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 regulation)
Core physiology:
★ Core Drugs to Master (PA Board Focus)
Systemic:
Inhaled / Intranasal:
Topical:
Mineralocorticoid:
(★ in tables below indicates high-yield focus drug.)
Systemic Glucocorticoids
| Drug | Relative GC Potency | Mineralocorticoid Activity | Duration | Core |
|---|---|---|---|---|
| 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 integration:
Inhaled Glucocorticoids
| Drug | Notes | Core |
|---|---|---|
| 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 | Core |
|---|---|---|
| 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 | Core |
|---|---|---|
| Hydrocortisone | Low | ★ |
| Desonide | Low–Moderate | |
| Triamcinolone | Moderate | ★ |
| Betamethasone | High | |
| Fluocinonide | High | |
| Clobetasol | Very High | ★ |
Used in:
GI-Targeted Glucocorticoids
Mineralocorticoids
| Drug | Primary Use | Core |
|---|---|---|
| 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 corticosteroids are foundational 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.
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