Synthetic Corticosteroids

Synthetic Corticosteroids

Question 1. Describe Contraindication To Glucocorticoid Therapy.
Or
Describe the Contraindications Of Corticosteroids.
Or
Give The Description Of Contraindications To Corticosteroids.
Answer:

The contraindications of glucocorticoid therapy are

• Peptic ulcer: By providing the therapy glucocorticoid causes bleeding and silent perforation of the ulcer
• Diabetes mellitus: In diabetes mellitus, they cause the precipitation of diabetes.
• Viral and fungal infection: During viral and fungal infections they increase susceptibility towards infection.
• Osteoporosis: Compression fractures of vertebrae and spontaneous fractures of long bones can occur.
• Psychosis: They cause psychiatric disturbances and hence produce mild euphoria.
• Herpes simplex keratitis: Posterior subcapsular cataract may develop.
• Corticosteroids are contraindicated in various other diseases such as hypertension, tuberculosis, epilepsy, congestive cardiac failure, renal failure, and glaucoma.

Question 2. Give The Description Of Synthetic Corticosteroids.
Answer:

Natural Glucocorticoids have undesirable effects. The most important of them are salt and water retention.

• Synthetic glucocorticoids have less salt and water-retaining effects and more anti-inflammatory effects.
• The synthetic glucocorticoids are prednisolone, methylprednisolone, triamcinolone, paramethasone, dexamethasone, and betamethasone.
• Synthetic glucocorticoids do not have mineralocorticoid action.
• Prednisolone: It is four times more potent than hydrocortisone, also a more selective glucocorticoid, but fluid retention does occur with high doses. It has an intermediate duration of action and causes less pituitary-adrenal suppression when a single morning dose or alternate-day treatment is given. It is used for allergic, inflammatory, and autoimmune diseases and in malignancies. It can be given 5 to 60 mg orally or 10 to 40 mg IM.
• Methylprednisolone: It is slightly more potent and more selective than prednisolone. Methylprednisolone acetate has been used as a retention enema in ulcerative colitis.
  Pulse therapy with high-dose methylprednisolone has been tried in nonresponsive active rheumatoid arthritis, renal transplant, pemphigus, etc. with good results and minimal suppression of the pituitary-adrenal axis. It can be given 4 to 32 mg orally.
• Triamcinolone: It is slightly more potent than prednisolone but highly selective glucocorticoid. It can also be used topically. It can be given 4 to 32 mg orally or 5 to 40 mg IM, intra-articular injection.
• Dexamethasone: It is a very potent and highly selective glucocorticoid. It is also long-acting, and causes marked pituitary—adrenal suppression, but fluid retention and hypertension are not a problem.
  It is used for inflammatory and allergic conditions. It can be given 0.5-5 mg/day orally. For shock, cerebral edema, etc. 4-20 mg/day IV infusion or IM injection is preferred. It can also be used topically.
• Betamethasone: It is similar to dexamethasone. It can be given 0.5—5 mg/day orally, 4 to 20 mg IM, IV injection, or infusion. It can also be used topically.