CORTICOSTEROIDS

BY: JAVAID MUSTUFFA ILYAS Click to edit Master subtitle style 5TH SEMESTER 5/13/12

INTRODUCTION

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Corticosteroids are Steriod Hormones. Secreated by Adrenal Cortex. Involved in normal metabolism of body, resistance to stress, salt and water metabolism

INTRODUCTION

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Two types : (Glucocorticoids and Mineralocorticoids) In humans, the major glucocorticoid is cortisol and the most important mineralocorticoid is aldosterone. Glucocorticoids: Primarily Effect carbohydrate,protein and fat Metabolism

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GLUCOCORTICOID ACTION

Carbohydrate Metabolism

Enhance Gluconeogenesis Promote glycogen deposition in liver Enhance proteolysis from tissues Inhibit glucose utilization by peripheral Tissues Promotes Lypolysis Inhibit Intestinal Absorption of Calcium

Fat Metabolism

Calcium Metabolism

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GLUCOCORTICOID ACTION

CVS

Facilitate actions of Adrenaline and Angiotensin Restrict cappilary permeability and cardiac contractility. Maintain normal level of sensory preception and normal level of excitability of neurons Increased secretion of gastric acid and pepsin

CNS

GIT

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GLUCOCORTICOID ACTION

Inflamatory Response

Reduce capillary permeability, Local Exudation, cellular infiltration and phagocytosis

Immunity

Lymphocyte activity is supressed Inhibits release of Histamine, cytokines, interleukin, TNF etc

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MINERALOCORTICOID ACTION

Enhance reabsorption of Sodium in kidney Increase Excretion of potassium and H ions from kidney Similer effects on other tissues (colon, swet glands,slivary glands)

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CORTICOSTEROIDS

Mechanism Of Action

They penetrate cells and bind to high affinity cytoplasmic receptor proteins.
The ligand-bound receptor complex transported into the nucleus, where it interacts with DNA and nuclear

proteins Binds to glucocorticoid receptor elements (GRE) Produce mRNAs Which then encode specific proteins

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SYNTHETIC CORTICOSTEROID PREPARATIONS 5/13/12

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CORTICOSTEROIDS

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THERAPEUTIC USES

Replacement Therapy
Adrenal insufficiency Addison`s disease Congenital Adrenal hyperplasia Organ transplant( immunosupressive effect) Combined with other immunosuppressants

THERAPEUTIC USES

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Non-Endocrine use

Rheumatic disorders Gout Heamolytic anemia etc

Renal Diseases

Nephrotic syndrome in childeren Renal sarcoidosis Glomerunephritis

Anti-inflamatorry effect

Asthama,arthritis,inflammatory bowel disease (LETS SEE)

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THERAPEUTIC USES

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Allergic Disorders

Seasonal Allergies, Bee sting, drug allergies Allergic rhinitis Only in sever infections to prevent complications AIDS Tubercular Meningitis Speticaemia etc

Infectious Diseases

THERAPEUTIC USES

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Occular Diseases

For supperessing inflammation in eye and preserving sight. Contraindicated in glaucoma, injuries, viral and fungal infections. Major application of corticosteroid therapy in

Skin Diseases

Allergic conditions, Eczema Psoriasis, pemphigus

Creams/ointments are used (betamethasone,aclomethasone e.t.c)

THERAPEUTIC USES

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GIT

Ulcerative cholitis Crohn`s disease Autoimmune chronic hepatitis Alcoholic liver disease In cerebral edema, COPD Spinal cord injury, antiemetic hyperthyroidism

Hepatic Diseases

Other uses

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ADVERSE EFFECTS

Mostly seen with prolong therapy

Edema Hypertension Muscular weakness Suseptibility to infections Hyperglycemia and diabetic effects Fragile skin,hirsuitism,easy bruising,cutaneous atrophy with topical use Delayed wound healing Risk of peptic ulcer

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Glaucoma Teratogenic Osteoprosis CONTRAINDICATIONS

peptic ulcer, epilepsy,viral & fungal infections, osteoprosis, renal failure

TB,

THANKYOU
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