endocrine:drug_classes:corticosteroids
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Corticosteroids (Glucocorticoids & Mineralocorticoids)
Corticosteroids are synthetic analogs of adrenal cortex hormones.
They are divided into:
- Glucocorticoids (anti-inflammatory, immunosuppressive)
- Mineralocorticoids (volume and sodium regulation)
Core physiology:
This is the master overview page. Each drug links to its full monograph.
Systemic Glucocorticoids
| Drug | Relative GC Potency | Mineralocorticoid Activity | Duration |
|---|---|---|---|
| Hydrocortisone | Low | Moderate | Short |
| Cortisone | Low | Moderate | Short |
| Prednisone | Moderate | Low | Intermediate |
| Prednisolone | Moderate | Low | Intermediate |
| Methylprednisolone | Moderate–High | Minimal | Intermediate |
| Triamcinolone | Moderate–High | None | Intermediate |
| Dexamethasone | High | None | Long |
| Betamethasone | High | None | Long |
Clinical use examples:
- Anaphylaxis (adjunct)
Inhaled Glucocorticoids
Primarily used in:
| Drug | Relative Potency | Notes |
|---|---|---|
| Beclomethasone | Moderate | Early ICS agent |
| Budesonide | Moderate | Also GI-targeted form |
| Ciclesonide | Moderate | Prodrug, activated in lung |
| Flunisolide | Moderate | Less commonly used |
| Fluticasone | High | Common ICS |
| Mometasone | High | Long pulmonary retention |
Intranasal Glucocorticoids
Used in:
| Drug | Notes |
|---|---|
| Beclomethasone | Also inhaled |
| Budesonide | Also inhaled |
| Flunisolide | Less common |
| Fluticasone | Most commonly used |
| Mometasone | High potency |
| Triamcinolone | Available OTC |
Topical Dermatologic Glucocorticoids
Used in:
| Drug | Typical Potency Range |
|---|---|
| Hydrocortisone | Low |
| Desonide | Low–Moderate |
| Triamcinolone | Moderate |
| Betamethasone | High |
| Fluocinonide | High |
| Clobetasol | Very High |
(Topical potency classes I–VII should be detailed on a separate potency page.)
GI-Targeted Glucocorticoids
Used in:
| Drug | Notes |
|---|---|
| Budesonide | High first-pass metabolism; targeted GI effect |
| Hydrocortisone | Rectal formulations |
Mineralocorticoids
Primarily aldosterone-like effects (volume expansion).
| Drug | Primary Use |
|---|---|
| Fludrocortisone | Adrenal Insufficiency |
Class-Wide Adverse Effects
Short-term:
- Hyperglycemia
- Mood changes
- Insomnia
- Fluid retention (more with mineralocorticoid activity)
Long-term:
- HPA axis suppression
- Osteoporosis
- Myopathy
- Increased infection risk
- Skin thinning
- Cataracts / glaucoma
See:
High-Yield Pearls
- All systemic glucocorticoids suppress the HPA axis with prolonged use.
- Dexamethasone and betamethasone have no mineralocorticoid activity.
- Inhaled steroids are foundational therapy in asthma.
- Intranasal steroids are first-line for allergic rhinitis congestion.
- One molecule = one page; routes are described within drug monographs.
endocrine/drug_classes/corticosteroids.1770926513.txt.gz · Last modified: by andrew2393cns