Steroids, also known as corticosteroids, are a class of drugs used to reduce inflammation and suppress the immune system. They are used to treat a variety of conditions, including autoimmune diseases, allergies, asthma, and more. Here’s an overview of corticosteroids, their uses, and guidelines as per UK standards.
Types of Steroids
1. Glucocorticoids:
- Medications: Prednisolone, dexamethasone, hydrocortisone.
- Uses: Anti-inflammatory and immunosuppressive effects. Used to treat conditions like asthma, rheumatoid arthritis, inflammatory bowel disease, and severe allergies.
2. Mineralocorticoids:
- Medications: Fludrocortisone.
- Uses: Primarily used to manage conditions like Addison’s disease by helping control blood pressure and balance salt and water in the body.
Common Corticosteroid Medications
1. Prednisolone:
- Mechanism of Action: Suppresses inflammation and the immune response by inhibiting multiple inflammatory cytokines.
- Uses: Asthma, allergies, arthritis, autoimmune diseases, and severe inflammatory conditions.
- Side Effects: Weight gain, osteoporosis, high blood pressure, diabetes, increased risk of infections.
2. Dexamethasone:
- Mechanism of Action: Similar to prednisolone, with a longer duration of action.
- Uses: Anti-inflammatory and immunosuppressive, used in conditions like severe allergies, asthma, adrenal insufficiency, and certain cancers.
- Side Effects: Insomnia, mood changes, increased appetite, weight gain, osteoporosis.
3. Hydrocortisone:
- Mechanism of Action: Reduces inflammation and suppresses the immune system.
- Uses: Adrenal insufficiency (like Addison’s disease), severe allergic reactions, and inflammatory conditions.
- Side Effects: Similar to other glucocorticoids, including potential for adrenal suppression with long-term use.
4. Fludrocortisone:
- Mechanism of Action: Mimics aldosterone, helping to maintain blood pressure and fluid balance.
- Uses: Addison’s disease and conditions of adrenal insufficiency.
- Side Effects: Hypertension, edema, hypokalemia (low potassium levels).
Considerations and Safety
- Monitoring and Review:
- Regular monitoring of patients on long-term corticosteroid therapy is essential. This includes checking blood pressure, blood glucose levels, and bone density.
- Tapering Off:
- Corticosteroids should not be stopped abruptly, especially if used long-term. Gradual tapering is necessary to prevent adrenal insufficiency.
- Preventing Side Effects:
- Patients may need additional medications or lifestyle changes to manage side effects, such as calcium and vitamin D supplements for bone health, and dietary modifications to control weight gain and blood sugar levels.
- Vaccinations:
- Live vaccines should be avoided in patients on high doses of corticosteroids due to the immunosuppressive effects.
Common Side Effects
- Short-term Use:
- Increased appetite, weight gain, insomnia, mood changes, increased risk of infections.
- Long-term Use:
- Osteoporosis, diabetes, hypertension, adrenal suppression, cataracts, glaucoma, muscle weakness.