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endocrine:drug_classes:corticosteroids

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:


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:


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:


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:


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.
endocrine/drug_classes/corticosteroids.txt · Last modified: by andrew2393cns