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endocrine:drug_classes:corticosteroids

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endocrine:drug_classes:corticosteroids [2026/02/12 19:42] – created andrew2393cnsendocrine:drug_classes:corticosteroids [2026/02/12 20:18] (current) – [Topical Dermatologic Glucocorticoids] andrew2393cns
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-====== Corticosteroids (Glucocorticoids) ======+====== Corticosteroids (Glucocorticoids & Mineralocorticoids) ======
  
-Corticosteroids are synthetic analogs of adrenal cortex hormones used for anti-inflammatory and immunosuppressive effects.+Corticosteroids are synthetic analogs of adrenal cortex hormones.
  
-This is the master class page.   +They are divided into: 
-For individual drug details, see links below.+  * Glucocorticoids (anti-inflammatory / immunosuppressive) 
 +  * Mineralocorticoids (volume regulation)
  
-----+Core physiology: 
 +  * [[endocrine:physiology:hpa_axis|HPA Axis Physiology]] 
 +  * [[endocrine:physiology:glucocorticoid_signaling|Glucocorticoid Signaling Pathway]]
  
-===== Core Mechanism =====+★ = High-yield / core drug for mastery
  
-All glucocorticoids:+----
  
-  * Bind intracellular glucocorticoid receptors +===== Systemic Glucocorticoids =====
-  * Alter gene transcription +
-  * ↓ Pro-inflammatory cytokines +
-  * ↓ Eosinophils +
-  * ↓ T-cell activation +
-  * ↓ Prostaglandins & leukotrienes+
  
-Full mechanism: +^ Drug ^ Relative GC Potency ^ Mineralocorticoid Activity ^ Duration ^ ★ ^ 
-  * [[endocrine:physiology:glucocorticoid_signaling|Glucocorticoid Signaling Pathway]]+| [[endocrine:drugs:hydrocortisone|Hydrocortisone]] | Low | Moderate | Short | ★ | 
 +| [[endocrine:drugs:cortisone|Cortisone]] | Low | Moderate | Short |  | 
 +| [[endocrine:drugs:prednisone|Prednisone]] | Moderate | Low | Intermediate | ★ | 
 +| [[endocrine:drugs:prednisolone|Prednisolone]] | Moderate | Low | Intermediate | ★ | 
 +| [[endocrine:drugs:methylprednisolone|Methylprednisolone]] | Moderate–High | Minimal | Intermediate | ★ | 
 +| [[endocrine:drugs:triamcinolone|Triamcinolone]] | Moderate–High | None | Intermediate |  | 
 +| [[endocrine:drugs:dexamethasone|Dexamethasone]] | High | None | Long | ★ | 
 +| [[endocrine:drugs:betamethasone|Betamethasone]] | High | None | Long | ★ |
  
 ---- ----
  
-===== Systemic Corticosteroids =====+===== Inhaled Glucocorticoids =====
  
-^ Drug ^ Relative Potency ^ Mineralocorticoid Activity ^ +^ Drug ^ Notes ^ ★ ^ 
-| [[endocrine:drugs:hydrocortisone|Hydrocortisone]] | Low | Moderate | +| [[endocrine:drugs:beclomethasone|Beclomethasone]] | Early ICS |  | 
-| [[endocrine:drugs:prednisone|Prednisone]] | Moderate | Low | +| [[endocrine:drugs:budesonide|Budesonide]] | Also GI-targeted form | ★ | 
-| [[endocrine:drugs:prednisolone|Prednisolone]] | Moderate | Low | +| [[endocrine:drugs:ciclesonide|Ciclesonide]] | Prodrug activated in lung |  | 
-| [[endocrine:drugs:methylprednisolone|Methylprednisolone]] | Moderate | Minimal | +| [[endocrine:drugs:flunisolide|Flunisolide]] | Less common |  | 
-| [[endocrine:drugs:dexamethasone|Dexamethasone]] | High | None |+| [[endocrine:drugs:fluticasone|Fluticasone]] | Most commonly used | ★ | 
 +| [[endocrine:drugs:mometasone|Mometasone]] | Long pulmonary retention |  |
  
----- +Used in:
- +
-===== Inhaled Corticosteroids ===== +
- +
-Used primarily in:+
   * [[respiratory:clinical:asthma|Asthma]]   * [[respiratory:clinical:asthma|Asthma]]
  
-Drugs:+----
  
-  * [[endocrine:drugs:fluticasone|Fluticasone]] +===== Intranasal Glucocorticoids =====
-  * [[endocrine:drugs:budesonide|Budesonide]] +
-  * [[endocrine:drugs:mometasone|Mometasone]]+
  
----- +^ Drug ^ Notes ^ ★ ^ 
- +| [[endocrine:drugs:beclomethasone|Beclomethasone]] | Also inhaled |  | 
-===== Intranasal Corticosteroids =====+| [[endocrine:drugs:budesonide|Budesonide]] | Also inhaled | ★ | 
 +| [[endocrine:drugs:flunisolide|Flunisolide]] | Less common |  | 
 +| [[endocrine:drugs:fluticasone|Fluticasone]] | First-line congestion therapy | ★ | 
 +| [[endocrine:drugs:mometasone|Mometasone]] | High potency |  | 
 +| [[endocrine:drugs:triamcinolone|Triamcinolone]] | OTC option |  |
  
 Used in: Used in:
   * [[allergy:clinical:allergic_rhinitis|Allergic Rhinitis]]   * [[allergy:clinical:allergic_rhinitis|Allergic Rhinitis]]
  
-Drugs:+----
  
-  * [[endocrine:drugs:fluticasone|Fluticasone]] +===== Topical Dermatologic Glucocorticoids =====
-  * [[endocrine:drugs:mometasone|Mometasone]] +
-  * [[endocrine:drugs:budesonide|Budesonide]] +
-  * [[endocrine:drugs:triamcinolone|Triamcinolone]]+
  
----- +^ Drug ^ Typical Potency ^ ★ ^ 
- +| [[endocrine:drugs:hydrocortisone|Hydrocortisone]] | Low | ★ | 
-===== Topical Corticosteroids =====+| [[endocrine:drugs:desonide|Desonide]] | Low–Moderate |  | 
 +| [[endocrine:drugs:triamcinolone|Triamcinolone]] | Moderate | ★ | 
 +| [[endocrine:drugs:betamethasone|Betamethasone]] | High | ★ | 
 +| [[endocrine:drugs:fluocinonide|Fluocinonide]] | High |  | 
 +| [[endocrine:drugs:clobetasol|Clobetasol]] | Very High | ★ |
  
 Used in: Used in:
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   * [[dermatology:clinical:contact_dermatitis|Contact Dermatitis]]   * [[dermatology:clinical:contact_dermatitis|Contact Dermatitis]]
  
-Organized by potency class (I–VII).+---- 
 + 
 +===== GI-Targeted Glucocorticoids ===== 
 + 
 +^ Drug ^ Notes ^ ★ ^ 
 +| [[endocrine:drugs:budesonide|Budesonide]] | High first-pass metabolism | ★ | 
 +| [[endocrine:drugs:hydrocortisone|Hydrocortisone]] | Rectal formulations |  | 
 + 
 +Used in: 
 +  * [[gastroenterology:clinical:ibd|Inflammatory Bowel Disease]]
  
 ---- ----
  
-===== Common Adverse Effects (Class-Wide) =====+===== Mineralocorticoids ===== 
 + 
 +^ Drug ^ Primary Use ^ ★ ^ 
 +| [[endocrine:drugs:fludrocortisone|Fludrocortisone]] | Adrenal insufficiency | ★ | 
 + 
 +---- 
 + 
 +===== Class-Wide Adverse Effects =====
  
 Short-term: Short-term:
   * Hyperglycemia   * Hyperglycemia
   * Mood changes   * Mood changes
-  * Fluid retention+  * Insomnia 
 +  * Fluid retention (more with mineralocorticoid activity)
  
 Long-term: Long-term:
   * HPA axis suppression   * HPA axis suppression
   * Osteoporosis   * Osteoporosis
-  * Cushingoid features+  * Myopathy
   * Increased infection risk   * Increased infection risk
   * Skin thinning   * Skin thinning
 +  * Cataracts / glaucoma
  
-See detailed discussion: +See: 
-  * [[endocrine:drugs:prednisone|Prednisone]] (systemic risks) +  * [[endocrine:physiology:hpa_axis|HPA Axis Physiology]]
- +
----- +
- +
-===== Clinical Integration ===== +
- +
-Corticosteroids are used in: +
- +
-  * [[allergy:clinical:allergic_rhinitis|Allergic Rhinitis]] +
-  * [[respiratory:clinical:asthma|Asthma]] +
-  * [[allergy:clinical:anaphylaxis|Anaphylaxis]] (adjunct) +
-  * [[rheumatology:clinical:rheumatoid_arthritis|Rheumatoid Arthritis]] +
-  * [[gastroenterology:clinical:ibd|Inflammatory Bowel Disease]] +
- +
-This reflects their broad immunosuppressive mechanism.+
  
 ---- ----
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 ===== High-Yield Pearls ===== ===== High-Yield Pearls =====
  
-  * All systemic steroids suppress the HPA axis with prolonged use. +  * Dexamethasone and betamethasone have no mineralocorticoid activity. 
-  * Dexamethasone has no mineralocorticoid activity.+  * Inhaled steroids are foundational therapy in asthma.
   * Intranasal steroids are first-line for allergic rhinitis congestion.   * Intranasal steroids are first-line for allergic rhinitis congestion.
-  * Inhaled steroids are foundational in asthma. +  * Chronic systemic use suppresses ACTH. 
-  * Epinephrine is first-line in anaphylaxis — steroids are adjunctive. +  * One molecule = one page; routes described within drug monographs.
- +
----- +
- +
-===== Related Pages ===== +
- +
-  * [[endocrine:physiology:hpa_axis|HPA Axis Physiology]] +
-  * [[allergy:immunology:type_i_hypersensitivity|Type I Hypersensitivity]]+
endocrine/drug_classes/corticosteroids.1770925368.txt.gz · Last modified: by andrew2393cns