Corticosteroids are class of steroid hormones that are naturally produced in the adrenal glands.They are used in medicines for anti-inflammatory and immunosuppressive properties.
Based on the activity , corticosteroids are divided in to 2 types
1. MINERALOCORTICOIDS
2.GLUCOCORTICOIDS
MINERALOCORTICOIDS
They maintain the minerals that is salt and water balance in the body.
They also absorb or retain sodium and water from collecting tubules and excrete potassium in return.
eg; Fludrocortisone
Fludrocortisone
It has 150 times more mineralo coricoid activity and less glucose activity.
It helps to maintain blood pressure.
GLUCOCORTICOIDS
Prepares" fight and flight "response. As a stress response releases glucose.
Reduces inflammation.
Glucocorticoids are divided depending upon the duration of action
1.Short- acting - 1-12 hours , (eg: Hydrocortisone)
2.Intermediate -acting - 12- 36 hours , (eg: Methyl prednisolone)
3. Long - acting - 36-56 hours, (eg: Dexamethasone)
Hydrocortisone
It has equal mineralocorticoid and glucocorticoid action .So it reduces inflammation and retain salt and water.
Increases glucose level.
Methyl Prednisolone
Its glucocorticoid activity is 5 times more than than Hydrocortisone.
Mineralocorticoid activity is half that of Hydrocortisone.
Hence it reduces more inflammation.
It does not retains that much water and salt so that fluid overload will be less.
Dexamethasone
Its glucocoricoid activity is 25 times more than Hydrocorisone.
No mineralocoricoid activity.
So reduces oedema and more inflammatory action.
Hydrocortisone used in sepsis guidelines.
Dexamethasone used in life-threatening conditions to reduce oedema ,meningitis cases etc.
Methy Prednisolone used in chest inflammatory conditions ,cardiac failures.
Fludrocortisone used in adrenal insufficiency.
Reference
#ICU talk 3
BY,
DR.RENJU THANKOM GEORGE,
INDIA.
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