What medications are classified as steroids? Steroid anti-inflammatory drugs for the treatment of joints list

The leading symptoms of degenerative-dystrophic and inflammatory pathologies of the musculoskeletal system are acute pain, severe swelling, and stiffness. If NSAIDs and analgesics do not cope with these clinical manifestations, then patients are prescribed steroidal anti-inflammatory drugs for joints (glucocorticosteroids). They quickly eliminate the clinical manifestations of osteoarthritis and correct the immune response in patients with arthritis.

The therapeutic effectiveness of glucocorticosteroids is sometimes offset by their severe adverse local and systemic reactions. When taken orally, medications have a negative effect on the gastrointestinal tract, urinary organs, and reduce bone mass. Therefore, when prescribing steroid drugs, the doctor carefully calculates single and daily dosages.

What are glucocorticosteroids

The coordinated functioning of all vital systems and individual organs is ensured by hormones - biologically active substances produced in the endocrine glands. They enter the bloodstream and then bind to receptors on target cells. Hormones regulate various processes in the human body, including metabolic ones. Glucocorticosteroids are analogues of hormones produced by glandular cells of the adrenal glands. An increase or decrease in their level in the systemic bloodstream seriously worsens a person’s well-being and causes the development of pathologies.

Steroidal anti-inflammatory drugs for the treatment of joints contain active ingredients that have a variety of effects on the body. After intra-articular injection or taking a tablet, the intensity of pain decreases and the range of motion increases. Glucocorticoids are able to normalize microcirculation and stop acute inflammatory processes.

Classification

The clinical and pharmacological group of steroids includes drugs with main components that have biological activity. Cortisone and Hydrocortisone are glucocorticosteroids of natural origin. The rest of the drugs are their synthetic analogues, derivatives of hydrocortisone, obtained as a result of fluoridation or other chemical reactions. Artificial steroids are characterized by higher therapeutic efficacy, lower frequency of use, and less pronounced adverse reactions. In medical practice, a classification of hormonal drugs is accepted depending on the time of their therapeutic effect:

• The half-life of short-acting steroids (cortisone, hydrocortisone) is from 8 to 12 hours. They are usually included in external agents that are rarely used in the treatment of joint pathologies. Intended mainly for the treatment of inflammatory skin lesions. Hormone replacement therapy is carried out using tablets and injections for a deficiency of natural hormones in the body;
• The half-life of steroids with an average duration of action (methylprednisolone, prednisolone, triamcinolone) is from 18 to 36 hours. They are most often used in orthopedics, rheumatology, and traumatology. They are several times more clinically effective than short-acting agents, but have less effect on water and electrolyte balance. Significantly less likely to provoke adverse systemic reactions;
• The elimination period for long-acting steroids (betamethasone, dexamethasone) ranges from 36 to 54 hours. The drugs are not intended for long-term treatment due to severe side effects and toxic effects on the body.

Glucocorticosteroids are also classified depending on the route of administration. Tablets and injectables are used to treat joint pathologies. The latter are injected intramuscularly, intravenously, into the joint cavity, sometimes directly into the inflamed tendon. Hormonal products are produced in the form of lyophilisates for the preparation of solutions and suspensions. The following steroid drugs are most often used in the treatment of degenerative-dystrophic and inflammatory joint pathologies:

• Dexamethasone;
• Depo-Medrol;
• Triamcinolone (Kenalog);
• Hydrocortisone;
• Betamethasone (Diprospan, Celeston, Flosteron);
• Prednisolone.

These hormonal agents are characterized by pronounced anti-inflammatory, antiallergic and immunosuppressive activity. They also affect metabolism: lipids, proteins, carbohydrates.

Pharmacological action

Steroid drugs contain ingredients that quickly penetrate cell membranes and act on cytoplasmic receptors. During the binding process, active complexes are formed that enter the nucleus and affect the biosynthesis of special proteins. The immune response changes, there is a direct or indirect effect on the production of mediators of pain, inflammation, fever - prostaglandins, leukotrienes, bradykinins. The ability of steroid drugs to inhibit phospholipid mediators, preventing platelet aggregation, has been clinically proven. Glucocorticosteroids are also characterized by other pharmacological properties:

• inhibition of the activity of phospholipase and hyaluronidase, which stimulate the biosynthesis of prostaglandins;
• stabilization of cell membranes, inhibition of the release of histamine, thromboxane, and leukotrienes from mast cells, which provoke inflammatory processes;
• slowing down the synthesis of specific cytokine proteins from arachidonic acid that regulate the immune response;
• enhancing glucose synthesis in hepatocytes and protein catabolism, providing the body with high-energy substances;
• immunosuppressive effect - suppression of excessive activity of the immune system in relation to the body's own cells.

Taking steroid drugs prevents the interaction of lymphocytes and their migration to inflammatory foci. With hormonal therapy, the release of adrenaline into the bloodstream increases, and the sensitivity of certain receptors to this bioactive substance is restored. At the same time, a narrowing of blood vessels occurs, reducing their permeability. The combination of these effects explains one of the side effects of glucocorticosteroids - a rise in blood pressure. But this property is often used to eliminate the state of shock in a critical, life-threatening situation.

Indications for use

In the treatment of autoimmune diseases, such as rheumatoid arthritis, steroid drugs are used in small doses for pathogenetic treatment. They are prescribed to patients not so much to relieve symptoms, but to correct the immune response. Hormonal agents are included in therapeutic regimens when diagnosing juvenile, psoriatic and gouty arthritis. The drugs are also used in the treatment of diseases not accompanied by inflammation in the joints.

Contraindications

Treatment with steroid drugs is carried out only after a thorough diagnosis of the patient and examination of the medical history. Throughout the therapy, the doctor monitors the patient’s condition based on the results of biochemical tests. But, despite the pronounced side effects of hormonal drugs, all contraindications to their one-time use are relative. If the patient requires urgent administration of injection solutions, then the only contraindication is hypersensitivity to the active auxiliary ingredients. When prescribing a long course of treatment, the doctor takes into account its possible consequences. Long-term use of hormonal drugs is contraindicated in the following pathologies:

• Itsenko-Cushing's disease (primary hypercortisolism);
• active forms of tuberculosis of any localization;
• severe arterial hypertension;
• ulcerative lesions of the gastrointestinal tract;
• severe circulatory failure;
• diabetes mellitus;
• acute and chronic pathologies of the urinary organs.

The steroid drug is not used in therapy if the patient has previously experienced allergic reactions after taking glucocorticosteroids.

Drugs are strictly prohibited during pregnancy due to the high likelihood of developing congenital anomalies of the adrenal glands in the fetus. Steroids are prescribed to children only for health reasons, as they provoke growth retardation.

Side effects

It is impossible to predict the occurrence of side effects of steroid drugs in a particular patient. Studying the medical history and minimizing the dosage of glucocorticosteroids helps to minimize the likelihood of local and systemic adverse reactions. But with long-term treatment, the following negative consequences often occur:

• symptomatic Itsenko-Cushing complex: due to sodium and water retention, edema forms, potassium deficiency occurs, blood pressure increases, and steroid-induced diabetes mellitus may develop;
• regeneration processes in tissues slow down;
• the mucous membranes of the digestive tract become ulcerated, gastritis, stomach and duodenal ulcers worsen;
• pancreatic tissue degenerates due to the development of necrosis, saturation of the parenchyma with blood, and bleeding;
• immunity decreases, respiratory and intestinal infections become more frequent;
• body weight increases, acne appears or worsens, and the menstrual cycle is disrupted.

Most of the complications that arise are reversible, that is, they disappear after treatment. Irreversible consequences include growth retardation in children, subcapsular cataracts, and steroid-induced diabetes.

Special instructions

The dosage regimen depends on the nature of the pathology, the patient's response to the steroid drug used, age and weight. But even with effective therapy without serious manifestations, the withdrawal syndrome characteristic of hormonal drugs should be taken into account. It consists of an exacerbation of the degenerative or inflammatory process after abrupt cessation of treatment. The following pathological conditions may also occur:

• increased body temperature;
• weakness, fatigue, drowsiness.

Sometimes (usually under stress) an Addisonian crisis occurs - vomiting, collapse, convulsions. In order to prevent the development of withdrawal syndrome, at the last stage of treatment, dosages are gradually reduced, as is the frequency of their administration.
The main principle of treating joint diseases with glucocorticosteroids is to ensure maximum therapeutic effects using minimal doses. It is unacceptable to use any hormonal drugs without a doctor's prescription.

ArticlesFOR DENTISTS

Steroid anti-inflammatory drugs. Classification. Mechanism of action and pharmacological effects.

Steroid anti-inflammatory drugs are created on the basis of glucocorticoids, natural hormones of the adrenal cortex.

Classification

Natural glucocorticoids: cortisone, hydrocortisone. Synthetic glucocorticoids Non-halogenated: methylprednisolone, prednisolone. Halogenated (fluorinated): betamethasone (diprospan*), dexamethasone, triamcinolone (kenalog*, polcortolone*, triacort*).

Mechanismactionspharmacologicaleffects

Glucocorticoids- hormones produced by the adrenal cortex. Their release is regulated by adrenocorticotropic hormone (ACTH) of the pituitary gland. Glucocorticoids act intracellularly at the level of nuclear structures, interacting with specific glucocorticoid receptors in the cytoplasm of target cells. The resulting hormone receptor complex undergoes conformational changes, is activated, penetrates the cell nucleus, where, by binding to DNA, it affects the expression of a number of genes. By influencing the transcription of a wide range of genes, glucocorticoids have a significant impact on carbohydrate, protein, fat, purine metabolism and water-salt balance. By activating gluconeogenesis in the liver through the utilization of amino acids and reducing the uptake of glucose by peripheral tissue cells, glucocorticoids increase the concentration of glucose in the blood and glycogen in the liver. They inhibit protein biosynthesis and enhance its catabolism in muscles, connective tissue and skin, and have an anti-anabolic effect. With long-term use, muscle weakness, osteoporosis, slower regeneration processes are observed, growth retardation in children, redistribution of fat occurs with an increase in its content in the upper half of the body, the concentration of fatty acids and triglycerides increases, and hypercholesterolemia develops. Due to mineralocorticoid activity, glucocorticoids retain sodium and water and increase the excretion of potassium and calcium.

In medical practice, glucocorticoids are used as highly active anti-inflammatory, antiallergic, antishock and immunosuppressive agents.

Mechanism of anti-inflammatory action. Glucocorticoids are active inhibitors of all phases of the inflammatory response. By stabilizing the membranes of cells and organelles (especially lysosomal ones), they limit the release of proteolytic enzymes from the cell, inhibit the formation of free oxygen radicals and lipid peroxides in the membranes, and prevent tissue destruction. Acting on gene expression, they induce the biosynthesis of protein inhibitors of phospholipase A2 in lipocortin leukocytes and reduce the formation of COX-2 at the site of inflammation, which limits the production of arachidonic acid from cell membrane phospholipids and the synthesis of its metabolites of inflammatory mediators (prostanoids, leukotrienes and platelet-activating factor ). Under the influence of glucocorticoids, the number of mast cells producing hyaluronic acid at the site of inflammation decreases, small vessels narrow, capillary permeability decreases, and fluid exudation decreases. Glucocorticoids prevent the adhesion of neutrophils and monocytes to the vascular endothelium, limit their penetration into tissues, reduce the activity of macrophages and fibroblasts, suppress lymphopoiesis, the synthesis of glycosaminoglycans and proteins, and inhibit the proliferation phase.

Considering the immunosuppressive effect of glucocorticoids, in case of inflammation of infectious origin they should be combined with antimicrobial therapy.

Immunosuppressive effect glucocorticoids is caused by a decrease in the level of circulating lymphocytes and macrophages, a violation of the production and action of a number of interleukins and other cytokines that regulate various phases of the immune response, suppression of the activity of T- and B-lymphocytes, a decrease in the production of immunoglobulins, a decrease in the content of complement in the blood, the formation of fixed immune complexes, inhibition formation of a factor that inhibits macrophage migration.

Anti-allergy action glucocorticoids are due to the suppression of various stages of immunogenesis. They slow down maturation and reduce the number of circulating basophils, block the synthesis and release of immediate-type allergy mediators (histamine, heparin, serotonin, etc.) from sensitized mast cells and basophils and reduce the sensitivity of effector cells to them, suppress the development of lymphoid and connective tissue, reduce the number T- and B-lymphocytes and mast cells inhibit antibody formation.

Antishock and antitoxic effects glucocorticoids are due to their participation in the regulation of vascular tone, water-salt balance, as well as an increase in the activity of liver enzymes involved in the processes of biotransformation of endogenous and exogenous substances. They increase the sensitivity of blood vessels to catecholamines and enhance the effect of angiotensin II, reduce vascular permeability, retain sodium and water, as a result of which the volume of blood plasma increases, hypovolemia decreases, vascular tone is normalized, myocardial contractility improves, and blood pressure increases.

Other articles

STEROID ANTI-INFLAMMATORY DRUGS (GLUCOCORTICOIDS).

Classification.

1. Natural: Hydrocortisone*, Cortisone*.

2. Synthetic: Prednisolone*, Methylprednisolone*, Dexamethasone*. Triamcinolone*.

Fluorocortisone acetate*.

3. Preparations for topical use: ointments - Prednisolone, Ledecort, Fluorocort (Triamcinolone*), Sinaflan (Fluocinolone acetonide*), Lorinden; produced in the form of aerosols for inhalation Beclomethasone dipropionate* (“Bekotide”, “Beclazone”), Ingacort, Budesonide*, Fluticasone*.

The difference between synthetic glucocorticoids and natural ones is that the former are more active, which means they can be used in low doses, with a lower risk of complications and less likelihood of changes in water-salt metabolism.

Mechanism of action.

After penetration into tissues, glucocorticoids diffuse across cell membranes and bind to a cytoplasmic complex consisting of a specific glucocorticoid receptor and heat shock protein. The heat shock protein is released and the hormone-receptor complex is transported into the nucleus, where it interacts with glucocorticoid effector elements on various genes and with other regulatory proteins (specific to different cells). This leads to an increase in the synthesis of mRNA, which, in turn, induces the formation of a special class of proteins - lipocortins, one of them (lipomodulin) inhibits phospholipase A2. In addition, the release of cytokines (interleukins 1 and 2 and interferon γ) from lymphocytes and macrophages is inhibited. And also directly and accordingly, collecting documents and all kinds of small price lists, for waste and sodomy;)))

Impact on various types of exchanges.

They act on protein, carbohydrate, fat and water-salt (table).

The influence of glucocorticoids on various types of metabolism.

Type of exchange
1. Protein	1. Anti-anabolic (inhibition of protein synthesis). 2. Catabolic (protein breakdown) => increased concentration of amino acids in the blood and urine (negative nitrogen balance).
2. Carbohydrate	1. Decreased utilization (uptake) of glucose by tissues => increased concentration of glucose in the blood. 2. Increasing the amount of glycogen in the liver (activation of gluconeogenesis processes - synthesis of glucose and glycogen from amino acids and fats).
3. Fat	Lipolytic (decomposition of adipose tissue => increase in the concentration of triglycerides in the blood).
4. Water-salt	1. Retention of Na+ and water in the body. 2. Removal of K+ from the body. 3Destruction of vitamin D => decreased absorption of Ca2+ ions from the intestine.

Pharmacodynamics.

1. Anti-inflammatory effect. Manifested by inhibition of alteration, exudation and

proliferation.

Alteration.

The synthesis of lipocortins is induced, and, in particular, lipomodulin, which suppresses the activity

phospholipase A2.

The membranes of cells and organelles (lysosomes) are stabilized.

Exudation.

The release of arachidonic acid from cell membrane phospholipids is inhibited and decreases

its metabolism and formation of prostaglandins, thromboxanes, leukotrienes.

Hyaluronidase, which breaks down the basic substance of connective tissue, is inhibited.

The division of mast cells is disrupted and their membranes are stabilized (the release of

inflammatory mediators).

The synthesis of platelet activating factor (PAF) is inhibited and, as a result, improves

microcirculation (due to the absence of platelet microthrombi).

Proliferation.

The production of Pg E2 decreases (the concentration of arachidonic acid falls) - the function decreases

fibroblasts (stimulated by Pg E2).

Collagen synthesis and connective tissue formation slow down.

2. Immunosuppressive and antiallergic effects.

The number of T- and B-lymphocytes decreases.

The migration of B lymphocytes and the interaction of T and B lymphocytes are suppressed.

The concentration of immunoglobulins in the blood serum decreases.

The interaction between phagocytes and lymphocytes is disrupted.

The division of mast cells is inhibited and their membranes are stabilized (the release of

allergy mediators - histamine, serotonin, bradykinin).

The sensitivity of β-adrenergic receptors to endogenous catecholamines increases and the concentration of the latter in the blood plasma increases (due to a decrease in cellular uptake).

3. Anti-shock and antitoxic effects.

Blood pressure increases (the content of catecholamines in the blood increases)

The sensitivity of adrenergic receptors to endogenous catecholamines is restored.

The permeability of the vascular wall decreases.

Cell membranes are stabilized.

Liver enzymes involved in the destruction of endogenous and exogenous substances are activated.

4.Hematological effects.

The number of lymphocytes and eosinophils decreases.

The number of red blood cells increases (the production of erythropoietin is stimulated).

5. Increased excitability of the central nervous system.

Indications for use.

1. Collagenosis (rheumatism, rheumatoid arthritis, systemic lupus erythematosus, etc.).

2. Immediate allergic reactions (Quincke's edema, itching, urticaria,

anaphylactic shock).

3. Bronchial asthma, status asthmaticus.

4. Autoimmune diseases (glomerulonephritis, thyroiditis)

5.Transplantation of organs and tissues.

6. Shock and collaptoid states.

7. Pulmonary and cerebral edema.

8. Hypofunction of the adrenal glands.

9. Blood diseases and some malignant neoplasms.

10. Poisoning and intoxication.

Complications.

1st group - early.

1. Edema (retention of Na+ ions and water in the body).

2. Increased blood pressure (increased circulating blood volume, activation

sympathoadrenal system).

3. Muscle weakness (due to hypokalemia).

4. Cardiac arrhythmias (decrease in the concentration of K+ ions in the blood).

5. Intestinal atony (decreased Ca2+ concentration).

Group 2 - late or with long-term use.

1. “Recoil” syndrome - resumption of symptoms of the underlying disease after abrupt withdrawal

drug.

2. Adrenal insufficiency (reduced production of endogenous glucocorticoids due to

atrophy of the adrenal cortex due to inhibition of ACTH production by the anterior lobe

pituitary gland).

3.Secondary immunodeficiency, manifested by exacerbation of chronic diseases, generalization

infectious process, development of opportunistic infections.

4. Slowing down of reparative processes.

5. Skeletal muscle atrophy and myocardial dystrophy.

6. Steroid diabetes.

7. Itsenko-Cushing syndrome (moon-shaped face, redistribution of fat).

8. Osteoporosis, spontaneous fractures, multiple caries, growth retardation (in children).

9. Steroid gastric ulcers (decreased prostaglandin production and slower reparative

processes in the gastrointestinal mucosa).

10. Excitation of the central nervous system up to psychosis (when prescribing large doses).

11. Tendency to thrombosis (increased blood viscosity due to an increase in the number

erythrocytes caused by increased production of erythropoietins).

Group 3 - for local use.

1. Skin atrophy at the application site.

2. Candidiasis of the oral mucosa by inhalation; as a preventive measure after the procedure

Contraindications.

1. Hypersensitivity.

2. Glaucoma.

3. Peptic ulcer of the stomach and duodenum.

4. Osteoporosis.

5. Systemic mycoses.

6. Acute viral and bacterial infections.

7. Pregnancy, breastfeeding.

8. Children under 6 years old

GREAT, GREAT!

In the treatment of complex diseases, anti-inflammatory drugs (steroids) are often used. They have a wide spectrum of action and can provide many positive effects for the body. There are several types of these funds, each of which is aimed at obtaining a specific effect.

General characteristics of the funds

Steroidal anti-inflammatory drugs (SAAIDs) are derivatives of glucocorticoid hormones produced by the adrenal glands. They are divided into the following types:

Natural. Synthetic: non-halogenated and halogenated.

The first group includes drugs such as Hydrocortisone and Cortisone. Non-halogenated steroids are presented in the form of Methylprednisolone and Prednisolone. Fluoridated - Triamcinolone, Dexamethasone and Betamethasone.

The effect of taking such substances is ensured by influencing the body at the cellular level. By binding to DNA, drugs can have a strong effect on various processes. The main ones include:

Water-salt exchange. Protein. Carbohydrate. Zhirovoy and others.

Among the most pronounced actions of glucocorticoids are the following: antipruritic, antiallergic, and naturally anti-inflammatory. They produce products for both external and internal use. Very often, various gels, ointments and creams are used to treat skin diseases, and injections are used for joint diseases.

The use of SPVP should only be prescribed by a doctor, since independent use can lead to various negative consequences.

Mechanism of action of SPVP

The principle of action of SPVP is based on intracellular effects. During the use of such funds, the following processes occur:

When entering the body, substances begin to interact with receptors in the cytoplasm of cells, penetrating into the nucleus. Due to their action on DNA, they influence some of the genes, which allows them to change the balance of purines, water, proteins and fats. The mechanism of action includes the process of activation of gluconeogenesis, which increases the amount of glucose in the blood and increases the concentration of glycogen in liver cells. This, in turn, helps to impede protein biosynthesis and increase the breakdown of structures located near muscle fibers, connective tissue and skin.

If there is an inflammatory process in the body, it includes protection from various pathogenic microflora. If the immune system is weakened, this protection is not enough, which often leads to the destruction of joints, tissues, and the development of other pathologies. The affected areas turn red and begin to feel painful.

SPVPs relieve pain and eliminate the inflammatory process. According to their chemical structure, they are classified as 17, 11-hydroxycorticosteroids. The first substance of the group to be obtained is a glucocorticoid from the adrenal glands. Now there is a large selection of these substances of both synthetic and natural origin.

Glucocorticoids help inhibit the process of protein synthesis, while enhancing catabolic reactions in muscle fibers, connective tissue and skin, providing an anti-anabolic effect. If you use such drugs for a long time, muscle weakness, slower regeneration processes, developmental delays, an increase in the amount of fat in the body and other adverse reactions may develop. In this regard, you should consult your doctor before taking such substances.

The effect of using SPVP

The anti-inflammatory effect provided by steroid drugs is ensured by their ability to be inhibited through lipocortin. They also inhibit the gene that encodes the production of COX-2, which is actively involved in areas of inflammation. Glucocorticoids also suppress prostaglandin activity. They provide an antioxidant effect, slowing down lipid oxidation and maintaining the integrity of cell membranes. Thus, the spread of the inflammatory process is prevented.

The main actions of SPVP include:

Anti-inflammatory. Glucocorticoids are inhibitors of all inflammation in the body. They help stabilize cell membranes, ensure the release of proteolytic enzymes from cells, prevent destructive changes in tissue, and also slow down the formation of free radicals. When the substance enters the body, the number of mast cells in areas of inflammation decreases, small vessels narrow, and capillary permeability decreases. Immunosuppressive. SPVPs reduce the level of circulating lymphocytes and microphages. They disrupt the production and action of interleukins and other cytokines that regulate various immune responses. There is a decrease in the activity of B and T lymphocytes, a decrease in the production of immunoglobulins and the amount of complement in the blood. Fixed immune complexes are formed, and the formation of factors that inhibit the movement of microphages is inhibited. Antiallergic. This effect is achieved by suppressing different stages of immunogenesis. Glucocorticoids slow down the process of formation of circulating basophils, and also reduce their number and prevent the development of the synthesis of sensitized cells, basophils, which contribute to the development of an allergic reaction and reduce the sensitivity of effector cells to them. The production of connective and lymphatic tissues is suppressed, as well as the formation of antibodies. Antitoxic and antishock. SPVPs are involved in ensuring vascular tone, water and salt balance. They improve the activity of liver enzymes, which are involved in the process of converting exogenous and endogenous substances. There is an increase in the sensitivity of blood vessels to catecholamines and their permeability decreases. The amount of blood plasma increases as the substances retain sodium and water in the body. This allows you to reduce hypovolemia, improve vascular tone and the process of myocardial contraction. Antiproliferative. This effect is associated with a decrease in the migration of monocytes in areas of inflammation and a slowdown in the process of fragmentation of fibroblasts. The synthesis of mucopolysaccharides is suppressed, which helps slow down the binding of plasma protein and water to tissues that have entered the site of inflammation.

Each of the drugs, depending on its type, can provide a certain effect. The selection of funds should only be carried out by a specialist.

Difference between non-steroidal anti-inflammatory drugs and non-steroidal anti-inflammatory drugs

Steroid and non-steroidal drugs are used to solve various health problems. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used if the disease has not reached an advanced stage. They come in two types:

Selective. Non-selective.

The first group includes substances that affect the COX-1 and 2 enzymes. The second group includes substances that affect the COX-2 enzyme. The enzyme COX-1 takes an active part in various processes of the body and provides its important functions. It works constantly. COX-2 is an enzyme that is produced only in the presence of an inflammatory process.

Based on their active substance, non-selective NSAIDs are of the following types: Ibuprofen, Diclofenac, Paracetamol. Selective ones include: Meloxicam, Nimesulide, Celecoxib. Non-steroidal anti-inflammatory drugs have the following effects:

Painkiller. Antipyretic. Anti-inflammatory.

These drugs help reduce pain, eliminate fever and inflammation. Unlike glucocorticoids, they do not cause as many negative effects.

Most NSAIDs are prescribed for acute and chronic diseases that occur with severe symptoms such as pain and inflammation. Their use is relevant in cases where the disease is not advanced. Most often, they are prescribed for arthritis, osteoarthritis, gout, fever, renal colic, migraine, headache, dysmenorrhea and other disorders.

SPVPs also have an effect on COX-2, but have no effect on COX-1. Very often, they are prescribed in combination with NSAIDs. Glucocorticoids are used in various fields of medicine. They are used to treat joints, dental diseases, skin diseases and others.

Glucocorticoids suppress the immune system, have an anti-inflammatory, anti-allergic and anti-shock effect. They are prescribed in cases where the use of NSAIDs has not brought positive results. There is also a difference between these drugs in the list of adverse reactions. NSAIDs have fewer of them.

Indications

Anti-inflammatory steroid drugs relieve inflammation by suppressing immune function. They ensure a reduction in the production of leukocytes and anti-inflammatory enzymes, which makes it possible to achieve relief of inflammation. These drugs are most often prescribed for the following disorders or diseases:

State of shock. Skin diseases. Systemic connective tissue diseases. Various types of hepatitis. Allergies. Pathologies of joints and muscles. Disturbances in the functioning of blood vessels. Inflammatory processes in internal organs and tissues.

Glucocorticoids are often used for rheumatism and rheumatic carditis, osteochondrosis, diseases of the hematopoietic organs, dermatomyositis, lupus erythematosus and other diseases. Anti-inflammatory steroid medications can treat a wide variety of conditions. In order for the effect of the products to be as effective as possible, they are most often administered locally.

SSAIDs are very powerful medications, so you cannot decide on their use on your own. Only a doctor should select medications and determine dosage.

Most popular SPVPs

Steroidal anti-inflammatory drugs cope well with the inflammation process and relieve pain. The means that are most often used in medical practice include:

Dexamethasone. It is used for inflammations that require immediate administration of such substances and for various states of shock. The product is sold as an injection solution. Cortisol. It can be used both orally and intramuscularly, if necessary, to relieve pain and acute rheumatoid arthritis. Presented in the form of a suspension. Sinalar. Used for skin diseases. Most often, with psoriasis and dermatitis, as well as other skin lesions accompanied by itching. It can be produced both in the form of a gel and an ointment. Bematethasone. Sold in the form of a gel, which is applied to the skin for allergies and inflammation with itching.

New anabolic agents are also now being introduced. They have pronounced effects and are used to treat various diseases. The most popular of them include:

Celeston. Used for dermatitis, allergic conjunctivitis and inflammation of internal organs. Produced in injection and tablet form. Mendrol. Prescribed for severe situations of stress, multiple sclerosis and slow development in children. Sold in tablet form. Urbazon. Used in states of shock. Available in injection form. Momat. Relieves inflammation and also eliminates itching. Used for various skin diseases. Sold as a cream or ointment. Berlicourt. Prescribed for asthma, acute rhinitis and allergies. Available in tablet form.

Each of the drugs is prescribed by a doctor, taking into account the individual characteristics of the patient, the nature of the course of the disease and its type. The dosage and course of treatment are also determined only by a specialist.

Contraindications and adverse reactions

Steroidal anti-inflammatory drugs are the most powerful in pharmacology, so they cannot be taken arbitrarily. Treatment is prescribed by a specialist. The main contraindications include:

Infectious tissue damage. Diseases caused by bacteria. Risk of bleeding. Taking blood thinners. Significant erosive lesions of joints and tissues. Weakened immunity. The period of pregnancy and lactation. Individual intolerance. In cases where three injections of SPVP are performed per month.

If the patient has various lesions and diseases of an infectious nature, steroids cannot be used. The active substances included in the products help reduce the body's defenses and suppress the immune system. In turn, this does not allow the body to overcome pathogens, which increases the spread of infection.

If a patient is taking blood thinners and is at risk of bleeding, steroid medications may cause severe bleeding at injection sites. Such drugs should not be used more than three times a month, as there is a possibility of infection as a result of weakening of the tissues.

Steroids belong to the group of hormonal drugs, so they cannot be used for a long time. This is due to the fact that there is a risk of developing various adverse reactions. The main ones include:

Hypertension. Exacerbation of peptic ulcer disease. Swelling. Osteoporosis. Decreased protective functions of the immune system. Increased blood clotting. Masculinization in women. Increased amount of subcutaneous fat.

In order to avoid such undesirable consequences, taking anti-inflammatory steroid drugs should last no more than two weeks. It is also advisable to take them with meals.

Preventing Negative Reactions

It is not recommended to take anti-inflammatory steroid drugs during pregnancy and breastfeeding. It is necessary to take into account the list of contraindications in which their use is completely excluded. There are certain recommendations that can reduce the risk of negative consequences. It includes:

Body weight control. Regular blood pressure measurement. Study of sugar levels in blood and urine. Monitoring the electrolyte composition of blood plasma. Diagnosis of the gastrointestinal tract and musculoskeletal system. Consultations with an ophthalmologist. Testing for infectious complications.

These measures make it possible to avoid various negative consequences, since they are aimed at studying exactly those indicators that may indicate the presence of changes in the body.

Steroidal anti-inflammatory drugs are very strong substances that should only be used for specific purposes. They cannot be used at your own discretion. The prescription should only be made by a doctor, based on the patient’s condition and the type of disease.

In the treatment of complex diseases, anti-inflammatory drugs (steroids) are often used. They have a wide spectrum of action and can provide many positive effects for the body. There are several types of these funds, each of which is aimed at obtaining a specific effect.

Steroidal anti-inflammatory drugs (SAAIDs) are derivatives of glucocorticoid hormones produced by the adrenal glands. They are divided into the following types:

• Natural.
• Synthetic: non-halogenated and halogenated.

The first group includes drugs such as Hydrocortisone and Cortisone. Non-halogenated steroids are presented in the form of Methylprednisolone and Prednisolone. Fluoridated - Triamcinolone, Dexamethasone and Betamethasone.

The effect of taking such substances is ensured by influencing the body at the cellular level. By binding to DNA, drugs can have a strong effect on various processes. The main ones include:

• Water-salt exchange.
• Protein.
• Carbohydrate.
• Zhirovoy and others.

Among the most pronounced actions of glucocorticoids are the following: antipruritic, antiallergic, and naturally anti-inflammatory. They produce products for both external and internal use. Very often, various gels, ointments and creams are used to treat skin diseases, and injections are used for joint diseases.

The use of SPVP should only be prescribed by a doctor, since independent use can lead to various negative consequences.

Mechanism of action of SPVP

The principle of action of SPVP is based on intracellular effects. During the use of such funds, the following processes occur:

• When entering the body, substances begin to interact with receptors in the cytoplasm of cells, penetrating into the nucleus. Due to their action on DNA, they influence some of the genes, which allows them to change the balance of purines, water, proteins and fats.
• The mechanism of action includes the process of activation of gluconeogenesis, which increases the amount of glucose in the blood and increases the concentration of glycogen in liver cells. This, in turn, helps to impede protein biosynthesis and increase the breakdown of structures located near muscle fibers, connective tissue and skin.

If there is an inflammatory process in the body, it includes protection from various pathogenic microflora. If the immune system is weakened, this protection is not enough, which often leads to the destruction of joints, tissues, and the development of other pathologies. The affected areas turn red and begin to feel painful.

SPVPs relieve pain and eliminate the inflammatory process. According to their chemical structure, they are classified as 17, 11-hydroxycorticosteroids. The first substance of the group to be obtained is a glucocorticoid from the adrenal glands. Now there is a large selection of these substances of both synthetic and natural origin.

Glucocorticoids help inhibit the process of protein synthesis, while enhancing catabolic reactions in muscle fibers, connective tissue and skin, providing an anti-anabolic effect. If you use such drugs for a long time, muscle weakness, slower regeneration processes, developmental delays, an increase in the amount of fat in the body and other adverse reactions may develop. In this regard, you should consult your doctor before taking such substances.

The effect of using SPVP

The anti-inflammatory effect provided by steroid drugs is ensured by their ability to be inhibited through lipocortin. They also inhibit the gene that encodes the production of COX-2, which is actively involved in areas of inflammation. Glucocorticoids also suppress prostaglandin activity. They provide an antioxidant effect, slowing down lipid oxidation and maintaining the integrity of cell membranes. Thus, the spread of the inflammatory process is prevented.

The main actions of SPVP include:

1. Anti-inflammatory. Glucocorticoids are inhibitors of all inflammation in the body. They help stabilize cell membranes, ensure the release of proteolytic enzymes from cells, prevent destructive changes in tissue, and also slow down the formation of free radicals. When the substance enters the body, the number of mast cells in areas of inflammation decreases, small vessels narrow, and capillary permeability decreases.
2. Immunosuppressive. SPVPs reduce the level of circulating lymphocytes and microphages. They disrupt the production and action of interleukins and other cytokines that regulate various immune responses. There is a decrease in the activity of B and T lymphocytes, a decrease in the production of immunoglobulins and the amount of complement in the blood. Fixed immune complexes are formed, and the formation of factors that inhibit the movement of microphages is inhibited.


3. Antiallergic. This effect is achieved by suppressing different stages of immunogenesis. Glucocorticoids slow down the process of formation of circulating basophils, and also reduce their number and prevent the development of the synthesis of sensitized cells, basophils, which contribute to the development of an allergic reaction and reduce the sensitivity of effector cells to them. The production of connective and lymphatic tissues is suppressed, as well as the formation of antibodies.
4. Antitoxic and antishock. SPVPs are involved in ensuring vascular tone, water and salt balance. They improve the activity of liver enzymes, which are involved in the process of converting exogenous and endogenous substances. There is an increase in the sensitivity of blood vessels to catecholamines and their permeability decreases. The amount of blood plasma increases as the substances retain sodium and water in the body. This allows you to reduce hypovolemia, improve vascular tone and the process of myocardial contraction.
5. Antiproliferative. This effect is associated with a decrease in the migration of monocytes in areas of inflammation and a slowdown in the process of fragmentation of fibroblasts. The synthesis of mucopolysaccharides is suppressed, which helps slow down the binding of plasma protein and water to tissues that have entered the site of inflammation.

Each of the drugs, depending on its type, can provide a certain effect. The selection of funds should only be carried out by a specialist.

Difference between non-steroidal anti-inflammatory drugs and non-steroidal anti-inflammatory drugs

Steroid and non-steroidal drugs are used to solve various health problems. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used if the disease has not reached an advanced stage. They come in two types:

• Selective.
• Non-selective.

The first group includes substances that affect the COX-1 and 2 enzymes. The second group includes substances that affect the COX-2 enzyme. The enzyme COX-1 takes an active part in various processes of the body and provides its important functions. It works constantly. COX-2 is an enzyme that is produced only in the presence of an inflammatory process.

Based on their active substance, non-selective NSAIDs are of the following types: Ibuprofen, Diclofenac, Paracetamol. Selective ones include: Meloxicam, Nimesulide, Celecoxib. Non-steroidal anti-inflammatory drugs have the following effects:

• Painkiller.
• Antipyretic.
• Anti-inflammatory.

These drugs help reduce pain, eliminate fever and inflammation. Unlike glucocorticoids, they do not cause as many negative effects.

Most NSAIDs are prescribed for acute and chronic diseases that occur with severe symptoms such as pain and inflammation. Their use is relevant in cases where the disease is not advanced. Most often, they are prescribed for arthritis, osteoarthritis, gout, fever, renal colic, migraine, headache, dysmenorrhea and other disorders.

SPVPs also have an effect on COX-2, but have no effect on COX-1. Very often, they are prescribed in combination with NSAIDs. Glucocorticoids are used in various fields of medicine. They are used to treat joints, dental diseases, skin diseases and others.

Glucocorticoids suppress the immune system, have an anti-inflammatory, anti-allergic and anti-shock effect. They are prescribed in cases where the use of NSAIDs has not brought positive results. There is also a difference between these drugs in the list of adverse reactions. NSAIDs have fewer of them.

Indications

Anti-inflammatory steroid drugs relieve inflammation by suppressing immune function. They ensure a reduction in the production of leukocytes and anti-inflammatory enzymes, which makes it possible to achieve relief of inflammation. These drugs are most often prescribed for the following disorders or diseases:

• State of shock.
• Skin diseases.
• Systemic connective tissue diseases.
• Various types of hepatitis.
• Allergies.
• Pathologies of joints and muscles.
• Disturbances in the functioning of blood vessels.
• Inflammatory processes in internal organs and tissues.

Glucocorticoids are often used for rheumatism and rheumatic carditis, osteochondrosis, diseases of the hematopoietic organs, dermatomyositis, lupus erythematosus and other diseases. Anti-inflammatory steroid medications can treat a wide variety of conditions. In order for the effect of the products to be as effective as possible, they are most often administered locally.

SSAIDs are very powerful medications, so you cannot decide on their use on your own. Only a doctor should select medications and determine dosage.

Most popular SPVPs

Steroidal anti-inflammatory drugs cope well with the inflammation process and relieve pain. The means that are most often used in medical practice include:

• Dexamethasone. It is used for inflammations that require immediate administration of such substances and for various states of shock. The product is sold as an injection solution.


• Cortisol. It can be used both orally and intramuscularly, if necessary, to relieve pain and acute rheumatoid arthritis. Presented in the form of a suspension.
• Sinalar. Used for skin diseases. Most often, with psoriasis and dermatitis, as well as other skin lesions accompanied by itching. It can be produced both in the form of a gel and an ointment.
• Bematethasone. Sold in the form of a gel, which is applied to the skin for allergies and inflammation with itching.

New anabolic agents are also now being introduced. They have pronounced effects and are used to treat various diseases. The most popular of them include:

1. Celeston. Used for dermatitis, allergic conjunctivitis and inflammation of internal organs. Produced in injection and tablet form.
2. Mendrol. Prescribed for severe situations of stress, multiple sclerosis and slow development in children. Sold in tablet form.
3. Urbazon. Used in states of shock. Available in injection form.
4. Momat. Relieves inflammation and also eliminates itching. Used for various skin diseases. Sold as a cream or ointment.
5. Berlicourt. Prescribed for asthma, acute rhinitis and allergies. Available in tablet form.

Each of the drugs is prescribed by a doctor, taking into account the individual characteristics of the patient, the nature of the course of the disease and its type. The dosage and course of treatment are also determined only by a specialist.

Contraindications and adverse reactions

Steroidal anti-inflammatory drugs are the most powerful in pharmacology, so they cannot be taken arbitrarily. Treatment is prescribed by a specialist. The main contraindications include:

• Infectious tissue damage.
• Diseases caused by bacteria.
• Risk of bleeding.
• Taking blood thinners.
• Significant erosive lesions of joints and tissues.
• Weakened immunity.
• The period of pregnancy and lactation.
• Individual intolerance.
• In cases where three injections of SPVP are performed per month.

If the patient has various lesions and diseases of an infectious nature, steroids cannot be used. The active substances included in the products help reduce the body's defenses and suppress the immune system. In turn, this does not allow the body to overcome pathogens, which increases the spread of infection.

If a patient is taking blood thinners and is at risk of bleeding, steroid medications may cause severe bleeding at injection sites. Such drugs should not be used more than three times a month, as there is a possibility of infection as a result of weakening of the tissues.

Steroids belong to the group of hormonal drugs, so they cannot be used for a long time. This is due to the fact that there is a risk of developing various adverse reactions. The main ones include:

• Hypertension.
• Exacerbation of peptic ulcer disease.
• Swelling.
• Osteoporosis.
• Decreased protective functions of the immune system.
• Increased blood clotting.
• Masculinization in women.
• Increased amount of subcutaneous fat.

In order to avoid such undesirable consequences, taking anti-inflammatory steroid drugs should last no more than two weeks. It is also advisable to take them with meals.

Preventing Negative Reactions

It is not recommended to take anti-inflammatory steroid drugs during pregnancy and breastfeeding. It is necessary to take into account the list of contraindications in which their use is completely excluded. There are certain recommendations that can reduce the risk of negative consequences. It includes:

1. Body weight control.
2. Regular blood pressure measurement.
3. Study of sugar levels in blood and urine.
4. Monitoring the electrolyte composition of blood plasma.
5. Diagnosis of the gastrointestinal tract and musculoskeletal system.
6. Consultations with an ophthalmologist.
7. Testing for infectious complications.

These measures make it possible to avoid various negative consequences, since they are aimed at studying exactly those indicators that may indicate the presence of changes in the body.

Steroidal anti-inflammatory drugs are very strong substances that should only be used for specific purposes. They cannot be used at your own discretion. The prescription should only be made by a doctor, based on the patient’s condition and the type of disease.

As a result of injury, the development of an infection, a burn, the introduction of foreign proteins or other damage, the body automatically develops a protective reaction, and as a result, the person develops an inflammatory process.

• To combat foreign substances entering the blood through the wound, so-called inflammatory mediators begin to be released in the damaged area.
• This leads to an increase in blood flow, an increase in body temperature, and the appearance of pain.
• Due to the activation of the immune system, immune proteins and white blood cells that are located in the inflammatory focus increase aggressiveness. As a result, the victim develops all sorts of symptoms in the form of pain, swelling and swelling, fever, and redness of the skin.

Steroidal anti-inflammatory drugs help stop inflammation by blocking the release of inflammatory mediators and reducing the aggressiveness of the immune system.

Features of steroidal anti-inflammatory drugs

Such drugs are created using glucocorticoids, natural hormones of the adrenal cortex. There are several types of drugs:

1. Glucocorticoids of natural origin, these include cortisones and hydrocortisones.
2. Glucocorticoids of synthetic origin.
3. Non-halogenated glucocorticoids, including prednisolone, methyl prednisolone.
4. Halogenated glucocorticoids, including dexamethasone, betamethasone, triamcinolone.

Glucocorticoids are produced by the adrenal cortex. Adrenocorticotropic hormone of the pituitary gland regulates their release. Medicines affect the body at the intracellular level.

The resulting substance interacts with receptors in the cytoplasm of cells and penetrates into the nuclei of cells. By acting on DNA, the drug affects certain genes, changing fat, protein, water and purine balance.

As a result of the activation of gluconeogenesis, there is an increase in glucose in the blood, and glycogen is also concentrated in the liver. This interferes with protein biosynthesis and increases the destruction of structures in the muscles, connective tissues and skin.

As you know, at the time of inflammation, the body activates protection against infection, viruses and bacteria. However, sometimes the immune system becomes disrupted, causing the immune system to become overactive. In this case, inflammation begins to destroy the joints and their tissues. The damaged area becomes red, warm, swollen, and painful.

Thus, steroid drugs relieve inflammation and reduce immune activity by reducing the production of inflammatory enzymes and suppressing the activity of leukocytes.

Treatment with steroid drugs

Steroid medications are used to treat joints by mouth or by injection. The drug is administered intravenously or intramuscularly into the area of ​​the joint, bursa, tendon or other soft tissue located next to the affected organ.

Using an injection, the medicine can be injected in large dosages directly into the area of ​​inflammation. However, if the drug is used orally, doctors do not guarantee that the steroid will reach the desired affected area.

Medicines are used to treat disorders of the body's protective functions that destroy joint tissue. In particular, steroids are needed for inflammation of blood vessels and muscles. Steroid drugs are used to treat rheumatoid arthritis, lupus, gout and Sørgen's syndrome.

When vital organs are damaged by the inflammatory process, steroids prevent their destruction, saving the victim’s life. Thus, such drugs often stop the progressive process of kidney inflammation, which leads to the development of renal dysfunction if the patient suffers from vasculitis.

If steroid treatment is used, the removal of waste products and fluids from the body that the kidneys cannot eliminate on their own can be avoided. Also, in some cases, internal organ transplantation will not be required if the treatment procedure is started on time.

In small dosages, the drugs relieve pain and stiffness in people with joint diseases. With short-term use of a large dosage of medication, acute manifestations of arthritis are relieved.

For rheumatoid arthritis, gout and other inflammatory conditions that require treatment, medications are injected into the joints. This includes an injection into the area of ​​the inflamed synovial bursa or joint tendon.

Once the drug is injected into the area of ​​a swollen or painful joint, the patient's symptoms of osteoarthritis are alleviated.

Compared to other forms of steroids, injections that are given into the affected area are generally well tolerated and do not cause serious side effects.

In addition, during treatment with injections, you can reduce the dosage of drugs used internally, which in some cases can lead to undesirable consequences.

The list of medications that relieve pain from joint diseases grows every year. The most popular medications are:

You can also find anti-inflammatory ointments in the pharmacy; they relieve inflammation, relieve pain, itching and alleviate the patient’s condition. In some cases, steroid ointments contain an analgesic to help relieve pain quickly.

• Such drugs include such well-known products as Fastum gel and the Russian analogue Bystrum gel.
• There are also ointments that contain ketoprofen. These are Ketonal and Finalgel.
• Ointments containing ibuprofen, diclofinac, nimesulide include Nise gel, Voltaren, Nurofen.

Any form of steroids should only be used if prescribed by a doctor.

What are the contraindications?

1. Steroid medications should not be used if the area is infected or the patient has an infectious disease. This is due to the fact that such a medicine reduces the body’s resistance and suppresses the immune system, which makes it impossible to fight harmful microorganisms and contributes to the spread of infection.
2. In particular, the infection has no effect if extensive erosion is observed in the joint area.
3. If the patient is taking blood thinners and there is a risk of bleeding, intra-articular steroid injections may cause excessive bleeding at the puncture site. For this reason, the injection should be performed carefully.
4. Because these steroid medications can weaken tissue and put you at risk for infection, steroids should be used no more than three times per month.

Since steroids are hormonal, long-term use can cause all sorts of side effects. The patient may increase body weight, develop swelling, osteoporosis, hypertension, the functioning of the immune system will decrease, peptic ulcer disease will worsen, and blood clotting will increase. The female body can acquire the properties of a male one.

To avoid negative consequences and addiction from the drug, steroids can be used for no longer than two weeks. It is also recommended to use them after meals. During pregnancy and breastfeeding, you should avoid using the drug.

Steroid and non-steroidal drugs - what they eat with and why they are needed

Steroids

Glucocorticosteroids (hormones of the adrenal cortex) began to be used for the treatment of joints more than 50 years ago, when their positive effect on the severity of joint syndrome and the duration of morning stiffness became known.

The most popular drugs from the group of steroids in rheumatology are:

• Prednisolone (Medopred);
• Triamcinolone (Kenacort, Kenalog, Polcortolone, Triamsinolol);
• Dexamethasone;
• Methylprednisolone (Metypred);
• Betamethasone (Celeston, Diprospan, Flosteron).

It is worth noting that non-steroidal hormones are not used in the treatment of joint diseases.

Mechanism of action

The pronounced anti-inflammatory effect of drugs with a steroid structure is achieved in several ways:

• an obstacle to the movement of neutrophils (the main inflammatory cells) from the vessels into the tissue, to the affected area;
• decreased permeability of biological membranes, which inhibits the release of proteolytic enzymes;
• suppression of cytokine formation;
• influence on epithelial cells;
• stimulation of lipocortin formation.

This mechanism of action, which slows down all phases of the inflammatory response, leads to rapid relief of symptoms and improvement in the condition of patients.

Indications

All anti-inflammatory steroid drugs have a strict list of indications for use. This is due to the fact that hormones have a large number of side effects. Therefore, they are a reserve group in the treatment of joint diseases.

Steroid drugs are prescribed for conditions such as:

1. High disease activity.
2. Systemic manifestations of pathology.
3. Weak effectiveness of non-steroidal anti-inflammatory drugs.
4. The presence of contraindications to the prescription of NSAIDs that prevent their use.

Side effects

Like any other drugs, steroid hormones have a number of undesirable effects. These include:

• dyspepsia (feeling of nausea, abdominal pain, vomiting, bloating, hiccups, loss of appetite, perversion of taste);
• increased pH of gastric contents;
• development of myocardial failure, if present - aggravation of the condition;
• increased blood pressure numbers;
• liver enlargement;
• blood clot formation;
• obesity;
• increased excretion of potassium and calcium, retention of sodium ions;
• osteoporosis;
• muscle weakness;
• skin rashes;
• increased sweating;
• weakness;
• depressive states;
• allergic local and systemic reactions;
• weakened immunity, decreased body resistance to infections, exacerbation of chronic diseases;
• increased blood sugar levels;
• impaired wound healing;
• menstrual irregularities, etc.

Almost all steroids have these side effects to a greater or lesser extent. Their quantity and strength depend on the method of administration of the drug, dosage and duration of use.

Contraindications

Anti-inflammatory steroid drugs should be prescribed with caution in the following conditions:

The listed contraindications do not mean that steroid drugs cannot be used. However, concomitant pathologies should always be taken into account when prescribing medications.

Main characteristics of NSAIDs

Medicines from the group of non-steroidal anti-inflammatory drugs are first-line drugs for the treatment of joint diseases. They are used to treat rheumatoid arthritis, reactive systemic arthritis, psoriatic arthritis, ankylosing spondylitis, gout, osteoarthritis of any localization, osteochondropathy, osteochondrosis, and other systemic pathologies.

The history of the creation of non-steroidal drugs goes back to ancient times. Our ancestors also knew that when the temperature rises, it is necessary to make a decoction from willow tree branches. It was later discovered that willow bark contains the substance salicyl, from which sodium salicylate was later created. It was only in the 19th century that salicylic acid, or aspirin, was synthesized from it. It was this medicine that became the first non-steroidal remedy for inflammation.

Pathogenetic mechanism, effects

Nonsteroidal anti-inflammatory drugs can inhibit the synthesis of prostaglandins (the main mediators of inflammation) from arachidonic acid. This is possible by blocking the action of the enzyme cyclooxygenase (COX).

It was found that non-steroidal drugs act on 2 types of enzyme: COX-1 and COX-2. The first affects platelet activity, the integrity of the gastrointestinal tract, prostaglandins, and renal blood flow. COX-2 primarily acts on the inflammatory process.

Nonsteroidal drugs that inhibit COX-1 have a large number of undesirable properties, so the use of selective NSAIDs is more preferable.

For therapeutic purposes in traditional medicine the following properties of non-steroidal anti-inflammatory drugs are used:

1. Analgesic: the drugs effectively relieve pain of mild to moderate intensity, which is localized in ligaments, articular surfaces, and skeletal muscle fibers.
2. Antipyretic: acute stages of inflammatory joint diseases are often accompanied by an increase in overall body temperature. NSAIDs do a good job of reducing it without affecting normal temperature readings.
3. Anti-inflammatory: The difference between NSAIDs and steroids is the strength of the effect. The latter have a different mechanism of action and a more powerful effect on the pathological focus. For the treatment of joint manifestations, Phenylbutazone, Diclofenac, and Indomethacin are most often used.
4. Antiplatelet: more typical for aspirin. It is used not only to treat joint diseases, but also for concomitant pathology in the form of coronary heart disease.
5. Immunosuppressive: Non-steroidal anti-inflammatory drugs slightly suppress the immune system. This occurs due to a decrease in capillary permeability and a decrease in the possibility of interaction of antigens with antibodies of foreign proteins.

Indications

Unlike steroid drugs, NSAIDs for the treatment of joints are prescribed in the following cases:

• the need for long-term medication;
• elderly and senile patients (over 65 years);
• severe somatic pathologies;
• the occurrence of side effects from taking hormonal medications;
• peptic ulcer (only for COX-2 inhibitors).

Treatment of almost all joint diseases is associated with the use of non-steroidal anti-inflammatory drugs. Therapeutic courses differ in duration, dosage, and method of drug administration.

It is important to remember that NSAIDs do not affect the pathogenesis of rheumatic diseases. The drugs significantly alleviate the condition of patients, relieving pain and stiffness. But they are not able to stop the pathological process, prevent joint deformation or cause remission.

Side effects

The main negative symptoms observed when using non-steroidal medications are gastrointestinal disorders. They manifest themselves in the form of dyspeptic disorders, the development of erosive-ulcerative disorders and perforation of the mucous membranes of the stomach and duodenum. Side effects are most common for COX-1 inhibitors (Aspirin, Ketoprofen, Indomethacin, Ibuprofen, Diclofenac). Other undesirable effects include the following:

• renal blood flow depletion and renal failure;
• analgesic nephropathy;
• development of anemia;
• bleeding from damaged surfaces of the skin and mucous membranes;
• hepatitis;
• allergic reactions;
• spasm of the bronchial muscles;
• weakening of labor and prolongation of pregnancy.

These side effects of non-steroidal drugs should be taken into account when choosing a treatment regimen for patients with joint diseases.

Contraindications

NSAIDs should not be prescribed to patients with concomitant pathologies such as:

1. Ulcers of the gastrointestinal tract, especially in the acute stage of the disease.
2. Significant decrease in the functional capacity of the kidneys and liver.
3. Pregnancy.
4. Cytopenic conditions (anemia, thrombocytopenia).
5. The presence of an allergic reaction to the components of the drugs.

Differences between steroid and non-steroidal drugs, their comparative characteristics

The main differences between the two groups of drugs in the treatment of joint diseases are the following:

1. Pathogenetic mechanism of action. Unlike NSAIDs, steroid medications have not only local but also systemic effects. Their influence is stronger and multi-component.
2. Application in the treatment of joints. The range of use of non-steroidal medications is wider; they are used not only in the treatment of inflammatory pathologies (arthritis), but also for pain syndrome associated with osteochondrosis of any localization.
3. Side effect. The range of adverse effects is much wider for steroid hormonal drugs. This is due to the fact that drugs have an affinity for endogenous compounds in the body.
4. Contraindications. Steroids affect almost every system of the human body. It is impossible to achieve selectivity of action using adrenal hormones. Therefore, many conditions exclude the use of this group of medications. Selective NSAIDs (COX-2 inhibitors), on the contrary, can only affect the inflammatory component, which significantly expands the therapeutic possibilities of this group of drugs. On the other hand, steroid drugs have a weaker negative effect on the mucous membrane of the stomach and intestines. It is this factor that is often decisive when choosing a medicine.
5. Features of treatment courses. As a rule, NSAIDs are the first-line drugs for the treatment of articular syndrome. If the product is chosen correctly, it can be used for a long time. Only in case of insufficient effectiveness are steroid medications prescribed. They are not used for a long time; they always try to resume taking NSAIDs. It is important to remember that withdrawal from steroids can have a detrimental effect on the body’s condition; withdrawal syndrome occurs. Non-steroidal drugs do not have this quality.
6. Release forms. Steroid and non-steroidal drugs are available in the form of ointments, solutions for intramuscular, intravenous, intra-articular administration, gels, suppositories, and tablets for oral administration. This allows you to avoid local reactions and choose the right form for maximum impact on the inflammatory focus.

Steroid and non-steroidal drugs are necessary to carry out the most effective course of treatment for rheumatic diseases. You cannot use them yourself without first consulting a specialist. Only strict adherence to the proposed treatment regimen can provide lasting relief from articular manifestations and avoid unwanted effects.

/ lectures pharma / STEROID ANTI-INFLAMMATORY DRUGS

STEROID ANTI-INFLAMMATORY DRUGS (GLUCOCORTICOIDS).

1. Natural: Hydrocortisone*, Cortisone*.

2. Synthetic: Prednisolone*, Methylprednisolone*, Dexamethasone*. Triamcinolone*.

3. Preparations for topical use: ointments - Prednisolone, Ledecort, Fluorocort (Triamcinolone*), Sinaflan (Fluocinolone acetonide*), Lorinden; produced in the form of aerosols for inhalation Beclomethasone dipropionate* (“Bekotide”, “Beclazone”), Ingacort, Budesonide*, Fluticasone*.

The difference between synthetic glucocorticoids and natural ones is that the former are more active, which means they can be used in low doses, with a lower risk of complications and less likelihood of changes in water-salt metabolism.

After penetration into tissues, glucocorticoids diffuse across cell membranes and bind to a cytoplasmic complex consisting of a specific glucocorticoid receptor and heat shock protein. The heat shock protein is released and the hormone-receptor complex is transported into the nucleus, where it interacts with glucocorticoid effector elements on various genes and with other regulatory proteins (specific to different cells). This leads to an increase in the synthesis of mRNA, which, in turn, induces the formation of a special class of proteins - lipocortins, one of them (lipomodulin) inhibits phospholipase A 2. In addition, the release of cytokines (interleukins 1 and 2 and interferon γ) from lymphocytes and macrophages is inhibited. And also directly and accordingly, collecting documents and all kinds of small price lists, for waste and sodomy;)))

Impact on various types of exchanges.

They act on protein, carbohydrate, fat and water-salt (table).

The influence of glucocorticoids on various types of metabolism.

Review of Steroidal Anti-Inflammatory Drugs

Steroid drugs are the most powerful anti-inflammatory drugs available today. This is a group of drugs based on cortisol, a hormone produced by the human adrenal glands. Medicines containing steroid hormones include the following:

• Steroid drug in the form of an ointment;
• New generation steroidal anti-inflammatory drugs;
• Steroid anti-inflammatory drugs for the treatment of joints

Mechanism of action

Steroid medications reduce inflammation by suppressing the functions of the immune system. They reduce the production of leukocytes and anti-inflammatory enzymes, thereby stopping tissue erosion at the site of the affected area.

List of indications

• There was a malfunction in the immune system, which led to skin allergies.
• The inflammatory process in the joint has a destructive effect on the surrounding tissues and causes severe pain (rheumatoid arthritis).
• With systemic inflammation of blood vessels (vasculitis).
• With systemic muscle inflammation (myositis).
• For inflammation of internal organs and tissues.
• Hepatitis.
• Shock states.

Watch a useful video on this topic

Contraindications

• Tissue damage is caused by infection.
• The body is exposed to bacterial diseases.
• With the potential for bleeding.
• When taking blood thinning medications.
• With extensive erosion of tissues and joints.
• In case 3 injections of steroid drugs have already been made this month.
• Immunodeficiency of the body.
• Pregnancy and lactation.

Side effects

The study showed that the use of steroid drugs may be accompanied by the following symptoms:

• Hypertension.
• Increased blood clotting.
• Low immunity.
• Peptic ulcer of the digestive system.
• Osteoporosis.
• Masculinization of the female body (acquiring masculine properties).

Withdrawal syndrome

The hormone cortisol is involved in the body's energy metabolism. It helps break down proteins. When the level of this hormone in the body increases, and then when it sharply decreases, problems with metabolism arise. Muscles may become more flabby, and the percentage of fatty tissue in the body increases.

Popular steroid drugs

Dexamethasone (price from 208 rubles).

Available in the form of a solution for injection. It is used in cases requiring immediate administration of an anti-inflammatory drug, as well as in shock conditions.

Cortisol (price from 426 rubles).

Available in the form of a suspension. Used orally or intramuscularly to relieve pain in acute rheumatoid arthritis.

Clear gel, cream or ointment. It is used externally for psoriasis, priororal dermatitis and other itchy skin lesions.

Ointment for external use. Used for itchy skin inflammation and skin allergies.

Bematethasone (price from 108 rubles).

White or transparent gel. Apply to the surface of the skin for allergic reactions and itchy inflammation.

New generation anabolic drugs

Celeston (price from 128 rubles).

Available in the form of tablets or ampoules for injection. It should be taken in cases of dermatitis, allergic conjunctivitis and other inflammations of internal organs.

Produced in tablet form. It is used for acute stressful situations, multiple sclerosis syndrome and growth retardation in children.

It is produced in the form of ampoules or a bottle for the preparation of a solution for injection. Accepted in shock situations.

White ointment or cream. Used as an antipruritic and anti-inflammatory agent.

Berlicourt (price from 208 rubles).

Available in tablet form. Used for asthma, acute rhinitis and allergic reactions.

Anti-inflammatory drugs for joints based on steroid hormones

Lidocaine (price from 134 rubles).

Powder for preparing a solution for infections. It is used for inflammation of the joints and in surgical practice.

Prednisolone (price from 115 rubles).

Tablets or solution for injection. Used for allergic reactions, inflammatory or shock conditions.

Cyanocobalamin (price from 32 rubles).

Solution for injection. It is used for pinching of the lumbosacral region, allergies and dermatitis.

Dexazon (price from 188 rubles).

Solution for intramuscular and intravenous administration. Used for acute shock or allergic conditions and inflammatory reactions.

Sold in the form of double ampoules with solution. It is used intramuscularly as an anti-inflammatory agent for acute joint pain.

Steroid ointments

Steroid ointments can come in the form of a cream, ointment, or gel. Each patient can individually choose a form that is convenient for themselves.

Steroid ointment, cream or gel. Used for skin dermatitis and eczema.

Akriderm (price from 102 rubles).

A cream distinguished by its softening properties. Used for itchy and flaky dermatitis and eczema.

Diprolene (price from 160 rubles).

Cream used for dermatitis.

Ointment used for seborrhea, psoriasis and dermatitis.

Frequently Asked Questions

What is the difference between hormonal and steroid drugs?

Steroid medications are a type of hormonal medication. In addition to adrenal hormones, there are drugs that can replace pituitary hormones, sex hormones, anabolic hormones, pancreatic hormones, thyroid and parathyroid hormones.

How is treatment carried out with both steroid and non-steroidal drugs?

Many diseases are recommended to be treated with steroidal and nonsteroidal (NSAIDs or NSAIDs) drugs simultaneously. Anabolic steroid drugs help reduce inflammation and tissue swelling, and non-steroidal drugs act on the cause of inflammation. When taking steroid drugs, be sure to take into account that they can provoke an allergic reaction to the medications and vitamins that you take at the same time. Only a highly qualified attending physician can draw up the correct dosage plan and combination of steroid hormones.

What is the best way to use such drugs for osteochondrosis?

Steroid drugs relieve pain well and relieve tissue swelling in osteochondrosis of the joints. Ambene is a fairly popular drug. This is a medicine that consists of two solutions for infections. This drug relieves tissue swelling well, relieves pain, reduces temperature and has a calming effect on the nervous system.

What are new generation steroidal anti-inflammatory drugs?

Recently, a new generation of anabolic steroid anti-inflammatory drugs have begun to be produced, which have fewer side effects. The use of such drugs is more preferable, but their anti-inflammatory effect is lower than that of traditional drugs.

How are anti-inflammatory drugs with a steroid structure produced?

Anabolic steroid drugs are obtained through a series of chemical and biological transformations and deep purification of the resulting raw materials. Special immobilized microbial cells participate in these transformations.

Steroid and non-steroidal drugs. What's the difference?

The difference between steroidal and non-steroidal drugs lies in their effect on the body. The effect of steroid drugs is that they suppress the human immune system. Non-steroidal non-narcotic painkillers have an analgesic effect on the body. They slow down the enzyme reaction in the membranes of nerve cells. Both medications have significant negative effects on the body, so they should not be used regularly.

The modern pharmaceutical market offers the use of steroid drugs that help avoid a large number of problems associated with allergic reactions of the body or exacerbation of inflammatory processes.

In the treatment of complex diseases, anti-inflammatory drugs (steroids) are often used. They have a wide spectrum of action and can provide many positive effects for the body. There are several types of these funds, each of which is aimed at obtaining a specific effect.

General characteristics of the funds

Steroidal anti-inflammatory drugs (SAAIDs) are derivatives of glucocorticoid hormones produced by the adrenal glands. They are divided into the following types:

• Natural.
• Synthetic: non-halogenated and halogenated.

The first group includes drugs such as Hydrocortisone and Cortisone. Non-halogenated steroids are presented in the form of Methylprednisolone and Prednisolone. Fluoridated - Triamcinolone, Dexamethasone and Betamethasone.

The effect of taking such substances is ensured by influencing the body at the cellular level. By binding to DNA, drugs can have a strong effect on various processes. The main ones include:

Among the most pronounced actions of glucocorticoids are the following: antipruritic, antiallergic, and naturally anti-inflammatory. They produce products for both external and internal use. Very often, various gels, ointments and creams are used to treat skin diseases, and injections are used for joint diseases.

The use of SPVP should only be prescribed by a doctor, since independent use can lead to various negative consequences.

Mechanism of action of SPVP

The principle of action of SPVP is based on intracellular effects. During the use of such funds, the following processes occur:

• When entering the body, substances begin to interact with receptors in the cytoplasm of cells, penetrating into the nucleus. Due to their action on DNA, they influence some of the genes, which allows them to change the balance of purines, water, proteins and fats.
• The mechanism of action includes the process of activation of gluconeogenesis, which increases the amount of glucose in the blood and increases the concentration of glycogen in liver cells. This, in turn, helps to impede protein biosynthesis and increase the breakdown of structures located near muscle fibers, connective tissue and skin.

If there is an inflammatory process in the body, it includes protection from various pathogenic microflora. If the immune system is weakened, this protection is not enough, which often leads to the destruction of joints, tissues, and the development of other pathologies. The affected areas turn red and begin to feel painful.

SPVPs relieve pain and eliminate the inflammatory process. According to their chemical structure, they are classified as 17, 11-hydroxycorticosteroids. The first substance of the group to be obtained is a glucocorticoid from the adrenal glands. Now there is a large selection of these substances of both synthetic and natural origin.

Glucocorticoids help inhibit the process of protein synthesis, while enhancing catabolic reactions in muscle fibers, connective tissue and skin, providing an anti-anabolic effect. If you use such drugs for a long time, muscle weakness, slower regeneration processes, developmental delays, an increase in the amount of fat in the body and other adverse reactions may develop. In this regard, you should consult your doctor before taking such substances.

The effect of using SPVP

The anti-inflammatory effect provided by steroid drugs is ensured by their ability to be inhibited through lipocortin. They also inhibit the gene that encodes the production of COX-2, which is actively involved in areas of inflammation. Glucocorticoids also suppress prostaglandin activity. They provide an antioxidant effect, slowing down lipid oxidation and maintaining the integrity of cell membranes. Thus, the spread of the inflammatory process is prevented.

The main actions of SPVP include:

1. Anti-inflammatory. Glucocorticoids are inhibitors of all inflammation in the body. They help stabilize cell membranes, ensure the release of proteolytic enzymes from cells, prevent destructive changes in tissue, and also slow down the formation of free radicals. When the substance enters the body, the number of mast cells in areas of inflammation decreases, small vessels narrow, and capillary permeability decreases.
2. Immunosuppressive. SPVPs reduce the level of circulating lymphocytes and microphages. They disrupt the production and action of interleukins and other cytokines that regulate various immune responses. There is a decrease in the activity of B and T lymphocytes, a decrease in the production of immunoglobulins and the amount of complement in the blood. Fixed immune complexes are formed, and the formation of factors that inhibit the movement of microphages is inhibited.
3. Antiallergic. This effect is achieved by suppressing different stages of immunogenesis. Glucocorticoids slow down the process of formation of circulating basophils, and also reduce their number and prevent the development of the synthesis of sensitized cells, basophils, which contribute to the development of an allergic reaction and reduce the sensitivity of effector cells to them. The production of connective and lymphatic tissues is suppressed, as well as the formation of antibodies.
4. Antitoxic and antishock. SPVPs are involved in ensuring vascular tone, water and salt balance. They improve the activity of liver enzymes, which are involved in the process of converting exogenous and endogenous substances. There is an increase in the sensitivity of blood vessels to catecholamines and their permeability decreases. The amount of blood plasma increases as the substances retain sodium and water in the body. This allows you to reduce hypovolemia, improve vascular tone and the process of myocardial contraction.
5. Antiproliferative. This effect is associated with a decrease in the migration of monocytes in areas of inflammation and a slowdown in the process of fragmentation of fibroblasts. The synthesis of mucopolysaccharides is suppressed, which helps slow down the binding of plasma protein and water to tissues that have entered the site of inflammation.

Each of the drugs, depending on its type, can provide a certain effect. The selection of funds should only be carried out by a specialist.

Difference between non-steroidal anti-inflammatory drugs and non-steroidal anti-inflammatory drugs

Steroid and non-steroidal drugs are used to solve various health problems. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used if the disease has not reached an advanced stage. They come in two types:

The first group includes substances that affect the COX-1 and 2 enzymes. The second group includes substances that affect the COX-2 enzyme. The enzyme COX-1 takes an active part in various processes of the body and provides its important functions. It works constantly. COX-2 is an enzyme that is produced only in the presence of an inflammatory process.

Based on their active substance, non-selective NSAIDs are of the following types: Ibuprofen, Diclofenac, Paracetamol. Selective ones include: Meloxicam, Nimesulide, Celecoxib. Non-steroidal anti-inflammatory drugs have the following effects:

These drugs help reduce pain, eliminate fever and inflammation. Unlike glucocorticoids, they do not cause as many negative effects.

Most NSAIDs are prescribed for acute and chronic diseases that occur with severe symptoms such as pain and inflammation. Their use is relevant in cases where the disease is not advanced. Most often, they are prescribed for arthritis, osteoarthritis, gout, fever, renal colic, migraine, headache, dysmenorrhea and other disorders.

SPVPs also have an effect on COX-2, but have no effect on COX-1. Very often, they are prescribed in combination with NSAIDs. Glucocorticoids are used in various fields of medicine. They are used to treat joints, dental diseases, skin diseases and others.

Glucocorticoids suppress the immune system, have an anti-inflammatory, anti-allergic and anti-shock effect. They are prescribed in cases where the use of NSAIDs has not brought positive results. There is also a difference between these drugs in the list of adverse reactions. NSAIDs have fewer of them.

Indications

Anti-inflammatory steroid drugs relieve inflammation by suppressing immune function. They ensure a reduction in the production of leukocytes and anti-inflammatory enzymes, which makes it possible to achieve relief of inflammation. These drugs are most often prescribed for the following disorders or diseases:

• State of shock.
• Skin diseases.
• Systemic connective tissue diseases.
• Various types of hepatitis.
• Allergies.
• Pathologies of joints and muscles.
• Disturbances in the functioning of blood vessels.
• Inflammatory processes in internal organs and tissues.

Glucocorticoids are often used for rheumatism and rheumatic carditis, osteochondrosis, diseases of the hematopoietic organs, dermatomyositis, lupus erythematosus and other diseases. Anti-inflammatory steroid medications can treat a wide variety of conditions. In order for the effect of the products to be as effective as possible, they are most often administered locally.

SSAIDs are very powerful medications, so you cannot decide on their use on your own. Only a doctor should select medications and determine dosage.

Most popular SPVPs

Steroidal anti-inflammatory drugs cope well with the inflammation process and relieve pain. The means that are most often used in medical practice include:

• Dexamethasone. It is used for inflammations that require immediate administration of such substances and for various states of shock. The product is sold as an injection solution.
• Cortisol. It can be used both orally and intramuscularly, if necessary, to relieve pain and acute rheumatoid arthritis. Presented in the form of a suspension.
• Sinalar. Used for skin diseases. Most often, with psoriasis and dermatitis, as well as other skin lesions accompanied by itching. It can be produced both in the form of a gel and an ointment.
• Bematethasone. Sold in the form of a gel, which is applied to the skin for allergies and inflammation with itching.

New anabolic agents are also now being introduced. They have pronounced effects and are used to treat various diseases. The most popular of them include:

1. Celeston. Used for dermatitis, allergic conjunctivitis and inflammation of internal organs. Produced in injection and tablet form.
2. Mendrol. Prescribed for severe situations of stress, multiple sclerosis and slow development in children. Sold in tablet form.
3. Urbazon. Used in states of shock. Available in injection form.
4. Momat. Relieves inflammation and also eliminates itching. Used for various skin diseases. Sold as a cream or ointment.
5. Berlicourt. Prescribed for asthma, acute rhinitis and allergies. Available in tablet form.

Each of the drugs is prescribed by a doctor, taking into account the individual characteristics of the patient, the nature of the course of the disease and its type. The dosage and course of treatment are also determined only by a specialist.

Contraindications and adverse reactions

Steroidal anti-inflammatory drugs are the most powerful in pharmacology, so they cannot be taken arbitrarily. Treatment is prescribed by a specialist. The main contraindications include:

• Infectious tissue damage.
• Diseases caused by bacteria.
• Risk of bleeding.
• Taking blood thinners.
• Significant erosive lesions of joints and tissues.
• Weakened immunity.
• The period of pregnancy and lactation.
• Individual intolerance.
• In cases where three injections of SPVP are performed per month.

If the patient has various lesions and diseases of an infectious nature, steroids cannot be used. The active substances included in the products help reduce the body's defenses and suppress the immune system. In turn, this does not allow the body to overcome pathogens, which increases the spread of infection.

If a patient is taking blood thinners and is at risk of bleeding, steroid medications may cause severe bleeding at injection sites. Such drugs should not be used more than three times a month, as there is a possibility of infection as a result of weakening of the tissues.

Steroids belong to the group of hormonal drugs, so they cannot be used for a long time. This is due to the fact that there is a risk of developing various adverse reactions. The main ones include:

• Hypertension.
• Exacerbation of peptic ulcer disease.
• Swelling.
• Osteoporosis.
• Decreased protective functions of the immune system.
• Increased blood clotting.
• Masculinization in women.
• Increased amount of subcutaneous fat.

In order to avoid such undesirable consequences, taking anti-inflammatory steroid drugs should last no more than two weeks. It is also advisable to take them with meals.

Preventing Negative Reactions

It is not recommended to take anti-inflammatory steroid drugs during pregnancy and breastfeeding. It is necessary to take into account the list of contraindications in which their use is completely excluded. There are certain recommendations that can reduce the risk of negative consequences. It includes:

1. Body weight control.
2. Regular blood pressure measurement.
3. Study of sugar levels in blood and urine.
4. Monitoring the electrolyte composition of blood plasma.
5. Diagnosis of the gastrointestinal tract and musculoskeletal system.
6. Consultations with an ophthalmologist.
7. Testing for infectious complications.

These measures make it possible to avoid various negative consequences, since they are aimed at studying exactly those indicators that may indicate the presence of changes in the body.

Steroidal anti-inflammatory drugs are very strong substances that should only be used for specific purposes. They cannot be used at your own discretion. The prescription should only be made by a doctor, based on the patient’s condition and the type of disease.

Steroid drugs

Steroid drugs are anti-inflammatory drugs based on hormones produced by the adrenal glands. Steroid medications affect the human body in the following ways:

• suppress immunity;
• have an anti-inflammatory effect;
• exhibit antiallergic properties;
• have an antishock effect.

Indications for the use of anti-inflammatory steroid drugs

Steroidal anti-inflammatory drugs are prescribed for diseases associated with various inflammatory processes in the body, including:

• rheumatism, osteochondrosis, intervertebral hernia, lumbago, etc.;
• certain skin diseases;
• diseases of the hematopoietic organs;
• some types of hepatitis;
• diseases of allergic etiology (bronchial asthma, atopic dermatitis, urticaria, etc.)
• systemic connective tissue diseases (lupus erythematosus, dermatomyositis, scleroderma).

Due to the fact that steroid drugs are derivatives of the hormone cortisol, their long-term use can be accompanied by a number of side effects. Side effects include:

• weight gain;
• osteoporosis;
• edematous phenomena;
• decreased immunity;
• formation or exacerbation of esophageal ulcer;
• increased blood clotting;
• hypertension;
• Women may experience masculinization (acquiring the properties of a male body).

To prevent these manifestations and addiction to steroids, their use is usually limited to two weeks. In addition, experts recommend taking steroid medications after meals to reduce side effects. It is not advisable to use steroid-based medications during pregnancy and lactation. In some cases, individual intolerance is noted.

Names of steroid drugs

Steroid drugs quickly and effectively eliminate pain. The list of steroid painkillers offered by pharmaceutical manufacturers is expanding every year. Popular steroids include:

All forms of anti-inflammatory steroid drugs should be used only as prescribed by a physician and under medical supervision. When treating, it is important to consider that the effect of steroids on the body will differ in each specific case.

Steroid and non-steroidal anti-inflammatory drugs

This article is for informational purposes only, and in no case is it a guide to action. If there are inflammations and injuries, you should contact a traumatologist and not self-medicate.

It should also be noted that this article is purely about sports injuries and inflammations that are caused by damage from exercise; other cases will not be discussed.

1. Inflammatory process.

An inflammatory process is a pathological process that occurs as a result of damage to cellular structures (muscles, joints, bones, ligaments or tendons). Most often in sports, the inflammatory process occurs due to injury; it can be a tear, rupture or damage to a muscle, joint, ligament or tendon.

• Acute inflammation lasts from several minutes to several hours.
• Subacute inflammation lasts from several days to several weeks.
• Chronic inflammation – duration from several months to lifelong.

1. Alturation is cell damage.
2. Exudation is the release of fluid and blood cells into cells and tissues from the blood.
3. Proliferation is cell reproduction and tissue proliferation. At this stage, tissue integrity is restored.

Inflammation must be eliminated as quickly as possible; a prolonged inflammatory process can lead to degenerative changes (reduction of bone, ligament or other tissue). Therefore, with a prolonged inflammatory process, the following more serious injuries are possible, and the inflammatory process is also accompanied by pain.

Before starting to describe the drugs, it should be added that all anti-inflammatory drugs also have an analgesic effect (pain reliever). Therefore, when taking them, it is necessary to completely eliminate heavy training, so that against the background of an anesthetized injury, you do not aggravate it with inadequate load.

2. Non-steroidal anti-inflammatory drugs (NSAIDs).

Nonsteroidal anti-inflammatory drugs are divided into two types:

• Non-selective drugs - act on the enzyme COX-1 and COX-2.
• Selective drugs - act on the COX-2 enzyme.

Enzymes COX-1 and COX-2 - Cyclooxygenases (very concise and short description).

• COX-1 is an enzyme that functions constantly and performs physiologically important functions.
• COX-2 is an enzyme that begins to function during inflammation.

Conclusion: Selective NSAIDs are more preferable, since they act only on COX-2, actually relieving inflammation, and do not affect COX-1; by acting on this enzyme, all side effects appear.

Preparations (according to active substance):

• Diclofenac - side effects on the stomach.
• Paracetamol is very toxic to the liver.
• Ibuprofen - stomach side effects.

The best course of NSAIDs (examples only, consult your doctor before use).

Many experts identify drugs that they consider more preferable in a given situation, but almost everyone agrees that Nimesulide is best suited for sports injuries. Since the drug is best suited for relieving inflammation in muscles, tendons, ligaments and joints.

Course of treatment: From 7-12 days, 200 mg daily in 2 doses, taken after meals and with a sufficient amount of water.

3. Steroidal anti-inflammatory drugs (SAAIDs).

Almost all SPVP go to glucocoticoids. Just like NSAIDs, they affect the COX-2 enzyme, but do not affect COX-1 at all. The course of treatment is sometimes combined with NSAIDs.

• Cortisone and hydrocortisone are natural glucocorticoids.
• Dexamethasone is a synthetic analogue of glucocorticoid.
• Diprospan is a glucocorticoid drug.

The course of treatment with SSVP usually lasts from one to two months, this is due to the fact that SSVP is resorted to in critical situations when NSAIDs have not worked. However, in some cases, the course of treatment can be short, up to several days, when treatment for PVS begins immediately after the injury. It should also be remembered that SPVP is most often injected locally, at the site of injury.

How and when to take SVP drugs.

Immediately after the injury, after some time, the first phase of the inflammatory process (acute inflammation) begins in the damaged area. In some cases, if you administer SPVP immediately after an injury, you can stop the inflammation already at the first stage of exudation. In this case, Dexamethosone is suitable, since this drug works faster and stops working quickly (about 4 hours), thereby it will work quickly and will not cause significant harm. In some cases, 1-3 injections of 1 ml of desamethasone are sufficient.

If the injury has already progressed to subacute or chronic inflammation, it is most likely necessary to use SPVA for a longer period of time, from three to four weeks. In this case, it is better to take a drug that works for a long time, and there is no need to inject it often; Diprospan is suitable here. About 3-4 injections once a week can completely relieve inflammation.

Various groups of drugs are used to treat joints. Some are necessary to relieve pain, others - to restore cartilage tissue, and others - to relieve the inflammatory process. Anti-inflammatory drugs include steroidal and non-steroidal drugs; the difference between them is what you need to know to correctly prescribe a course of treatment.

Glucocorticosteroids (hormones of the adrenal cortex) began to be used for the treatment of joints more than 50 years ago, when their positive effect on the severity of joint syndrome and the duration of morning stiffness became known.

The most popular drugs from the group of steroids in rheumatology are:

Doctor Myasnikov: “Cure your joints for only 99 rubles*, before you get into a wheelchair! Remember: arthritis and arthrosis destroy cartilage tissue in 3 years.” Read more>>

• Prednisolone (Medopred);
• Triamcinolone (Kenacort, Kenalog, Polcortolone, Triamsinolol);
• Dexamethasone;
• Methylprednisolone (Metypred);
• Betamethasone (Celeston, Diprospan, Flosteron).

It is worth noting that non-steroidal hormones are not used in the treatment of joint diseases.

Don't Miss: Prednisolone for Rheumatoid Arthritis

Mechanism of action

The pronounced anti-inflammatory effect of drugs with a steroid structure is achieved in several ways:

• an obstacle to the movement of neutrophils (the main inflammatory cells) from the vessels into the tissue, to the affected area;
• decreased permeability of biological membranes, which inhibits the release of proteolytic enzymes;
• suppression of cytokine formation;
• influence on epithelial cells;
• stimulation of lipocortin formation.

This mechanism of action, which slows down all phases of the inflammatory response, leads to rapid relief of symptoms and improvement in the condition of patients.

Indications

All anti-inflammatory steroid drugs have a strict list of indications for use. This is due to the fact that hormones have a large number of side effects. Therefore, they are a reserve group in the treatment of joint diseases.

Steroid drugs are prescribed for conditions such as:

1. High disease activity.
2. Systemic manifestations of pathology.
3. Weak effectiveness of non-steroidal anti-inflammatory drugs.
4. The presence of contraindications to the prescription of NSAIDs that prevent their use.

Side effects

Like any other drugs, steroid hormones have a number of undesirable effects. These include:

• dyspepsia (feeling of nausea, abdominal pain, vomiting, bloating, hiccups, loss of appetite, perversion of taste);
• increased pH of gastric contents;
• development of myocardial failure, if present - worsening of the condition;
• increased blood pressure numbers;
• liver enlargement;
• blood clot formation;
• obesity;
• increased excretion of potassium and calcium, retention of sodium ions;
• osteoporosis;
• muscle weakness;
• skin rashes;
• increased sweating;
• weakness;
• depressive states;
• allergic local and systemic reactions;
• weakened immunity, decreased body resistance to infections, exacerbation of chronic diseases;
• increased blood sugar levels;
• impaired wound healing;
• menstrual irregularities, etc.

Almost all steroids have these side effects to a greater or lesser extent. Their quantity and strength depend on the method of administration of the drug, dosage and duration of use.

Contraindications

Anti-inflammatory steroid drugs should be prescribed with caution in the following conditions:

The listed contraindications do not mean that steroid drugs cannot be used. However, concomitant pathologies should always be taken into account when prescribing medications.

Alexander Leonidovich Myasnikov, a doctor of the highest medical category, talks about how to completely cure joints for 99 rubles* and finally forget about excruciating pain! Read more>>

Non-steroidal drugs (NSAIDs, NSAIDs)

Medicines from the group of non-steroidal anti-inflammatory drugs are first-line drugs for the treatment of joint diseases. They are used to treat rheumatoid arthritis, reactive systemic arthritis, psoriatic arthritis, ankylosing spondylitis, gout, osteoarthritis of any localization, osteochondropathy, osteochondrosis, and other systemic pathologies.

Don't miss: Gouty joint arthritis or gout

The history of the creation of non-steroidal drugs goes back to ancient times. Our ancestors also knew that when the temperature rises, it is necessary to make a decoction from willow tree branches. It was later discovered that willow bark contains the substance salicyl, from which sodium salicylate was later created. It was only in the 19th century that salicylic acid, or aspirin, was synthesized from it. It was this medicine that became the first non-steroidal remedy for inflammation.

Don't miss: Everything you need to know about rheumatoid arthritis

Pathogenetic mechanism, effects

Nonsteroidal anti-inflammatory drugs can inhibit the synthesis of prostaglandins (the main mediators of inflammation) from arachidonic acid. This is possible by blocking the action of the enzyme cyclooxygenase (COX).

It was found that non-steroidal drugs act on 2 types of enzyme: COX-1 and COX-2. The first affects platelet activity, the integrity of the gastrointestinal tract, prostaglandins, and renal blood flow. COX-2 primarily acts on the inflammatory process.

Nonsteroidal drugs that inhibit COX-1 have a large number of undesirable properties, so the use of selective NSAIDs is more preferable.

For therapeutic purposes in traditional medicine the following properties of non-steroidal anti-inflammatory drugs are used:

1. Analgesic: the drugs effectively relieve pain of mild to moderate intensity, which is localized in ligaments, articular surfaces, and skeletal muscle fibers.
2. Antipyretic: acute stages of inflammatory joint diseases are often accompanied by an increase in overall body temperature. NSAIDs do a good job of reducing it without affecting normal temperature readings.
3. Anti-inflammatory: The difference between NSAIDs and steroids is the strength of the effect. The latter have a different mechanism of action and a more powerful effect on the pathological focus. For the treatment of joint manifestations, Phenylbutazone, Diclofenac, and Indomethacin are most often used.
4. Antiplatelet: more typical for aspirin. It is used not only to treat joint diseases, but also for concomitant pathology in the form of coronary heart disease.
5. Immunosuppressive: Non-steroidal anti-inflammatory drugs slightly suppress the immune system. This occurs due to a decrease in capillary permeability and a decrease in the possibility of interaction of antigens with antibodies of foreign proteins.

Don't miss: All about psoriatic joint arthritis

Indications

Unlike steroid drugs, NSAIDs for the treatment of joints are prescribed in the following cases:

• the need for long-term medication;
• elderly and senile patients (over 65 years);
• severe somatic pathologies;
• the occurrence of side effects from taking hormonal medications;
• peptic ulcer (only for COX-2 inhibitors).

Treatment of almost all joint diseases is associated with the use of non-steroidal anti-inflammatory drugs. Therapeutic courses differ in duration, dosage, and method of drug administration.

It is important to remember that NSAIDs do not affect the pathogenesis of rheumatic diseases. The drugs significantly alleviate the condition of patients, relieving pain and stiffness. But they are not able to stop the pathological process, prevent joint deformation or cause remission.

Side effects

The main negative symptoms observed when using non-steroidal medications are gastrointestinal disorders. They manifest themselves in the form of dyspeptic disorders, the development of erosive-ulcerative disorders and perforation of the mucous membranes of the stomach and duodenum. Side effects are most common for COX-1 inhibitors (Aspirin, Ketoprofen, Indomethacin, Ibuprofen, Diclofenac).

Other undesirable effects include the following:

• renal blood flow depletion and renal failure;
• analgesic nephropathy;
• development of anemia;
• bleeding from damaged surfaces of the skin and mucous membranes;
• hepatitis;
• allergic reactions;
• spasm of the bronchial muscles;
• weakening of labor and prolongation of pregnancy.

These side effects of non-steroidal drugs should be taken into account when choosing a treatment regimen for patients with joint diseases.

Don't miss: NSAIDs and the gastrointestinal tract: complications and their prevention

3 plants that penetrate joints and restore cartilage 20 times better than pharmaceutical chemicals! Read more>>

Contraindications

NSAIDs should not be prescribed to patients with concomitant pathologies such as:

1. Ulcers of the gastrointestinal tract, especially in the acute stage of the disease.
2. Significant decrease in the functional capacity of the kidneys and liver.
3. Pregnancy.
4. Cytopenic conditions (anemia, thrombocytopenia).
5. The presence of an allergic reaction to the components of the drugs.

The discovery of a pensioner from Izhevsk shocked world medicine: “I TREAT JOINTS WITH A SIMPLE COPY CREAM” Read more>>

Differences between steroid and non-steroidal drugs, their comparative characteristics

The main differences between the two groups of drugs in the treatment of joint diseases are the following:

1. Pathogenetic mechanism of action. Unlike NSAIDs, steroid medications have not only local but also systemic effects. Their influence is stronger and multi-component.
2. Application in the treatment of joints. The range of use of non-steroidal medications is wider; they are used not only in the treatment of inflammatory pathologies (arthritis), but also for pain syndrome associated with osteochondrosis of any localization.
3. Side effect. The range of adverse effects is much wider for steroid hormonal drugs. This is due to the fact that drugs have an affinity for endogenous compounds in the body.
4. Contraindications. Steroids affect almost every system of the human body. It is impossible to achieve selectivity of action using adrenal hormones. Therefore, many conditions exclude the use of this group of medications. Selective NSAIDs (COX-2 inhibitors), on the contrary, can only affect the inflammatory component, which significantly expands the therapeutic possibilities of this group of drugs. On the other hand, steroid drugs have a weaker negative effect on the mucous membrane of the stomach and intestines. It is this factor that is often decisive when choosing a medicine.
5. Features of treatment courses. As a rule, NSAIDs are the first-line drugs for the treatment of articular syndrome. If the product is chosen correctly, it can be used for a long time. Only in case of insufficient effectiveness are steroid medications prescribed. They are not used for a long time; they always try to resume taking NSAIDs. It is important to remember that withdrawal from steroids can have a detrimental effect on the body’s condition; withdrawal syndrome occurs. Non-steroidal drugs do not have this quality.
6. Release forms. Steroid and non-steroidal drugs are available in the form of ointments, solutions for intramuscular, intravenous, intra-articular administration, gels, suppositories, and tablets for oral administration. This allows you to avoid local reactions and choose the right form for maximum impact on the inflammatory focus.

Steroid and non-steroidal drugs are necessary to carry out the most effective course of treatment for rheumatic diseases. You cannot use them yourself without first consulting a specialist. Only strict adherence to the proposed treatment regimen can provide lasting relief from articular manifestations and avoid unwanted effects.

Looking for a good doctor?
Make an appointment with the best rheumatologist or orthopedist in your area.

295

59

Rheumatologist

We will find you a doctor for free in 10 minutes.

Steroid and non-steroidal anti-inflammatory drugs. What is it and how are they different? — details about joint diseases on the website