What compounds are collectively called corticosteroids. Instructions for use and list of corticosteroid ointments

Corticosteroids are a group of potent drugs for the treatment of joints and spine. Medicines based on steroid hormones show high effectiveness as part of complex therapy for arthritis, arthrosis, osteochondrosis, bursitis, glenohumeral periarthritis, and other pathologies of the musculoskeletal system.

Corticosteroids are often prescribed for severe pain when NSAIDs are ineffective. More than half of the population suffers from negative manifestations of joint pathologies and diseases of the spine, especially after 50–60 years. The benefits and harms of glucocorticosteroids, indications for use, review of effective means - information that will be useful to many.

General characteristics

What are corticosteroids? These are highly active substances belonging to the subclass of steroid hormones. A characteristic feature is that production is carried out only by the adrenal cortex. For this reason, corticosteroids do not exhibit androgenic, estrogenic or progestogenic effects. The main types of steroid hormones that the body produces in the adrenal cortex are hydrocortisone and cortisone.

According to the European classification, the following groups of corticosteroids are presented on the pharmaceutical market:

weak (Hydrocortisone, Prednisolone);
moderate action (Lorinden, Fluorocort);
strong (Triderm, Advantan, Elokom, Celestoderm);
very strong (Klovate).

Functions:

regulate protein and water-salt metabolism;
support the correct course of various processes in the body;
participate in important biochemical reactions;
have a positive effect on the immune system;
prevent and stop inflammatory processes;
accelerate the regeneration of connective tissue.

When used correctly, synthetic steroid hormones act on the body in the same way as natural ones. For diseases of the spine and joint pathologies, the selection of medications and the duration of treatment are determined by an orthopedic traumatologist or rheumatologist. Failure to comply with the terms of treatment or exceeding the dosage can lead to serious disorders. for the functioning of organs and systems, often provokes irreversible processes in the body.

It is important to remember the side effects that develop with long-term use of potent drugs. The doctor never prescribes glucocorticosteroids for mild and moderate stages, if weaker drugs show a positive effect.

Steroid hormones are effective in treating the following diseases:

spicy .

Important! Corticosteroids are indispensable in the treatment of severe systemic pathologies. Various forms of drugs are used for acute rheumatic fever, systemic vasculitis and lupus erythematosus, systemic scleroderma.

Contraindications

Potent drugs have limitations. It is prohibited to use corticosteroids without a doctor's prescription.

External, intra-articular and oral use should be used with caution in the following cases:

epilepsy;

arterial hypertension;

mental disorders;

stomach and duodenal ulcers;

diabetes mellitus

Potent formulations are contraindicated for the following diseases:

problems with blood clotting;

infectious problems in joints or other parts of the body;

destructive processes in the bones, incurable deformation of the joints;

transarticular fracture;

severe osteoporosis.

Benefits and harms

Corticosteroids are effective in treating various pathologies of the joints and spine. The drugs are quite safe if the rules of use are strictly followed. Patients should remember: Potent compounds exhibit both positive and negative effects on the body.

Useful properties:

act quickly;

exhibit a powerful anti-inflammatory effect;

reduce pain in the affected joint or spine.

Side effects:

acne, thinning of the epidermis;

damage to muscle tissue;

discomfort in the stomach and intestines;

sudden changes in mood, irritability;

sleep problems;

headache;

increased levels of lipids and glucose in the blood;

growth retardation in childhood, problems with puberty;

osteoporosis, compression fractures of the spine due to calcium leaching;

cataract, glaucoma;

ulcerative lesions in the intestines and stomach;

increase in body weight.

Important! After the first two or three procedures, many patients note increased pain in the affected area, but later the discomfort disappears and the pain quickly decreases. Doctors consider such manifestations acceptable in a short period.

General rules of use
Side effects will be minimal, and the beneficial effect will be maximum with a balanced approach to prescribing and taking corticosteroids. For statutory pathologies and diseases of the spine, drugs are often prescribed in the form of intra-articular injections, injections into the soft tissue near the pinched nerve root.

Potent drugs will be quite safe if the following rules are observed:

short course of treatment. The task of corticosteroids is to break the chain of the inflammatory process. The optimal period of use is from one to five days, the maximum period is 3 months. With a longer course duration, irreversible changes often develop in various body systems;

strict adherence to the doctor’s recommendations, a ban on additional injections, and taking pills at the patient’s initiative. Exceeding the dosage and frequency of use of potent hormonal agents negatively affects various parts of the body;

taking into account contraindications. The introduction of hormonal compounds with absolute and relative restrictions provokes problems with weakened organs and systems and increases the risk of side effects;

selection of corticosteroids- the task of an experienced doctor. You cannot give injections, apply ointments or take tablets that have shown high effectiveness in treating diseases of the spine and joint pathologies in relatives (neighbors, colleagues, friends). Potent remedies are selected only individually: unprofessionalism is costly for health.

Review of effective drugs

With an active inflammatory process, severe pain in the joints and spine, doctors prescribe hormonal drugs. It is important not only the effectiveness of the drug, but also taking into account contraindications for each patient.

How to take vodka tincture to treat joint diseases? We have the answer!

The rules for the rehabilitation and treatment of a non-displaced fracture of the medial malleolus are described on page.

Celeston

Characteristic:

a highly effective hormonal agent with active anti-inflammatory, antirheumatic, analgesic effects;

active ingredient – betamethasone;

noticeable glucocorticosteroid activity, elimination of negative symptoms in various forms of diseases of the musculoskeletal system;

release form: solution and suspension for injection, tablets;

injections of the drug Celeston are given into muscles, soft tissues, into the joint cavity, intravenously;

for systemic osteoporosis, ankylosis, “dry joint”, polio, acute viral and bacterial infections, the doctor will select another type of anti-inflammatory drug;

Against the background of active action, side effects appear in various organs and systems. A short course duration and adherence to the dosage help reduce the risk of negative manifestations;

for acute pain, it is allowed to mix Celeston with local analgesics;

It is not always possible to find the drug Celeston in the pharmacy. If not available, analogues are recommended: Diprospan, Beloderm, Akriderm.

Hydrocortisone

Characteristic:

drug for injection with active antiallergic and anti-inflammatory effects. The drug also produces an antishock, immunosuppressive, antipruritic, antiexudative effect;

active ingredient – hydrocortisone acetate (1 ml of product contains 0.025 g of active ingredient);

release form - suspension for injection, color - white with a yellowish tint or white;

hydrocortisone acetate – a group of glucocorticosteroids of natural origin;

the drug is recommended for synovitis, non-infectious arthritis, rheumatic osteoarthritis, osteoarthritis, and other pathologies of non-infectious etiology;

the medicine is injected into the gluteal muscle or intra-articular cavity;

Hydrocortisone suspension has side effects: before starting the course, it is important to take into account contraindications. In particular, hormonal injections are prohibited during pregnancy, breastfeeding, and diabetes;

in case of overdose, gastric bleeding, disruption of the synthesis of own hormones, and the development of Itsenko-Cushing syndrome are possible;

the average price is 150 rubles.

Diprospan

Characteristic:

a group of broad-spectrum hormonal steroid drugs;

the composition is effective in the treatment of inflammatory and degenerative-dystrophic processes in parts of the musculoskeletal system;

suspension for injection. Active ingredients: betamethasone dipropionate and betamethasone sodium phosphate;

the combination of active ingredients enhances the therapeutic effect of the drug and provides a prolonged effect;

In acute forms of articular pathologies, degenerative-dystrophic changes, and damage to various parts of the spine, it is important to break the chain of the inflammatory process. Eliminating the cause of discomfort will reduce the degree of negative manifestations and reduce pain. Corticosteroids have been developed to provide a rapid response to acute symptoms. A list of medications for joints and spine will be provided by your attending physician.

Video review on how to protect yourself from side effects while taking corticosteroids:

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There is a fairly large group of drugs used in the treatment of dermatological pathologies such as dermatitis, allergic rashes, etc. These drugs are called corticosteroids among pharmacists.

General information

Corticosteroids are hormonal substances produced by the adrenal glands to regulate metabolic processes.

These hormones block the formation of prostaglandins, which, in fact, are the initiators of inflammatory processes. As a result of the correct use of corticosteroids, inflammatory symptoms disappear: itching and soreness are eliminated, swelling disappears, and purulent processes stop.

In addition to the therapeutic effect, glucocorticosteroids can cause adverse reactions associated with suppression of immune activity and atrophy of skin tissue.

Such undesirable effects should be taken into account when using drugs in this group. In the production of ointment products, analogues of human hormones of synthetic origin and various additives are used to enhance the therapeutic properties.

Corticosteroid ointments can be divided into several types:

Lungs - made on the basis of prednisolone or hydrocortisone;
Moderate – based on prednicarbate, fluocortolone, flumethasone (etc.);
Strong - these ointments are based on budesonite, mometasone, betamethasone, methylprednisolone and other corticosteroid hormonal substances (Elocom, Celestoderm B, Sinaflan, etc.);
Very strong are flumethasone-based drugs (Dermovate).

There is also a separate group of products of mixed origin, to which, in addition to corticosteroids, additional active ingredients with antifungal or antibacterial action are added, for example, Flucinar, Lorinden, etc.

The drugs of these groups differ from each other in the intensity of their therapeutic effects, so they are selected in accordance with the severity of a particular skin disease.

How to use correctly

Any drug of corticosteroid origin should be used only as prescribed by a doctor. The specialist will determine the duration of such therapy and the number of applications of the drug to the skin per day.

Most often, a single application to the affected area during the day with a thin layer is indicated. The duration of corticosteroid therapy depends on the extent of the disease.

Before you start using any of the drugs, read the instructions for it.

Popular drugs

Corticosteroid drugs in the form of ointment or cream have antipruritic, anti-inflammatory and antiallergic effects. Different dermatoses are treated with hormonal drugs with varying strengths.

For example, exudative psoriatic forms are treated with moderate corticosteroid ointments (Fluorocort, etc.), and more severe forms of pathology require the use of stronger drugs (Celestoderm B or Dermovate, etc.). Let's consider the most common means of this group.

The main active ingredient of the drug is methylprednisolone. Advantan helps suppress allergic and inflammatory reactions on the skin, relieves pain, itching and irritation, reduces erythema and swelling.

The active ingredients of the drug are betamethasone and gentamicin. Belogent has antipruritic, antiproliferative, anti-inflammatory and antiallergic effects.

After application, it quickly affects the skin and reduces pathological symptoms. Gentamicin functions as a bactericidal component that can destroy most pathogenic microorganisms, including strains. Side effects occur very rarely, manifesting themselves as pimples, burning or redness.

Beloderm, Celestoderm B

Instructions, price, reviews: , Celestoderm

The main active ingredient of the cream is betamethasone. The drug has antiallergic, vasoconstrictor, antipruritic, antiproliferative and anti-inflammatory effects.

A more modern analogue of Beloderm is Celestoderm B. This remedy is also based on betamethasone and has an identical effect.

Its use in pediatrics is allowed in patients older than 6 months. Pregnant women can use this drug only in short courses and no more than once a day.

Hydrocortisone

Glucocorticosteroid drug with antiallergic and anti-inflammatory action. The active ingredient is hydrocortisone. The use of ointment is contraindicated during the period of vaccination, as well as infectious, viral and fungal diseases.

Glucocorticosteroid drug of synthetic origin. The main active ingredient is hydrocortisone.

Able to quickly provide antipruritic, anti-edematous and anti-inflammatory effects. If dosages are observed, it does not cause suppression of adrenal activity.

Long-term use of the drug can lead to increased levels of cortisol in the blood, but after stopping Lokoid, cortisol production returns to normal on its own.

Medicinal agent with anti-inflammatory, antifungal, antibacterial effects. The main active ingredients of Lorinden C are flumethasone and clioquinol.

Flumethasone is a glucocorticosteroid with vasoconstrictor and anti-inflammatory, antipruritic and antiallergic, anti-edematous effects. Clioquinol is a substance active against yeast fungi, dermatophytes and gram-positive bacteria.

As a result of this composition, allergic and inflammatory reactions complicated by fungal and antibacterial infections are suppressed.

Prednisolone ointment

The main active component of Sinaflan and its analogue Flucinar is fluocinolone. These drugs have a pronounced anti-inflammatory and antiallergic effect.

They are easily absorbed through the skin, and in children the absorption is much higher than in adult patients. The duration of use of the drugs does not exceed 2 weeks.

Fluorocort

The active ingredient of the ointment is triamcinolone. Accumulating in the skin, this glucocorticosteroid drug reduces the manifestations of exudation and itching, provides anti-edema and anti-allergic effects. The daily dose of the drug is 15 g, the course of therapy is no more than 10 days.

Fucidin G

The main active ingredients of Fucidin G ointment are hydrocortisone and fusidic acid, which is an antibiotic substance. A combined glucocorticosteroid drug with increased anti-inflammatory and antipruritic effects. Approved in pediatrics from 2 years. The duration of treatment is no more than 14 days. Do not confuse with regular Fucidin.

Elokom

Corticosteroid ointment with the active ingredient mometasone. It has an effect similar to other hormonal ointments. It is recommended to apply no more than once a day.

The duration of therapy depends on the tolerability of the drug and side effects. Contraindicated in children under 2 years of age.

Precautions

Corticosteroid drugs can cause a variety of adverse reactions. The use of weak and moderate group drugs contributes to less severity and rare occurrence of undesirable effects. If treatment involves the use of such drugs in high doses or the use of an occlusive dressing or the use of highly active glucocorticosteroids, the following manifestations may occur:

Increased blood pressure;
Weight gain;
Menstrual irregularities;
Increased swelling;
Increased blood sugar, even steroid diabetes;
Gastrointestinal bleeding, formation or exacerbation of gastric ulcers;
Osteoporosis;
Increased rate of thrombosis;
Hypersweating;
Neurological disorders;
Skin atrophy;
Increased hair growth in the facial area;
Bone necrosis;
Increased susceptibility to fungal and bacterial infectious processes against the background of secondary immunodeficiency;
The occurrence of cataracts, glaucoma;
Acne;
Slow recovery of damaged tissues;
Suppression of adrenal activity;
Tendency to depression, mood swings.

With long courses of corticosteroid therapy, even the patient’s appearance may change:

Individual areas of fat form, for example on the neck (bull neck), abdomen, chest or face (moon face);
Muscle tissue atrophy occurs;
Striae and bruising appear on the skin.

To reduce the risk of unwanted manifestations, you need to monitor your condition and, at the slightest hint of a side effect, adjust the dosage of corticosteroids. In addition, during the course of corticosteroid therapy, it is recommended to limit the water-salt regime and calorie intake, and monitor weight changes.

Features of use in children

For pediatric patients, corticosteroid ointments or creams are prescribed exclusively in short courses and only on small areas. The fact is that in children, sensitivity to adverse reactions of such drugs is more pronounced than in adults. Therefore, up to a year in children’s treatment, only the latest generation drugs or drugs with 1% hydrocortisone are used; at 1-5 years of age, moderate strength drugs are used.

Attention! Only a doctor should prescribe the drug, since unauthorized prescription of such drugs can be dangerous for the child.

According to medical prescription, from 2 years of age you can use Metazon long-acting ointment, which is applied to the affected areas 1 r. per day. Advantan is often used against atopic dermatitis in children; it can be treated for a month, but only in small areas, since the ointment has side effects.

Features of use in pregnant women

The use of glucocorticosteroids in pregnant women has an extremely negative effect on the fetus, therefore the use of hormonal ointments during such a period is allowed only for a short course over a small area and only in cases where the expected therapeutic effect is higher than the risk of use.

According to research, the use of strong and very strong hormonal ointments in the treatment of pregnant women can cause placental insufficiency, lack of weight in the fetus or cleft palate. The use of corticosteroid ointments of weak or moderate strength is considered relatively safe and does not contribute to pregnancy problems or increase the risk of malformations.

6 comments

Good afternoon
8 months ago a reddish spot appeared on my temple. Now there is a spot on both the forehead and cheeks with a diameter of 5-10 mm, there is itching. I was treated by a dermatologist, having previously passed all possible tests, everything is in order, it is neither a fungus nor an infection. At first they prescribed Fucidin G cream and Claritin + Lactofiltrum for 2 weeks, it helped a little, the spots almost disappeared, but then they appeared again in the same places. The dermatologist prescribed Bepanten and Belogent, which also didn’t help much. I noticed that exacerbation appears after a stressful situation, fatigue, alcohol, sweating or being in a sauna is not allowed. Since December 2016, the dermatologist, throwing up his hands, sent him to a therapist, also passed all possible tests, found nothing, the therapist also shrugged his shoulders...
What can you recommend? One is familiar with being treated against fungal spots on the body with IRUNIN tablets, SEBOZOL Shampoo, Mikospor and Thermikon Spray. It helps him.
Thank you!

Hello,
If they did a scraping and the analysis showed nothing, it means it’s not a fungus. Again, since corticosteroids help, the description is more like eczema or dermatitis. Usually in such cases, the acute phase can be relieved with hormonal ointment, but the disease is not completely cured.

Hello, please tell me how to apply diathesis on a 2-year-old child’s cheeks. She constantly scratches these sores and they don’t go away for a long time

Hello,

The first thing to do is adjust your diet. Mothers always take this fact with hostility, but without this nothing will help. Hormonal ointment is the last thing to use.

Good evening. I have a rash on my chin and stomach. She was treated with Azithromycin Baneocin ointment and wet lotions based on dimexide and ceftriaxone. There is an improvement, but new rashes still appear. Help with advice please. What else can you try?

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! Only a doctor can make an accurate diagnosis.

Steroid hormone preparations were, are and will remain one of the leading groups of drugs used to treat joint diseases, because they have such important qualities for a rheumatological patient: a rapid onset of action and a powerful anti-inflammatory effect, exceeding the strength of any of them.

However, these drugs not only have advantages, but also a number of quite serious side effects, which, if glucocorticoids are used incorrectly, can cause serious damage to the patient’s health. That is why the attitude of many patients and even doctors towards this group of drugs is ambiguous. Some are ready to take them constantly, “just so it doesn’t hurt,” while others categorically refuse to take at least one injection into a joint, “because it’s harmful.” Both approaches are fundamentally wrong: glucocorticoids, or corticosteroids, are simply necessary in certain clinical situations and with a skillful approach to their treatment; but in some cases, of course, you can and should do without them.

What are glucocorticoids and what are their main effects?

Glucocorticoids, or corticosteroids, are steroid hormones produced by the adrenal cortex: cortisone and hydrocortisone. This term also refers to hydrocortisone derivatives of semi-synthetic origin: prednisolone, dexamethasone, methylprednisolone and others. These are the ones that will be discussed in this article.

The main effects of corticosteroids on the human body are:

Anti-inflammatory: these substances inhibit the formation of the phospholipase-A2 enzyme, as a result of which the synthesis of inflammatory mediators: leukotrienes and prostaglandins is disrupted; Regardless of the cause of inflammation, corticosteroids effectively inhibit all its phases.
Antiallergic and immunoregulatory effects. They affect the immune system, providing an immunostimulating effect in low doses, and an immunosuppressive effect in high doses; inhibit the production of antibodies by B-lymphocytes and plasma cells, reduce the production of cytokines and lymphokines. They inhibit the increased formation of eosinophils and destroy existing cells in the blood, and also reduce the production of immunoglobulin E, increase the histamine-binding capacity of the blood and stabilize the membranes of mast cells, which prevents the release of histamine and other allergy mediators from them: all this leads to a decrease in the manifestations of allergic reactions.
Affect water-electrolyte metabolism. They increase the reabsorption of water and sodium from the lumen of the renal tubules into the blood and promote the excretion of potassium.
Affect exchange. They slow down the processes of microelement absorption in the intestine, accelerate its release from the bones, and increase its excretion from the body in the urine.
Affects carbohydrate metabolism. They stimulate gluconeogenesis in the liver (the formation of glucose from non-carbohydrate products), reduce the permeability of cell membranes to glucose, which causes an increase in glucose levels in the blood and urine - hyperglycemia and glucosuria, up to the development of steroid.
Affect protein metabolism. They slow down the processes of protein synthesis and accelerate its breakdown in tissues, especially in muscles, bones and skin. The patient loses weight, his skin and muscles atrophy, stretch marks (striae) appear, hemorrhages appear, wounds heal slowly, and diarrhea develops.
Participate in the processes of fat metabolism. In the tissues of the upper and lower extremities, fats are predominantly broken down, and in the area of the face, neck, shoulder girdle, and torso they are synthesized. Subcutaneous fatty tissue is redistributed according to the Cushingoid type.
Affects the cardiovascular system. They increase systemic blood pressure, increasing the sensitivity of the heart muscle and arterial walls to adrenaline and norepinephrine, and also enhance the pressor effect of angiotensin-II.
Affects the blood system. Stimulate the formation of platelets and red blood cells, inhibit the production of lymphocytes, monocytes, eosinophils.
Affect other hormones. Inhibits the production of sex hormones and luteinizing hormone of the pituitary gland. Promote the development of glucocorticoid. Reduces the sensitivity of tissues to thyroid hormones, as well as somatomedin and somatotropin.

Pharmacodynamics of glucocorticoids

They are quickly and completely absorbed in the small intestine when taken orally, reaching maximum concentrations in the blood after 30-90 minutes. Eating at the same time as taking the drug slows down the absorption process, but does not affect the degree of its effect.

The time for the effect to appear from drugs administered parenterally (intramuscularly or intravenously) depends on the characteristics of the drug and varies from 1-2 to 24-48 hours.

Once in the blood, corticosteroids bind to proteins by 40-60% and undergo structural changes in the liver. Excreted by the kidneys. No dosage adjustment of the administered drug is required.

Routes of administration and indications for use

If the joint is severely inflamed, corticosteroids may be injected directly into the joint.

To treat joint diseases, corticosteroids can be used both systemically (orally, intramuscularly or intravenously) and locally (usually through intra-articular injections).

Direct indications for the use of systemic corticosteroids in rheumatology are:

acute rheumatic fever, systemic and other diseases with severe articular syndrome;
І-ІІ degrees in the absence of effect from other types of treatment or ІІІ degrees, especially with systemic manifestations;
systemic

Indications for the injection of glucocorticoids into the joint are:

juvenile rheumatoid arthritis or rheumatoid arthritis in adults;
acute traumatic arthritis;
periarthritis of the shoulder joint;
synovitis of the knee joint that occurred after plastic surgery of the hip joint on the opposite side.

Even with the conditions listed above, corticosteroids are not always indicated. They are prescribed if NSAID therapy for 2 weeks has not given a positive result, or when synovitis has already developed - inflammation of the synovial membrane of the joint with the formation of effusion in it (clinically, this condition is manifested by swelling of the joint, soreness and pain, as well as limitation active and passive movements in it).

Contraindications to the use of corticosteroids

There are no absolute contraindications to the use of systemic drugs in this group. Relative contraindications are:

peptic ulcer of the stomach and duodenum;
epilepsy, mental disorders;
severe heart failure;
expressed

In emergency situations, glucocorticoids, if indicated, are administered to everyone without exception, without taking into account contraindications. The latter should be taken into account only in the case of planned long-term hormone therapy.

Intra-joint injection of corticosteroids is contraindicated in:

systemic or local infectious process;
severe periarticular osteoporosis;
transarticular fracture;
severe bone destruction or joint deformation that cannot be corrected;
difficult access to the affected joint;

Side effects of glucocorticoids

Systemic administration of glucocorticoids, especially over a long period of time, is often accompanied by many adverse reactions, the development of which should be anticipated and prevented with appropriate drugs.

So, the adverse reactions of corticosteroids are:

osteoporosis and vertebral compression fractures and other pathological fractures arising from this disease, as well as aseptic necrosis of the femoral head;
, improved appetite;
muscle damage, atrophy;
thinning of the skin, stretch marks and hemorrhages on it, acne;
prolonged wound healing;
frequent infectious diseases, blurring their clinical picture;
, vomiting, discomfort, and esophagus, bleeding, steroid ulcers of the digestive system, ;
psychoses, sleep disturbances, sudden mood swings, pseudotumor cerebri syndrome;
slower linear growth and delayed puberty in children, secondary amenorrhea, suppression of the functions of the hypothalamic-pituitary-adrenal system, steroid diabetes;
cataract, glaucoma, exophthalmos;
water and sodium retention, which manifests itself as a decrease in blood levels, hyperosmolar coma;
increased levels of glucose and lipids in the blood, Cushingoid syndrome.

Some of the side effects (emotional instability, sleep disturbances and others) occur immediately after the start of treatment and cannot be avoided. Others develop later, and their occurrence can be prevented by using small doses of the hormone or by prescribing medications to prevent complications.

Side effects of local (into the joint) administration of glucocorticoids are:

osteonecrosis;
steroid arthropathy (joint destruction);
tendon ruptures;
fat necrosis, lipodystrophy, atrophy of joint tissue, its calcification;
“post-injection exacerbation”;
feeling of heat;
damage to nerve trunks.

With a skillful approach to treatment, technically correct injection, and not multiple but single injections, the development of side effects from the injection of the hormone into the joint is unlikely. As a rule, these reactions develop in case of abuse of glucocorticoid drugs and when they are administered technically incorrectly.

Features of corticosteroid therapy

Treatment with glucocorticoids should be prescribed exclusively by a doctor if there are direct indications for it. During therapy with systemic drugs, the patient should be under the supervision of a specialist and undergo periodic examinations to monitor the occurrence of adverse reactions. The examinations are as follows:

regular weighing;
daily measurement of blood pressure, if hypertension is detected, consult a doctor and then take antihypertensive drugs;
blood and sugar test;
biochemical blood test to determine its electrolyte composition;
monitoring the condition of the skeletal and muscular system;
in case of complaints of pain in the bones, conducting blood tests for calcium metabolism, as well as to confirm the diagnosis of osteoporosis; Prophylactic intake of calcium-containing medications and vitamin D is recommended to prevent the development of this condition;
in case of complaints from the digestive tract, esophagogastroduodenoscopy is performed to examine the mucous membrane of the relevant organs for the presence of erosions and ulcers; possible prophylactic administration of antacid drugs;
consultation with an ophthalmologist with relevant examinations;
control of infectious diseases.

The effectiveness of local - into the joint cavity - therapy with corticosteroids varies from patient to patient, but, as a rule, after 1-2 injections there is some degree of clinical improvement. If it is minimally expressed or absent altogether, local treatment with hormones is stopped and they are used systemically.

To increase the effectiveness of intra-articular anti-inflammatory therapy, the affected joints must be provided with complete rest for 2-3 days after the hormone injection.

To prevent infection from entering the joint, the doctor must follow all the rules of asepsis when performing manipulation.

Different volumes of the drug are injected into different joints: it depends on the volume of the joint. Thus, 1-2 ml is injected into large (knee, shoulder, ankle) joints at a time, into medium (wrist, elbow) - 0.5-1 ml, and into small (metatarsophalangeal, interphalangeal, metacarpophalangeal) - only 0.1-0.5 ml of hormone solution. A corticosteroid is injected into small joints mixed with an anesthetic.

With frequent - more than 3-4 times a year - administration of a glucocorticoid into the same joint, a metabolic disorder in the articular cartilage is possible with subsequent disruption of its structure, chondrodestruction. With less frequent administration of the drug, there is no negative effect on cartilage.

Review of drugs

Let's take a closer look at glucocorticoids used to treat joint diseases.

Dexamethasone (Dexona, Dexamethasone)

For the treatment of joint diseases, it is used in the form of tablets of 0.5 mg and an injection solution containing 4 mg of active substance per 1 ml.

For exacerbation of rheumatoid arthritis, the dose of the drug is 4-16 mg per day. If long-term corticosteroid therapy is required, it is recommended that prednisolone be used instead of dexamethasone.

When taken orally, the daily dose of the drug should be taken once, in the morning (this is due to circadian rhythms), after meals, with a small amount of liquid.

It is also used intra-articularly (inside the joint). As a rule, it is injected into small joints - 2 mg (0.5 ml) of the drug at a time.

Contraindications to the use of dexamethasone are similar to those listed above in the section on general contraindications to glucocorticoids. The side effects are the same. Functional insufficiency of the adrenal cortex usually develops after 14 or more days of daily use of the drug.

Prednisolone (Prednisolone)

For joint diseases, it is used in the form of an injection solution in ampoules containing 30 mg of active substance per 1 ml, as well as in the form of 5 mg tablets.

Orally, regardless of food intake, 20-75 mg is used at the beginning of treatment, subsequently 5-25 mg (this is the so-called maintenance dose). The drug is discontinued gradually, reducing the dose over a period of time. At the end of treatment, corticotropin is administered to prevent adrenal atrophy.

The maximum single dose for an adult patient is 15 mg, the daily dose is 100 mg.

The duration of treatment is individual and depends on the specific disease and the severity of its course. However, it should be remembered that prednisolone should be taken in the minimum effective dose for the minimum time necessary to achieve the desired effect of treatment.

The drug is administered intramuscularly or intravenously in emergency situations. The daily dose for an adult in this case is 25-50 mg.

Take prednisolone only as prescribed by a doctor and under his strict supervision. They are contraindicated during treatment. During pregnancy, it is used according to strict indications; during breastfeeding, it is permissible to take a dose of up to 5 mg per day; higher doses can harm the health of the child.

Methylprednisolone (Medrol, Depo-medrol, Metypred, Solu-medrol, Methylprednisolone)

For the treatment of joint diseases, it is used in the dosage form of tablets of 4, 8, 16 and 32 mg, powder and suspension for injection in ampoules.

There are 4 regimens for taking methylprednisolone:

Continuous: take the drug daily, taking into account the circadian rhythm of cortisol release in the body; in this case, 2/3 of the recommended daily dose is taken in the morning, and the remaining 1/3 – in the afternoon.
Alternating: a double dose of the drug is recommended to be taken in the morning once every 48 hours. With this treatment regimen, the effect will be the same, and the likelihood of developing side effects is significantly reduced. On days when the hormone is not taken, NSAIDs can be used. In severe cases of the disease, a continuous regimen is first prescribed, and after acute manifestations subside, they switch to an alternating regimen, with a gradual reduction in the dose of the drug. In case of moderate severity of the disease, treatment can begin directly with an alternating regimen.
Intermittent: take methylprednisolone daily for 3-4 days, then take a short break for another 4 days. After this period, they start taking the drug again, and so on in a circle.
Pulse therapy: rapid infusion (over 30 minutes) of ultra-high doses of the drug: 500-1000 mg per administration. The course of treatment according to this regimen is 3 days. This treatment is prescribed for severe rheumatic diseases, characterized by high activity of the inflammatory process, which cannot be treated using other regimens. The advantages of pulse therapy are the rapid onset of action of the drug, which is manifested by an effective reduction in the severity of symptoms of the disease, a long-lasting therapeutic effect - up to 12 months, a low risk of side effects, and a milder subsequent course of the disease (especially if this treatment regimen is used at an early stage). Despite the many advantages of pulse therapy, patients for it are selected according to strict criteria, since the reaction of a particular person to the administration of such a large dose of the hormone cannot be predicted.

Recommended doses for oral administration range from 16 to 96 mg per day; if treatment is necessary for a long time, in order to minimize possible side effects, it is necessary to select the minimum effective dose of the drug. Can be taken every other day. The maintenance dose of methylprednisolone is 4-14 mg per day.

In emergency conditions, as well as in case of exacerbation of rheumatic diseases, methylprednisolone is administered intravenously by stream or drip, as well as intramuscularly. Dose – 100-500 mg per administration.

If indicated, the drug is administered intra-articularly. Its dose in this case depends on the size of the joint and the severity of the pathological process. The solution is injected into the synovial space, into a large joint - 20-80 mg, into a medium joint - 10-40 mg, into a small joint - 4-10 mg of solution. If necessary, the injection can be repeated after 1-5 weeks or more.

This dosage form of the drug, such as a depot suspension, is administered intramuscularly at 40-120 mg once every 1-4 weeks according to indications. Inside the joint - 4-80 mg, repeating after 1-5 weeks, also according to indications.

The use of methylprednisolone is contraindicated for systemic (mycoses), as well as in cases of individual hypersensitivity to methylprednisolone.

Side effects and special instructions are similar to those described in the general section - see above.

Triamcinolone (Polcortolon, Kenalog)

Release forms for the treatment of joint diseases: injection suspension, 4 mg tablets.

Recommended doses for oral administration are 4-16 mg per day, the frequency of administration is 2-4 times. When the therapeutic effect is achieved and the acute manifestations of the disease have decreased, the dose should be reduced to a maintenance dose of 1 mg per day. The dose should be reduced gradually - by 2 mg every 1-2 days.

Systemically injected deep into the muscle, 40 mg per injection. In severe cases of the disease, this dose can be doubled. To prevent the suspension containing the active substance from flowing out of the injection channel after the needle is pulled out, press a sterile cotton swab or napkin as tightly as possible to the injection site for 1-2 minutes. If after a single administration of the drug there is a need for a second injection, the interval between them should be at least 1 month.

When the drug is administered into the cavity of small joints, the dose is 10 mg, into medium joints - 30 mg, into large joints - 40 mg. If it is necessary to administer triamcinolone in parallel to several joints, the total dose of the drug should not exceed 80 mg.

Contraindications to the use of this drug are peptic ulcer of the stomach and duodenum, a history of acute psychosis, with metastases, in an active form, as well as individual hypersensitivity to the components of the drug.

Side effects are observed quite rarely, regardless of the frequency and method of administration of the drug. These are allergic reactions, redness of the skin and a feeling of hot flashes, increased blood pressure. With repeated administration of triamcinolone in the same place around the latter, atrophy of the subcutaneous fatty tissue, which is reversible, is possible. After injection into the joint, pain sometimes occurs in it, which goes away on its own after some time.

It is not recommended to use during pregnancy and breastfeeding.

Hydrocortisone (Solu-cortef, Hydrocortisone acetate, Hydrocortisone)

Chemical formula of hydrocortisone

Release form: 10 mg tablets, suspension for injection and powder for solution for injection.

The initial dose of the drug, administered orally, varies widely depending on the disease and the severity of its course and for adults is 20-240 mg per day in 2-3 doses. When the therapeutic effect is achieved, the initial dose is gradually, slowly reduced to a maintenance dose.

125-200 mg of the active substance is administered intramuscularly. A dose of 5 to 25 mg is administered inside the joint, depending on its size and severity of the lesion. The effect of intra-articular administration of hydrocortisone develops over a period of 6 to 24 hours and lasts from 2-3 days to several weeks.

Contraindications, side effects and special instructions are similar to those described in the general section of this article - see above.

Betamethasone (Diprospan, Celeston, Betaspan, Flosteron, Loracort)

For the treatment of joint diseases, it is used in the form of a suspension and solution for injection in ampoules containing 4 mg of active substance, as well as in the form of tablets.

The daily dose at the first stage of treatment when taking the drug orally is 0.25-8 mg and directly depends on the severity of the disease. If necessary, the indicated dose can be increased to the level at which the effect occurs. When positive treatment results are achieved, the dosage of betamethasone is gradually reduced to maintenance. If for some reason therapy with this drug needs to be stopped, it should, again, be discontinued not immediately, but gradually. The daily dose can be divided into 2-3-4 doses or, if it is convenient for the patient, it can be taken in one dose, in the morning.

Betamethasone is administered intramuscularly in an initial dose calculated individually, depending on the patient’s body weight - it is 0.02-0.125 mg per kg of body weight and is administered 1-2 times a day. Sometimes the drug is administered intravenously in a 0.9% sodium chloride solution.

Intra-articularly, 1-2 ml is injected into large joints, 0.5-1 ml into medium joints, and 0.25-0.5 ml of injection solution into small joints. In some cases, simultaneous administration of a local anesthetic (usually lidocaine or procaine) is indicated. The duration of the therapeutic effect after the introduction of betamethasone into the joint is up to 4 weeks or more.

The use of this drug is contraindicated in persons with hypersensitivity to it or other corticosteroids, as well as those suffering from systemic mycoses. The drug should not be administered intramuscularly to patients with idiopathic thrombocytopenic purpura.

The drug in suspension dosage form is not indicated for subcutaneous or intravenous administration. The introduction of betamethasone into the joint can be accompanied not only by a pronounced local effect, but also have a systemic effect. The drug should not be injected into a joint if there is an infection in it: it is indicated only in the case of aseptic inflammation. To prevent atrophy of subcutaneous fatty tissue at the injection site, the solution should be injected deep into a large muscle mass.

During pregnancy, the drug is used according to strict indications. Breastfeeding should be discontinued during treatment with medium and high doses of betamethasone.

Conclusion

In conclusion, we would like to once again draw your attention to the fact that the information about the drugs given above is intended for informational purposes only. Only a specialist should recommend treatment with glucocorticoids. Uncontrolled use of these drugs will lead to serious complications. We ask you to take responsibility for your health and the health of your loved ones.

Which doctor should I contact?

Glucocorticoids for joint damage are prescribed by a rheumatologist. In some cases, they are used by orthopedists. If side effects of corticosteroids develop, the patient is consulted by a cardiologist (for increased blood pressure), a gastroenterologist (for damage to the gastrointestinal tract), an immunologist (for frequent infectious diseases), an endocrinologist (for suspected development of adrenal insufficiency or, conversely, signs of an overdose of adrenal hormones).

Sometimes, when treating an allergic reaction of the body to any irritant, specialists use corticosteroid drugs, but not all patients know what this is.

These hormonal agents can give a quick effect, relieve inflammation and swelling of tissues. But, like all other medications, they have contraindications and limitations in use.

It is important to understand their action, study the advantages, disadvantages and rules of use in order to understand why the doctor in one case or another prescribes such serious medications.

The essence of drugs is important

Knowing what corticosteroids are is important to understand how they work. These are steroid hormones that are naturally produced by the adrenal cortex. Their analogues are drugs with corticosteroids of synthetic origin, which are designed to compensate for the lack of hormones in the human body if necessary.

Main functions:

relieving inflammation;
control of kidney function;
regulation of hormonal balance;
normalization of metabolic processes;
reducing the body's sensitivity to stress.

Natural hormones are able to block the root cause of inflammation in the body, but they are not always enough to suppress the synthesis of inflammatory mediators. In this case, specialists resort to the help of drugs that are derivatives of cortisol, that is, a natural human hormone.

This group of drugs is used in the treatment of many diseases. Although corticosteroids do not have an analgesic effect, the pain goes away after the source of inflammation is eliminated. There is a certain condition of the patient when the use of these drugs helps to break the vicious circle of the pathological process. When the source of inflammation is suppressed and tissue swelling is relieved, it is possible to weigh everything correctly and decide on the correct course of further therapy.

You can often encounter an unjustified fear of a patient about taking hormonal drugs, but you should understand that nothing bad can happen if the drugs are administered as prescribed by a doctor, in particular, 5 times within 10 days. However, the benefits for a weakened body will be significant, since they not only suppress inflammation, but also activate protective properties to fight the disease.

Harm can only be caused by uncontrolled use of hormones for a month or more, which results in problems with the body’s self-regulation.

Features of synthetic hormones

The main advantage of corticosteroid hormones is their high efficiency and instant results, which sometimes save a person’s life. The drugs can not only eliminate inflammation and swelling of tissues due to allergies, but also enhance the effectiveness of chemotherapy to suppress the further development of tumor processes.

Hormonal drugs are not able to neutralize the main cause of the pathology and the mechanism of its development. They only relieve unpleasant symptoms.

The use of corticosteroid medications is allowed if other means have not brought the desired result.

Indications for use are:

lichen;
psoriasis;
hives;
chicken pox;
lupus erythematosus;
multiple sclerosis;
rheumatoid diseases;
spinal cord damage;
tumor pathologies of the blood;
and dermatitis;
dysfunction of the immune system;
viral diseases (hepatitis, mononucleosis);
some types of malignant tumors;
impaired skin pigmentation due to immune failure;
severe allergic symptoms (, asthma attack, anaphylactic shock);
eye diseases of allergic and non-infectious properties (conjunctivitis, blepharitis).

Like other medications, corticosteroids have some contraindications. But experts say that they are not absolute, but relative. For example, if there is a direct threat to life in the case of angioedema or anaphylactic shock, then hormonal drugs are used, regardless of contraindications.

But when prescribing long-term therapy for them, you should definitely take into account:

osteoporosis;
epilepsy attacks;
arterial hypertension;
high blood sugar;
severe mental disorders;
acute heart failure;
chronic pathologies of the digestive system (ulcers).

Although hormones can effectively eliminate inflammation in the body in many diseases, they can also cause many side effects. This especially happens with long-term therapy with high dosages. Common side effects:

acne;
swelling;
arrhythmia;
neuritis;
psychoses;
myopathy;
glaucoma;
obesity;
pancreatitis;
insomnia;
headache;
muscle atrophy;
development of cataracts;
increased appetite;
urolithiasis;
tendon damage;
fatty liver;
ischemic bone necrosis;
metabolic disorders;
heart failure;
thinning of the skin;
active growth of facial hair;
delayed sexual development;
menstrual irregularities;
frequent urge to urinate;
blood clotting disorder;
causeless irritability;
intrauterine developmental delay.

Release forms for effective treatment

Synthetic corticosteroid medications are available in several basic forms:

pills;
solutions for inhalation;
solutions for injection of corticosteroids;
means for external use (cream,).

The most common and popular drugs with corticoids are shown in the table.

Group name	Drug name	Peculiarities
Corticosteroids tablets	Metipred	The active ingredient is methylprednisolone. Has a rapid anti-inflammatory effect. The dosage for an adult is 1 tablet per day, and the tablet must be swallowed whole without chewing. For children, the dosage is determined by the doctor. The duration of action is 18-36 hours. The main contraindication is hypersensitivity to the component. Has a number of restrictions: pregnancy, acute form of psychosis, complex infections, endocrine system disorders
	Celeston	The active component of the drug is betamethasone. The dosage is prescribed by the doctor based on the patient’s condition. The use of the drug for severe infections, glaucoma, hypertension, poliomyelitis, and after a myocardial infarction is unacceptable.
	Prednisolone	It has a strong anti-allergic and anti-inflammatory effect. The use of the drug in acute renal failure, stomach ulcers, tuberculosis, and pregnancy is unacceptable. May provoke side effects such as insomnia, edema, and immunodeficiency. The product can be produced in the form of ointments and injections.
	Kenacort	The medicine has a stabilizing effect, eliminating the symptoms of inflammation and allergies. The active ingredient is triamcinolone. Compared with other drugs, it has minimal negative effects on the digestive system and psyche
Solutions for injections	Flosteron	Thanks to the betanidozole included in its composition, it has a long-lasting effect. Contraindicated in glaucoma, tuberculosis, complex infections, viral diseases
	Kenalog	Compared to other similar drugs, it has a more gentle effect on the body, without affecting the function of the pituitary gland and metabolic processes. The active ingredient of the drug is triamcinolone
	Hydrocortisone	Effectively suppresses inflammation and allergy symptoms. Inadmissible for use in cases of psychosis, nephritis, severe hypertension, tuberculosis, diabetes mellitus
	Diprospan	The drug is recommended for use in cases of cerebral edema, acute adrenal insufficiency and shock of various types. The active ingredient is betamethasone dipropionate
External products	Elokom	Used to relieve negative symptoms of inflammation and annoying itching. The active ingredient is mometasone furoate. Contraindicated in case of hypersensitivity to components
	Flucourt	The drug is indicated for childhood and atopic eczema, dermatitis of various types, and lichen. Contraindicated during pregnancy, during breastfeeding, under the age of 1 year, with individual sensitivity
		Used to relieve inflammation, swelling and itching. The active substance is hydrocortisone acetate. Do not use for rosacea, acne vulgaris, open wounds and ulcers, as well as in case of fungal, viral and bacterial skin lesions
	Lorinden S	The ointment is indicated for allergies with the addition of a secondary infection, seborrheic dermatitis, eczema, herpes, eczema. Not recommended for use on large areas of skin
Inhaled corticosteroids	Nasobek	Recommended for eliminating rhinitis, as the main symptom of allergies. Active ingredient: beclomethasone
	Aldecin	Indicated for bronchial asthma of varying severity. The dosage of this inhaled corticosteroid is prescribed by the attending physician based on the patient's condition. After inhalation, it is recommended to rinse your mouth with water.
	Beclomethasone	Relieves the unpleasant symptoms of allergies in the form of rhinitis. Use is possible from the age of six. Limitations include tuberculosis, nasal infections, cataracts, glaucoma, nosebleeds

This list of drugs with artificial corticosteroids in the form of injections, tablets and other forms is not provided for independent use, but in order to better understand medical prescriptions.

Types of medicines

Depending on the hormones they contain, synthetic corticosteroids are divided into the following types:

very strong action (Dermovate);
strong (Elokom, Celestoderm, Afloderm);
moderate (Flucinar, Fluorocort, Lorinden);
gentle action (, Prednisolone).

In addition, drugs with corticosteroid hormones are divided depending on the composition:

Fluoridated products. They have a strong anti-inflammatory effect, but the likelihood of side effects increases, so therapy should be carried out for no more than 1 week (Flumetasone, Betamethasone);
Fluoride free. They have a gentle effect, so the likelihood of side symptoms is minimal. When used on the face and in skin folds, the duration of therapy is 2 weeks, and in other cases 20 days are allowed (Mometasone furoate, Methylprednisolone aceponate).

Prescriptions for Special Patient Groups

Children

Treatment of children with systemic corticosteroids is prescribed when absolutely indicated. In case of broncho-obstructive syndrome, when the situation threatens the life of the child, it is recommended to administer Prednisolone intravenously. The dosage of the medicine is calculated based on individual characteristics. The procedure is repeated after 3-4 hours until the condition improves. Then the drug is discontinued.

In the case of a child’s hormonal dependence during the treatment of bronchial asthma, after administering the drug intravenously, it is impossible to radically interrupt the treatment and therefore he is gradually transferred to a moderate dosage of the drug. In case of regular attacks of the disease, it is recommended to use Beclamethasone dipropionate in the form of inhalations. The dosage and course of treatment are prescribed individually. If the situation improves, the child should be switched to a moderate dosage.

Corticosteroids in the form of ointments, creams and lotions are used in exceptional cases: the child’s body is hypersensitive to the effects of drugs, resulting in an increased risk of developmental and growth delays, and possible disruption of the endocrine glands.

For children under 1 year of age, the use of Prednicarbate (Dermatol) is allowed, and for children under 5 years of age - Hydrocortisone 17-butyrate. From the age of two, the use of Mometasone ointment is allowed, but it should be taken into account that the duration of action is 24 hours.

The choice of corticosteroid drugs for treating a child should be made exclusively by a doctor, since any self-medication can lead to serious consequences.

Pregnant

During pregnancy, even short-term use of corticosteroids can negatively affect the baby's health. This is due to the fact that they imitate stress for the baby, as a result of which the child’s body has to activate internal protective functions.

In addition, synthetic corticosteroids help reduce the immunity of a pregnant woman, therefore increasing susceptibility to viruses and infections, which negatively affects the fetus.

Taking medications of this type during pregnancy is possible only if the benefits are much higher than the risk of side effects for the child. Most often, Prednisolone is used to treat a woman during this period, and Metipred and Dexamethasone are used for the fetus. But the final decision is made by the doctor.

Safe use

It is important to know not only what these drugs are - corticosteroids, their list, but also the rules of use:

strictly follow the doctor’s instructions;
avoid getting medications into your eyes;
do not exceed the required dosage;
Before starting treatment, read the instructions and pay attention to contraindications.

In case of long-term use of hormones, it is impossible to abruptly stop treatment. The body must be gradually adjusted to a more moderate dosage. This is due to the fact that the drugs can suppress the function of the adrenal cortex and therefore, if suddenly discontinued, adrenal insufficiency may occur.

Corticosteroids are strong and effective medications, but their improper use can have detrimental effects on your health and can last for several years. Therefore, the use of tablets, ointments, creams and other drugs in this category should be carried out exclusively by the attending physician, taking into account the characteristics of the patient.

What are corticosteroids? This is the collective name for a whole group of hormones produced by the adrenal cortex. Preparations based on them are actively used in modern medicine. They are divided into two groups, the first is glucocorticoids, which include, in particular, cortisone (an oral glucocorticosteroid used for chronic adrenal insufficiency) and hydrocortisone. The second group is mineralocorticosteroids - regulators of water and sodium metabolism in the body.

For the first time, doctors and scientists started talking about their benefits and importance for the human body in 1886. Corticosteroids are necessary for humans to normalize metabolism, control kidney function, and also puberty.

Classification of corticosteroid hormones

In modern medicine, natural hormones are not used; they have been replaced by synthetic substitutes that affect humans in a similar way. Doctors classify them by activity level:

Steroid hormones produced exclusively by the adrenal cortex with reduced activity (Hydrocortisone and Prednisolone).
Steroid hormones with average activity, these include Flumethasone and Fluocortolone.
Hormones with highly pronounced activity are the most common steroids at present (Betamethasone and Mometasone).
Hormones with very high activity, these include Clobetasol and Chalcinonide.

Action

So what are “corticosteroids” and what effect do they have on the human body? Those drugs that are sold in pharmacies are synthetic compounds; they can be produced under different trade names, but the active substance in each group is the same. The effects of corticosteroids are as follows:

anti-inflammatory effect without affecting the infectious origin and pathogens;
the ability to influence all forms of metabolism: water-electrolyte, lipid, protein and carbohydrate;
anti-allergic effect;
effects on the cardiovascular system, increased sensitivity of the walls of blood vessels and heart muscles to adrenergic agonists and epinephrine, effect on blood pressure;
the ability to stimulate the formation of blood platelets, fragments of megakaryocytes and red blood cells;
the ability to suppress the production of sex hormones, as well as reduce the sensitivity of organs and tissues to steroids produced by the thyroid gland.

Indications for use

Corticosteroids are used where conventional drugs (anti-inflammatory, painkillers, anti-allergenic) are powerless. Glucocorticoids and mineralocorticoids differ in the nature of their effects on the body. The former are most relevant in the treatment of bronchial asthma, rheumatism, pancreatitis, viral hepatitis, rheumatoid arthritis, etc. They have a pronounced anti-inflammatory effect. Mineralocorticoids are used for diseases the occurrence of which is associated with impaired mineral metabolism.

Glucocorticoids - what are they?

Corticosteroids produced by the adrenal cortex. This type of hormones most effectively affects carbohydrate metabolism. Steroid hormones get their name for their ability to increase sugar levels in the blood and lymph by enhancing the process of combining glucose in the liver. They also affect the metabolism of fats and proteins. The most effective of them is cortisol (a biologically active glucocorticoid hormone of a steroid nature, that is, it has a sterane core in its structure).

all forms of arthralgia (joint pain);
salt deposition in chronic metabolic diseases, which are characterized by a failure of purine metabolism and the inability of the kidneys to excrete uric acid;
chronic systemic diseases of the joints with a predominant localization of the inflammatory process in the spine.

Important!Doctors prescribe steroid drugs if the use of other anti-inflammatory drugs has not given a positive result within fourteen days.

In addition to painful deviations from the normal state of the joints, corticosteroids are often prescribed for disturbances in the functioning of other organs and tissues (autoimmune diseases, bronchial asthma, severe allergic reactions).

Mineralocorticosteroids

Having found out what corticosteroids are, it would not be a bad idea to learn about their classification. This group includes hormones of the adrenal cortex that affect mineral metabolism, mainly the metabolism of sodium and potassium. These steroids are responsible for regulating the water-salt balance. Unlike other corticosteroids, this type is not in great demand in medicine. Mineralcorticoids are prescribed for:

chronic adrenal insufficiency, or hypocortisolism (a rare endocrine disease, as a result of which the adrenal glands lose the ability to produce sufficient amounts of hormones, primarily cortisol);
syndrome of severe muscle weakness, accompanied by a significant decrease or complete cessation of motor activity;
Addison's disease.

Contraindications

Despite the high activity of many drugs with corticosteroids, there are no specific contraindications. However, there are conditions for which health care providers prescribe them with caution. Such diseases and disorders include:

Diabetes mellitus (a disease of endocrine origin that develops due to the lack or absence of insulin in the body).
Ulcer of the gastrointestinal tract during exacerbation.
Heart failure.
High blood pressure.
Acute renal or liver failure.
Glaucoma (an eye disease characterized by a constant or periodic increase in ophthalmotonus).
Cataract (a physiological condition associated with clouding of the lens of the eye and causing varying degrees of visual impairment up to its complete loss).
Chicken pox (an acute viral infection transmitted by airborne droplets).
Tuberculosis (an infectious disease caused by Mycobacterium tuberculosis).
Thrombosis.
Epilepsy (a common chronic neurological disease in humans, manifested in the body’s predisposition to the sudden onset of seizures).
Mental illnesses.

Side effects

The explicitness of adverse reactions when taking corticosteroids is determined by the class they belong to. Glucocorticosteroids of the first type (Cortisone) provoke side effects more often than new, more modern drugs (Mometasone and Betamethasone). In addition, the strength of the effect directly depends on the dose and duration of use. The higher the dosage and duration of the course, the higher the likelihood of adverse reactions. In most cases, these medications cause:

Edema that is caused by sodium retention.
Increased blood pressure and increased blood glucose concentrations.
An inflammatory disease of the gastric mucosa, leading to its degenerative changes.
Dermatitis, acne, and in especially severe cases - atrophy of the skin.
An inflammatory lesion of the skin that occurs as a result of exposure to damaging factors of a chemical, physical or biological nature.
Depression, stress, mental disorders.
Malfunction of the adrenal glands.

Important! To prevent the occurrence of adverse reactions, it is necessary to timely adjust the dose and duration of taking steroid hormones.

Features of application

Corticosteroids are recommended to be taken from six o'clock in the morning to twelve o'clock in the afternoon. These conditions are as close as possible to the physiological production of adrenaline and norepinephrine (adrenal hormones) in the body. As a rule, the medication should be taken during or after meals.

Treatment with corticosteroids, especially with long courses, must be supplemented with calcium intake to protect against calcium deficiency, as well as food rich in protein.

Release form

Synthetic steroid hormones are produced in several forms:

tablets or capsules;
injection solutions in ampoules;
topical corticosteroids, which are used externally (ointments, creams);
solutions for inhalation.

Corticosteroids: list of drugs

The most popular steroids in tablet form are:

"Prednisolone."
"Celeston."
"Kenacourt."
"Metypred."
"Lemod."

Prednisolone is a drug that has a strong antiallergic and anti-inflammatory effect. The medication should not be taken if you have a stomach or intestinal ulcer, vaccination or persistent high blood pressure. The cost of Prednisolone (100 tablets) is about one hundred and fifty rubles. The drug is also available in the form of an injection solution.

“Celeston” is an anti-inflammatory medicine that contains betamethasone; tablets are prescribed after a heart attack, for high blood pressure, diseases of the endocrine system, glaucoma, osteoporosis, and sexually transmitted diseases.

"Kenacort" - tablets for stabilizing cell membranes, eliminate symptoms of inflammation and allergies. Contraindicated in psychosis (a pronounced disorder of mental activity, in which mental reactions grossly contradict the real situation), as well as in neuritis (inflammatory disease of the peripheral nerves, in which, along with pain, symptoms are identified, the so-called loss, that is, loss or decrease in sensitivity, and also paralysis and paresis) and fungal infections. The cost of a package of tablets (50 pieces) is approximately two hundred and fifty rubles.

Methylprednisolone is a hormonal drug classified as a glucocorticosteroid. The only contraindication is individual intolerance. In emergency situations, it is prescribed to pregnant women, for psychosis and diseases of the endocrine system, as well as for disorders of the gastrointestinal tract. The cost of "Metyprednisolone" varies from 160 to 300 rubles.

"Lemod" is a medicine that is effective in the fight against disorders of an endocrine, allergic, musculoskeletal, and oncological nature. It is not recommended to take it for corneal herpes (a viral disease with a characteristic rash of grouped blisters), tuberculosis (a contagious infectious disease, the main cause of which is infection of the body with Koch bacilli), as well as for diabetes and fungal diseases. The cost of the drug is about 500 rubles.

The list of corticosteroids is extensive; hormones are also available in injection form:

"Hydrocortisone."
"Diprospan".
"Kenalog."
"Flosteron."
"Depo-Medrol."

Hydrocortisone is a hormonal steroid medicine. The medication suppresses inflammatory, allergic and immune reactions. The price of “Hydrocortisone” (10 ampoules) is about 150 rubles.

"Diprospan" is a hormonal drug that, in its pharmacological action, belongs to the group of glucocorticoids. The active ingredient is betamethasone. Injections are effective in the following cases:

a pathological process manifested by excessive accumulation of fluid in the cells of the brain or spinal cord;
adrenal insufficiency.

Contraindications for use:

excessive sensitivity to one of the components;
infectious lesion;
diseases of the digestive system;
high blood pressure;
kidney and liver diseases.

The cost of one Diprospan ampoule is approximately 210 rubles.

Kenalog is a drug used to relieve inflammation and severe allergy attacks. The active ingredient of the drug is triamcinolone. "Kenalog" is characterized by a mild effect on the human body. Does not affect the functioning of the pituitary gland and metabolism. Five ampoules of the drug cost about 450 rubles.

"Flosteron" is a drug with anti-inflammatory, antitoxic, desensitizing, immunosuppressive effects. The active substance included in the composition is betamethazole (has a prolonged effect). The price of five ampoules of Flosteron is approximately 250 rubles.

"Depo-Medrol" - what kind of corticosteroid drug is it? The medication belongs to the group of glucocorticosteroids (hormones of the adrenal cortex) and is used in the treatment of diseases of almost all internal organs, including the spinal column. Available in the form of a suspension. The cost of the Belgian drug is about 500 rubles.

The most common ointments with corticosteroids are:

"Lokoid".
"Lorinden S."
"Fluorocort".
"Fucidin G".
"Sinflan" ("Flucinar").

"Lokoid" is a synthetic glucocorticoid ointment for external use, widely used for the treatment of psoriasis, dermatitis and eczema. The medication has anti-inflammatory and antipruritic effects. The cost of "Lokoid" is within 350 rubles.

"Lorinden S" is an external preparation with antimicrobial, anti-allergenic and anti-inflammatory effects. The price of the drug "Lorinden S" varies from 350 to 600 rubles.

Inhaled steroids reduce the permeability of cell membranes and also limit the release of protease beyond the cellular organelles. Inhaled corticosteroids are:

"Beclamitozone" (analogs: "Alcedin", "Bekotide", "Beklokort").
"Baconase."
"Flunisolide" (analogue: "Ingacort").

"Beclocort" - the active ingredient of the drug inhibits the process of releasing chemical compounds from the group of physiologically active lipids, which are formed in the body enzymatically. The drug also reduces the production of pathological fluid released into the tissue or cavity from small blood vessels during inflammation. The medication is contraindicated in children under six years of age, as well as in case of individual intolerance. The cost of Beclamitozone varies from 300 to 450 rubles.

"Beconase" is an antiallergenic agent that reduces swelling of the epithelium and secretion of mucus by the bronchial glands. Used as a nasal corticosteroid. The price of the drug is approximately 350 rubles.

Flunisolide is an anti-inflammatory drug that is effective for chronic respiratory diseases, obstructive bronchitis and runny nose. The medicine is not recommended for use in the first trimester of pregnancy, for children under five years of age, or for tuberculosis.