemia
• adrenal atrophy
• hypothalamic-pituitary axis suppression
• cushingoid signs and symptoms (such as buffalo hump,moon face, and elevated blood glucose levels).

11. nursing
- Administer drug daily at 8 to 9 am to mimic normal peak diurnal concentration levels and thereby minimize suppression of the hypothalamic–pituitary axis. - Use the minimal dose for the minimal amount of time to minimize adverse effects. - Taper doses when discontinuing from high doses or from long-term therapy . - Do not give live virus vaccines when the patient is immunosuppressed because there is an increased risk of infection. - Protect the patient from exposure to infection .
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12. Mineralocorticoids
Mineralocorticoids affect electrolyte and water balance. These drugs include:
• fludrocortisone acetate, a synthetic analogue of hormones secreted by the adrenal cortex
• aldosterone, a natural mineralocorticoid (the use of which has been curtailed by high cost and limited availability).
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13. Pharmacokinetics
Fludrocortisone acetate is metabolized in the liver to inactive metabolites.
.The drug is excreted by the kidneys.
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14. Pharmacodynamics
Fludrocortisone acetate affects fluid and electrolyte balance by acting on the distal renal tubule to increase sodium reabsorption and potassium and hydrogen secretion.
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15. Pharmacotherapeutics
Fludrocortisone acetate is used as replacement therapy for patients with adrenocortical insufficiency .
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16. Implementation With Rationale
- Monitor for hypokalemia. - Discontinue if signs of overdose (excessive weight gain, edema, hypertension, cardiomegaly) occur to prevent the development of more severe toxicity.
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