Corticosteroids (Glucocorticoids & Mineralocorticoids)

Corticosteroids are synthetic analogs of adrenal cortex hormones.

They are divided into:

Glucocorticoids (anti-inflammatory / immunosuppressive)
Mineralocorticoids (volume regulation)

Core physiology:

★ = High-yield / core drug for mastery

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	★

Inhaled Glucocorticoids

Drug	Notes	★
Beclomethasone	Early ICS
Budesonide	Also GI-targeted form	★
Ciclesonide	Prodrug activated in lung
Flunisolide	Less common
Fluticasone	Most commonly used	★
Mometasone	Long pulmonary retention

Used in:

Asthma

Intranasal Glucocorticoids

Drug	Notes	★
Beclomethasone	Also inhaled
Budesonide	Also inhaled	★
Flunisolide	Less common
Fluticasone	First-line congestion therapy	★
Mometasone	High potency
Triamcinolone	OTC option

Used in:

Allergic Rhinitis

Topical Dermatologic Glucocorticoids

Drug	Typical Potency	★
Hydrocortisone	Low	★
Desonide	Low–Moderate
Triamcinolone	Moderate	★
Betamethasone	High	★
Fluocinonide	High
Clobetasol	Very High	★

Used in:

GI-Targeted Glucocorticoids

Drug	Notes	★
Budesonide	High first-pass metabolism	★
Hydrocortisone	Rectal formulations

Used in:

Inflammatory Bowel Disease

Mineralocorticoids

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:

HPA Axis Physiology

High-Yield Pearls

Dexamethasone and betamethasone have no mineralocorticoid activity.
Inhaled steroids are foundational therapy in asthma.
Intranasal steroids are first-line for allergic rhinitis congestion.
Chronic systemic use suppresses ACTH.
One molecule = one page; routes described within drug monographs.