Treatment and Prevention

Glucocorticoid drugs: indications and contraindications for use, overdose and possible side effects

In the body of people a lot of biologically active substances are formed. They affect all phenomena that occur in cells and intercellular substance.

The study of such compounds, among which many belong to the group of hormones, allows not only to understand the mechanisms of their functioning, but also to be used for therapeutic purposes.

Hormone therapy has proven to be a real miracle for many patients with diseases that cannot be cured by other means. A very well-known group of such drugs are glucocorticoids, the indications for use of which are relevant in many branches of medicine.

General properties

Glucocorticosteroids are biologically active compounds produced by the adrenal glands of mammals. These include cortisol, corticosterone and some other hormones. Most abundantly they are released into the blood under stressful situations, intense blood loss or injuries.

Having anti-shock action, glucocorticosteroids have the following effects:

  1. increase the pressure in the arteries;
  2. increase the sensitivity of myocardial cell walls to catecholamines;
  3. prevent loss of receptor sensitivity at high catecholamine levels;
  4. stimulate the production of blood cells;
  5. intensify the formation of glucose in the liver;
  6. promote the increase of blood glucose;
  7. inhibit the use of glucose by peripheral tissues;
  8. intensify glycogen synthesis;
  9. inhibit the processes of protein synthesis and accelerate their decay;
  10. Intensify the consumption of fat in the cells of the subcutaneous tissue;
  11. promote the accumulation of water in the body, sodium and chlorine, as well as the elimination of calcium and potassium;
  12. inhibit allergic reactions;
  13. affect the sensitivity of tissues to various hormones (adrenaline, growth hormone, histamine, hormones of the genital and thyroid glands);
  14. have a multi-directional effect on the immune system (suppress the production and activity of some protective cells, but accelerate the formation of other cells of the immune system);
  15. increase the effectiveness of the protection of tissues from radiation.

This long list of effects of glucocotricoids can actually continue for a long time. It is likely that this is only a small part of their properties.

One of the most valuable effects that cause the use of glucocorticoids is the anti-inflammatory effect.

These substances inhibit the breakdown of tissues and organic compounds under the influence of violent inflammatory phenomena by inhibiting the activity of specific enzymes.

Glucocorticosteroid hormones prevent the formation of edema at the site of inflammation, as they reduce the permeability of the vascular wall. They also trigger the formation of other substances with anti-inflammatory effects.

It should be understood, if we consider glucocorticoids, the use of drugs with a wide range of effects should be strictly controlled by a doctor, as there may be many complications.

Indications for use of glucocorticoids

Indications for use of glucocorticoids are as follows:

  1. treatment of diseases of the adrenal glands (glucocorticoids used in acute deficiency, chronic deficiency, congenital hyperplasia of the cortical layer), in which they are not able to fully (or even) produce hormones in abundance;
  2. Therapy for autoimmune diseases (rheumatism, sarcoidosis) is based on the ability of these hormones to influence the immune processes, to suppress or activate them. Glucocorticoids are also used for rheumatoid arthritis;
  3. treatment of diseases of the urinary system, including inflammatory. These hormones are able to effectively deal with violent inflammations;
  4. In case of allergies, glucocorticoids are used as agents affecting the production of biologically active compounds, provoking and enhancing individual intolerance reactions;
  5. treatment of diseases of the respiratory system (prescribed glucocorticoids in bronchial asthma, Pneumonia, allergic rhinitis). It should be noted that different drugs have different pharmacodynamics. Some drugs act fairly quickly, others - slowly. Means with a delayed, prolonged effect cannot be used if it is necessary to remove the acute manifestations (for example, during an asthmatic attack);
  6. glucocorticoids in dentistry are used in the treatment of pulpitis, periodontitis, other inflammatory phenomena, as well as in the composition of filling mixtures and as an antishock remedy for anaphylactic shocks caused by drugs;
  7. treatment of dermatological problems, inflammatory processes in the dermis;
  8. therapy of diseases of the gastrointestinal tract. The indication for glucocorticoid use is Crohn's disease;
  9. The treatment of patients after injuries (including back) is due to the anti-shock, anti-inflammatory effects of the drugs.
  10. as part of complex therapy - with cerebral edema.

Drug Cortisone

On the basis of substances belonging to the group of glucocorticosteroids, medications were created in the form of ointments, tablets, solutions in ampoules, inhalation fluids:

  • Cortisone;
  • Prednisolone;
  • Dexamethasone;
  • Hydrocortisone;
  • Beclomethasone;
  • Triamcinolone.
Only a doctor on the basis of indications can prescribe local glucocorticoids and decide on the duration of therapy.

Side effects

A lot of positive effects that have glucocorticoids, led to their widest use in medicine.

Hormone therapy was not at all safe, it is characterized by the presence of many side effects:

  1. deterioration in the quality of hair and skin, the appearance of stretch marks, acne;
  2. intensive hair growth in atypical areas of the body in women;
  3. reduction of vascular strength;
  4. the appearance of hormonal changes;
  5. provoking anxiety, psychosis;
  6. reduced vision;
  7. violation of water-salt metabolism.

The use of glucocorticoids can lead to the appearance of many diseases:

  1. peptic ulcer;
  2. diabetes;
  3. obesity;
  4. hypertension;
  5. immunodeficiency;
  6. dysmenorrhea.

There are also cases when glucocorticosteroids provoke the rapid development of infections, the pathogens of which were in the body before, but were not able to reproduce rapidly due to the activity of the immune system.

Negative effects occur not only with prolonged use of glucocorticosteroids or their overdose. They are also detected with the abrupt cancellation of drugs, because by obtaining artificial analogues of hormones, the adrenal glands stop them on their own.

After the end of hormone therapy, the following manifestations are possible:

  1. weakness;
  2. the appearance of muscle pain;
  3. loss of appetite;
  4. temperature rise;
  5. aggravation of other existing pathologies.

The most dangerous effect provoked by the abrupt cancellation of such hormones is acute adrenal insufficiency.

Its main symptom is a drop in blood pressure, additional symptoms are digestive disorders accompanied by pain, a state of lethargy, epileptic seizures.

It is as dangerous to voluntarily stop taking glucocorticosteroids as it is to self-medicate with their use.

Contraindications

The abundance of side effects caused by taking glucocorticosteroids, and causes many contraindications for their use:

  1. severe hypertension;
  2. circulatory failure;
  3. pregnancy;
  4. syphilis;
  5. tuberculosis;
  6. diabetes;
  7. endocarditis;
  8. nephritis.

The use of drugs containing glucocorticoids for the treatment of infections is not allowed unless the body is additionally protected against the development of other infectious diseases. For example, smearing the skin with glucocorticoid ointments, a person lowers local immunity and runs the risk of developing fungal diseases.

When prescribing glucocorticoids, women of reproductive age need to be sure that there is no pregnancy - such hormone therapy can lead to adrenal insufficiency in the fetus.

Related videos

About the possible side effects of glucocorticosteroids in the video:

Glucocorticoids truly deserve close attention and recognition from medical professionals, because they can help in such various difficult situations. But hormonal drugs require special attention when developing the duration of treatment and dosage. The physician should inform the patient about all the nuances that may arise when using glucocorticoids, as well as the dangers that await in case of an abrupt refusal of the drug.

Watch the video: Prednisone: Dosing and Side Effects (September 2019).