home Thyroid What drugs are classified as corticosteroids? Corticosteroids: list of drugs and description of the mechanism of action. Topical corticosteroids for external use

What drugs are classified as corticosteroids? Corticosteroids: list of drugs and description of the mechanism of action. Topical corticosteroids for external use

Corticosteroid-based ointments should be included in complex therapy for patients with rheumatic diseases if there are clinical signs of inflammatory activity. To achieve success in treatment, it is very important to correctly select a drug that will simultaneously be highly effective and have a good safety profile.

The variability of hormonal drugs and their generics makes it difficult to find the optimal drug. This publication provides a list of corticosteroid ointments with names that have received the most positive feedback from patients and doctors.

Corticosteroids are a group of steroid hormones synthesized by the adrenal cortex. They have an effect against inflammation, itching, and allergies.

Drugs in this group do not have a direct analgesic effect; their principle of action is based on inhibition of the release of inflammatory mediators by mast cells and eosinophils.

With the cessation of inflammation, pain simultaneously disappears, swelling subsides, and motor activity is restored.

The disadvantage of hormonal drugs is the ability to suppress the immune system (immunosuppressive effect), retain sodium ions and water in the body, increase the loss of calcium from bone tissue, and increase the concentration of glucose in the blood. The result of metabolic disorders will be atrophy of muscle tissue, delayed bone formation in children, and osteoporosis.

For therapeutic purposes, synthetic hormonal ointments (obtained by the synthesis of natural hormones) are used. Their advantage lies in the ability to develop a pharmacological effect at lower doses. The mechanism of action of steroid drugs is similar. However, due to the inclusion of individual chemical components in the composition, the severity and duration of the therapeutic response change.

Reference. Hormonal ointments are not used for first aid, as they only temporarily eliminate inflammation and improve the patient's condition. To solve the problem, it is necessary to choose pathogenetic therapy drugs.

The active components of ointment/gel forms are completely absorbed from the skin, creating therapeutic concentrations in the focal affected area. Hormones are determined in the systemic circulation in small amounts and, after processing, are excreted by the liver and kidneys.

Types of ointments

Corticosteroid-based ointments/creams are classified into groups. Distribution is carried out depending on the degree of manifestation of anti-inflammatory and antiallergic reactions.

There are four classes of drugs:

There is a separate class of hormonal drugs for external use - combined. In addition to corticosteroids, they contain other components that have antibacterial and antifungal effects. Examples of such medications include Lorinden, Belosalik, and Flucinar.

Reference. The rate of hormone absorption and the development of pharmacodynamic response are influenced by the thickness of the epidermis, the degree of hydration and temperature conditions.

Operating principle

Glucocorticosteroids have anti-inflammatory, antitoxic, antishock, antiallergenic, immunosuppressive and desensitizing effects.

The drug slows down the development of the inflammatory process at all stages: it inhibits the process of release and accumulation of macrophages and lymphocytes, inhibits phagocytosis and the synthesis of inflammatory mediators.

The antiallergic effect is realized through the cessation of secretion and synthesis of allergic mediators. The anti-shock effect is achieved by increasing blood pressure levels. The immunosuppressive effect is associated with blocking the release of cytokines from macrophages and lymphocytes.

Indications and contraindications

Hormonal drugs are effective for shocks of various origins, allergic and anaphylactoid reactions, diseases of the respiratory tract, endocrine system, visual organs, liver, neurological disorders, and oncology.

In vertebroneurology and rheumatology, the following conditions justify the use of ointment with glucocorticosteroids:

External use of corticosteroids is unacceptable if there are scratches, abrasions, wounds, dermatoses, eczema and other skin diseases associated with a violation of the integrity of the epidermis on the skin above the problem area.

Absolute contraindication to the use of ointments/creams based on glucocorticosteroids is individual intolerance to the components of the composition and fungal infections.

Reference. For pregnant, lactating women and young children, glucocorticoids are prescribed in special cases when the benefits of hormone therapy outweigh the risk of side effects.

General rules of application

Hormonal therapy should be carried out exclusively as prescribed by a doctor and under medical supervision. The patient is preliminarily examined for possible contraindications, the stage of progression and severity of clinical signs of the disease are assessed.

Reference. With the haphazard use of external preparations, there is a threat of irreversible changes in the skin: loss of elasticity of the fibers, reduction in its volume.

The success of treatment and side effects depend on the duration of use and dosage regimen of glucocorticosteroids. That's why The doctor’s task is to select the minimum effective dosage.

Experts recommend applying ointment/cream to the affected areas once or twice every 24 hours, depending on the severity of the lesion.

The course of therapy is determined individually, based on diagnostic data, patient factors, and the basics of pathogenetic tactics. It should not last more than a month without further assessment of the advisability of continuing treatment.

In case of recurrence of joint diseases, the course may be repeated. If the clinical manifestations are not completely relieved after the end of the course, corticosteroids of the first or second classes with a less pronounced pharmacological effect can be prescribed.

The therapeutic effect of some hormonal drugs can be enhanced by using an occlusive dressing. The problem area is treated with ointment/cream and covered with cellophane on top so that it widely covers the skin around the lesion. When the intended result is achieved, further treatment is continued without applying a hermetic bandage.

Features of use in children

In case of severe disease and ineffectiveness of previously conducted non-hormonal treatment, the issue of prescribing glucocorticoids to children in minimal doses is considered.

When choosing the optimal drug, it is necessary to take into account the morphological and physiological characteristics of the child’s skin. Their epidermis is very delicate and thin, rich in blood vessels with a dense network of wide capillaries located close to the surface.

This structure of the epidermis creates favorable conditions for the rapid and active absorption of hormones into the bloodstream with consequences in the form of unwanted side reactions. Children from 0 to 12 months are prescribed class 1 corticosteroids. From one to 5 years, the list of possible hormonal ointments expands; you can already choose between drugs of the first and second classes.

The dosage regimen and course duration are selected depending on the nature/severity of the disease. The list of contraindications is similar to an adult patient: infections, eczema, dermatoses, acne, wounds, abrasions.

Parents should monitor the general well-being of the child and the condition of the skin. If a rash, redness, itching, dryness of the epidermis occurs in areas of action of hormonal drugs it is necessary to stop treatment and seek medical help.

Features of use in pregnant women

The period of gestation and breastfeeding make it difficult to take most of the hormonal ointments. This limitation is due to the ability of glucocorticosteroids to cross the placental barrier and be excreted in breast milk.

When the effect of treatment for the mother outweighs the possible threat to the development of the fetus, hormones are prescribed locally. The dosage is chosen to be the minimum that ensures a therapeutic effect and there is no risk of unwanted reactions.

Reference. Before prescribing hormonal ointments, the doctor must consult the patient about possible adverse reactions.

Review of popular ointments

The list of corticosteroid ointments is quite variable; it is difficult to identify the most effective drug for all cases.

The choice of the optimal hormonal agent should be made for a specific patient and take into account the mechanisms underlying the onset of the disease, the severity of the course and the patient’s medical history.

Particularly popular in the treatment of inflammatory lesions of the structures of the musculoskeletal system and connective tissue are such drugs as Advantan, Belogent, Beloderm, Lorinden A.

"Advantan"

The drug has different dosage forms for external therapy (ointment, cream, emulsion), which allows you to choose the most optimal and convenient method of use.

For very dry skin, it is recommended to choose an ointment with an oily base; For skin prone to oily skin, cream is optimal.

The main active component is methylprednisolone aceponate at a concentration of 1 mg/g, the mechanism of action of which is aimed at stopping the inflammatory process and allergic reaction, due to which the clinical picture is normalized and the patient’s subjective sensations are improved.

The drug is well tolerated by patients. The occurrence of adverse reactions is associated with treatment with high doses and unsystematic use. The maximum duration of the course is three months.

Reference. In pediatric practice, it is allowed for children who are four years old.

"Belogent"

It has a two-component composition: betamethasone (has anti-inflammatory, antihistamine, antipruritic effects) and gentamicin (gives a bactericidal effect).

When used locally, the plasma concentration in the blood does not exceed the physiological norm, so side effects are not particularly pronounced. Of the most common undesirable effects, it should be noted skin reactions: itching, redness, rash, peeling, atrophy.

The product is used externally. Apply enough ointment/cream to the problem area twice a day to cover the affected area. The course of treatment is 3-4 weeks. Can be prescribed to children for a short period of time in small doses.

"Beloderm"

The active ingredient in the composition is betamethasone dipropionate, which, after contact with the skin, enters the site of inflammation, stopping pain, swelling, and stiffness of movement. After using the drug, there is a decrease in the severity of signs of an allergic response.

You cannot use Beloderm for varicose veins, rosacea, skin tuberculosis, and other infectious lesions of the epidermis associated with the activity of bacterial and mycotic flora. It is prescribed with extreme caution to infants, as the drug has increased absorption.

For effective treatment, it is enough to apply the ointment to the affected joints 1-2 times daily for 2-4 weeks, depending on the severity of the disease. When using a standard treatment regimen, side effects are unlikely.

Reference. If the drug is applied in large doses under sealed dressings, a systemic overdose may occur. The leading criteria for suppression of the functions of the hypothalamic-pituitary-adrenal system are hyperpigmentation of the skin, asthenia, arterial hypertension, fainting, and depression.

"Hydrocortisone"

1 g of ointment contains hydrocortisone acetate at a dosage of 10 and 25 mg. Local forms of the drug include cream and emulsion. Hydrocortisone has a similar mechanism of action to cortisone, but is more active. Like all hormonal agents, it exhibits anti-inflammatory, antiallergic, antishock, desensitizing and immunosuppressive activity.

Advice. Since “Hydrocortisone” disrupts water-electrolyte metabolism and promotes increased excretion of calcium ions, with long-term use of the drug, a diet with a sufficient amount of protein and sodium restriction is prescribed in parallel.

Mostly patients are satisfied with the results of treatment with Hydrocortisone. Negative reviews are extremely rare. The drug is used externally for a week 2-3 times daily.

If there is no improvement, treatment is stopped and further actions are agreed with the doctor. Prescribed in pediatric practice under medical supervision.

"Lorinden A"

The active composition of the ointment is formed from flumethasone pivalate and salicylic acid. External the use of hormonal ointment allows eliminate signs of allergy (itching, redness, peeling, rash) and inflammation (pain, swelling, swelling).

Salicylic acid improves the conductivity of the hormone flumethasone pivalate and is responsible for inhibiting the growth of connective tissue at the site of inflammation, stopping hypersensitivity reactions and exudative processes.

After the pain disappears, the affected area continues to be treated for another 3-4 days.

Conclusion

Local hormonal drugs should be prescribed only by a specialist after conducting a series of diagnostic studies. The therapeutic effect will depend on how well the local drug and dosage regimen are selected, and at what stage therapy is started.

Patients' opinions on the benefits of corticosteroids in the treatment of joint diseases varied. Some people report that hormone therapy has helped relieve joint pain, restore mobility, improve their quality of life, and improve their ability to work. Another part of patients speaks of a short-term effect or its complete absence.

In 1563, Bartolomeo Eustachius, the personal physician of the Roman Cardinal Della Rovere, who, thanks to his connections, received permission to perform autopsies, first discovered an organ called the adrenal gland (see Figure 1.5.15, view B). It is now well known that the adrenal glands are an important element of the endocrine system and in their “depths” many hormones necessary for human life are produced and are, as it were, medicines within us.

These hormones include corticosteroids (from Latin cortex, bark + steroids), which are produced by the adrenal cortex and contain a common structural element characteristic of steroid compounds. According to the severity and direction of the effect, corticosteroids are divided into glucocorticoids And mineralocorticoids . The main glucocorticoids synthesized in the human body are hydrocortisone And cortisone , and mineralocorticoid – aldosterone . Glucocorticoids have a versatile effect, as they affect most cells of the body, “unlocking” or “locking” certain biochemical processes in our organs. They affect the metabolism of carbohydrates (in particular, they increase the content of glucose in the blood), proteins and fats, have a catabolic (promote the breakdown of proteins) effect, and have anti-inflammatory and immunosuppressive properties. The main function of mineralocorticoids in the body is to participate in water-salt metabolism; they are able to retain sodium ions and water, while accelerating the excretion of potassium. Insufficiency of adrenal function is accompanied by thickening of the blood, decreased blood pressure, gastrointestinal disorders, decreased vitality (asthenia), decreased body temperature due to decreased blood glucose (hypoglycemia), loss of sodium, retention of potassium and nitrogenous substances.

Glucocorticoids also play a large role in the body’s ability to adapt to changing environmental conditions.

Stress! Who doesn't know this word? We owe its appearance to Hans Selye, a Nobel laureate. Even as a student, G. Selye wondered why a variety of pathogenic agents (germs, viruses, allergens, toxins) cause symptoms that are common to many, if not all, diseases. This eminent scientist wrote: “I could not understand why, from the very beginning of medicine, doctors have always tried to concentrate all their efforts on the recognition of individual diseases and on the discovery of specific remedies for them, without paying any attention to the much more obvious “syndrome of malaise” as such.” The scientist found that a foreign factor (stressor) enhances the function of the hypothalamus and the production of corticosteroids. For the first time, G. Selye showed that pathological and adaptation processes are based on the same mechanisms, no matter what factors (stressors) they are caused by. The main targets of stress are the heart, brain and gastrointestinal tract. G. Selye managed to show that stress determines the rate of wear and tear of our body. And the most important protective factors against stress are glucocorticoids and mineralocorticoids.

G. Selye believed that according to the way they respond to stress, people are divided into two groups. The first ones - “racehorses” - feel great in stressful situations; they feel happiness only at a fast, dynamic pace of life. The second - “turtles” - need peace and quiet to be happy, that is, something that would bore people of the first group.

Subsequently, G. Selye established that stress syndrome or general adaptation syndrome can be divided into three stages:

1) “alarm reaction” – mobilization of protective forces;

2) “stability stage” – complete adaptation (adaptation) to the stressor;

3) “exhaustion stage,” which occurs if the stressor is very strong or lasts for a long time.

At that time, the scientist believed that reserves of “adaptive energy,” or the body’s adaptability, are always limited. G. Selye formulated this belief as “wear and tear” (“tear down and throw away”). In the last years of his life, G. Selye set the task of stress management, studying the possibilities of increasing resistance to stressors.

In the 30s of our century, a young doctor, Philip Hench, worked at one of the most famous clinics in the world - Mayo (Rochester, USA). He drew attention to the fact that the condition of patients with rheumatic diseases improves significantly during pregnancy or the occurrence of jaundice. There was an assumption that this relief of the condition was somehow connected with the appearance in the body of patients of certain steroid substances, similar in structure to sex hormones (they are released in increased quantities during pregnancy) or to bile acids (accumulate during jaundice). Only 20 years later this assumption was verified. It was at this time that, independently of each other, the Swiss chemist Tadeusz Reichstein and the American biochemist Edward Kendall isolated corticosteroids from the adrenal cortex. Kendall worked at the same hospital as Hench. In September 1948 they introduced for the first time cortisone patient with rheumatism. The entire hospital held its breath. And a miracle happened. The patient, who had been lying motionless for six years due to severe pain when trying to move, stood up on his own. Thus, in 1948, the era of corticosteroid therapy began, saving millions of lives. In 1950, Kendall, Hench and Reichstein were awarded the Nobel Prize.

Another case demonstrating the strength and depth of the effects of glucocorticoids. A girl suffering from rheumatoid polyarthritis was given adrenocorticotropic hormone from the pituitary gland (we already know that it stimulates the production of glucocorticoids by the adrenal cortex). The girl not only began to recover quickly, but also discovered the ability to play the piano masterfully, although she only learned a little about this in childhood. Now she spent almost every evening at the instrument, and people gathered near the house where she lived to listen to the magnificent performance. However, along with this, excessive mental excitability appeared and intensified, which over time turned into a mental disorder. Treatment had to be stopped. Soon, the newly acquired ability to play the piano also disappeared.

Since then, a large number of synthetic corticosteroids have been created for medical purposes, mimicking the effects of natural hormones and having much higher activity. Along with natural ones, they are used for diagnosis and therapy adrenal dysfunction, but much more often (and in higher doses) at different inflammatory processes And diseases of the immune system. In this case, their anti-inflammatory, anti-allergic, anti-shock, anti-toxic and immunosuppressive properties are used.

The main indications for the use of glucocorticoids are: collagenoses , rheumatism , rheumatoid arthritis , bronchial asthma , acute lymphoblastic and myeloblastic leukemia , Infectious mononucleosis , neurodermatitis , eczema and others skin diseases, various allergic diseases , hemolytic anemia , glomerulonephritis , acute pancreatitis , viral hepatitis, prevention and treatment shock. The ability of glucocorticoids to suppress the immune system (immunosuppressive effect) is used during transplantation ( transplantation) organs and tissues to suppress the rejection reaction, as well as for various autoimmune diseases. Mineralocorticoids are used in the treatment Addison's disease , myasthenia gravis , general muscle weakness , adynamia , hypochloremia and other diseases associated with disturbance of mineral metabolism .

For topical use, special preparations have been created that have less absorption and, therefore, weaker systemic action . Corticosteroids are included in many combination drugs for topical use in the treatment of skin diseases. Such drugs, along with glucocorticoids, contain antifungal and antimicrobial components or substances that promote tissue regeneration.

Corticosteroid drugs have greatly expanded the possibilities of medicine, but at the same time they have brought a lot of troubles. The variety of pharmacological effects of glucocorticoids determines not only their high therapeutic value, but also the possibility of unwanted reactions. However, to avoid serious complications, a clear diagnosis and careful medical supervision are required. The most common side effects of glucocorticoids are: sodium and water retention with the possible appearance of edema, loss of potassium, increased blood pressure, increased blood glucose levels (up to diabetes mellitus - it is called steroid diabetes), increased calcium secretion and osteoporosis, slower tissue regeneration processes , exacerbation of peptic ulcer disease, decreased resistance to infections, increased blood clotting with the risk of thrombosis, the appearance of acne, moon-shaped face, obesity, menstrual irregularities, neurological disorders and others. Remember the girl with rheumatoid arthritis and the acquired ability to play the piano? So, the mental disorder that arose in her forced her to refuse treatment. And such disorders are observed on average in 5% of patients treated with corticosteroids. These drugs cause stomach ulceration, porosity of bone tissue, which leads to fractures, even of the spine; they can also awaken an infection dormant in a person or aggravate the purulent process. This should always be kept in mind when prescribing corticosteroid therapy.

In addition, long-term use (and this is necessary in the treatment of severe chronic illnesses) of corticosteroid drugs suppresses the formation of glucocorticoids in the adrenal cortex. At the same time, the ability to produce one’s own corticosteroids is not restored for several months, and sometimes even for one and a half to two years. Correct dose selection and constant monitoring of the patient, as a rule, can minimize or completely eliminate such adverse reactions.

The main corticosteroid drugs are listed below. More details about them can be found on the website.

[Tradename(composition or characteristics) pharmachologic effect dosage forms firm]

Advantan(methylprednisolone aceponate) cream; ointment; greasy ointment; emuls.external Schering(Germany)

Akriderm SK(betamethasone + salicylic acid) glucocorticoid, antiseptic, keratolytic ointment Akrikhin(Russia)

Aldecin(beclomethasone) aerosol dose Schering-Plough(USA)

Ambien(dexamethasone + lidocaine + phenylbutazone + cyanocobalamin) anti-inflammatory, analgesic, antipyretic, uricosuric solution d/in. ratiopharm(Germany)

Aurobin(lidocaine + panthenol + prednisolone + triclosan) anti-inflammatory, antiallergic, antiexudative, analgesic, regenerating, antiseptic, local anesthetic ointment Gedeon Richter(Hungary)

Afloderm(alclomethasone) antipsoriatic, anti-inflammatory, antiallergic, antipruritic, vasoconstrictor, antiproliferative cream; ointment Belupo(Croatia)

Beclazon(beclomethasone) aerosol.inhalation.dose. (Czech Republic/UK)

Beclazon Easy Breathing(beclomethasone) anti-inflammatory, antiallergic, antiexudative aerosol.inhalation.dose. Galena a.s./Norton Healthcare Ltd.(Czech Republic/UK)

Becloforte(beclomethasone) aerosol.inhalation.dose. GlaxoSmithKline(Great Britain)

Bekodisk(beclomethasone) anti-inflammatory, glucocorticoid por.d/inhal. GlaxoSmithKline(Great Britain)

Bekotide(beclomethasone) anti-inflammatory, glucocorticoid aerosol.inhalation.dose. GlaxoSmithKline(Great Britain)

Belogent(betamethasone + gentamicin) cream; ointment Belupo(Croatia)

Beloderm(betamethasone) anti-inflammatory, antipruritic, antiallergic cream; ointment Belupo(Croatia)

Belosalik(betamethasone + salicylic acid) lotion; ointment Belupo(Croatia)

Benacort(budesonide) anti-inflammatory por.d/inhal.dose. Pulmomed(Russia)

Budenofalk(budesonide) anti-inflammatory caps. Dr. Falk(Germany)

Budesonide(budesonide) anti-inflammatory, antiallergic aerosol dose; aerosol.dose.forte GlaxoSmithKline(Great Britain)

Garazon(betamethasone + gentamicin) anti-inflammatory, antipruritic, antiallergic, antibacterial eye/ear drops Schering-Plough(USA)

Gepatrombin G(heparin + polidocanol + prednisolone) antithrombotic, anti-inflammatory, antipruritic, decongestant, venosclerotic, local anesthetic ointment; Supt.Rect. Hemofarm(Yugoslavia)

Hydrocortisone(hydrocortisone) anti-inflammatory, antiallergic, decongestant, antipruritic eye ointment Jelfa S.A.(Poland)

Hydrocortisone-POS N(hydrocortisone) eye ointment ICN Pharmaceuticals

Dexa-Gentamicin(gentamicin + dexamethasone) glucocorticoid, anti-inflammatory, antiallergic, antibacterial (bactericidal) eye drops; eye ointment ICN Pharmaceuticals(USA), manufactured by: Ursapharm Arzneimittel (Germany)

Dexaven(dexamethasone) anti-allergic, anti-inflammatory, anti-shock solution d/in. Jelfa S.A.(Poland)

Dexamethasone(dexamethasone) anti-inflammatory, antiallergic, antipruritic eye susp. Warszawskie Zaklady Farmaceutyczne Polfa(Poland)

Dexapos(dexamethasone) glucocorticoid, anti-inflammatory, antiallergic eye drops ICN Pharmaceuticals(USA), manufactured by: Ursapharm Arzneimittel (Germany)

Dexon(dexamethasone) anti-inflammatory eye/ear drops; solution d/in.; table Cadila Healthcare(India)

Dermovate(clobetasol) anti-inflammatory cream; ointment GlaxoSmithKline(Great Britain)

Dermozolon(clioquinol + prednisolone) anti-inflammatory, antiallergic, antipruritic, antiseptic, antifungal ointment Gedeon Richter(Hungary)

Diprosalik(betamethasone + salicylic acid) anti-inflammatory, antipruritic, antiallergic, keratolytic, antimicrobial lotion; ointment Schering-Plough(USA)

Diprospan(betamethasone) anti-inflammatory, antiallergic solution d/in. Schering-Plough(USA)

Cortineff(fludrocortisone) mineralocorticoid, glucocorticoid table Pabianickie Zaklady Farmaceutyczne Polfa(Poland)

Cutivate(fluticasone) anti-inflammatory, antiallergic, antipruritic cream; ointment GlaxoSmithKline(Great Britain)

Laticort(hydrocortisone) anti-inflammatory, antiallergic, antiexudative, antipruritic cream; lotion; ointment Jelfa S.A.(Poland)

Lokoid(hydrocortisone 17-butyrate) local anti-inflammatory, decongestant, antipruritic ointment Yamanouchi(Netherlands)

Maxitrol(dexamethasone + neomycin + polymyxin B) local anti-inflammatory, antibacterial eye drops; eye ointment Alcon(Switzerland)

Nasonex(mometasone) anti-inflammatory, antiallergic spray name dosage Schering-Plough(USA)

Nasobek(beclomethasone) anti-inflammatory, glucocorticoid, antiallergic spray name dosage Galena a.s./Norton Healthcare Ltd.(Czech Republic/UK)

Oxycort(hydrocortisone +oxytetracycline) anti-inflammatory, antiallergic, antibacterial aerosol external Tarchominskie Zaklady Farmaceutyczne “Polfa”(Poland)

Oxycort(hydrocortisone +oxytetracycline) anti-inflammatory, antiallergic, antipruritic, antibacterial ointment Jelfa S.A.(Poland)

Drugs based on steroid hormones in the treatment of joint diseases are currently one of the leading groups of drugs in terms of their effective therapeutic properties.

Their use for treatment provides significant benefits for the rheumatological patient, which exceed the strength of any non-steroidal anti-inflammatory drugs (NSAIDs). These include: a rapid onset of action and a strong anti-inflammatory effect on the lesion.

However, corticosteroid drugs have not only a positive side, but also a number of quite serious negative consequences, which, in cases of improper prescription and use, can cause significant harm to the patient’s health.

As a result, there is always an ambiguous position of both the patients themselves and doctors towards this. Some are ready to accept them just to eliminate the pain, while others, on the contrary, firmly refuse treatment, since it can cause harm.

Both judgments are incorrect, since corticosteroids or glucocorticoids are simply irreplaceable in some clinical circumstances with a competent approach to treatment. However, there are a number of situations when it is possible to do without them.

What are corticosteroids and their main effects

Corticosteroids or glucocorticoids is a subclass of steroid hormones that are produced exclusively by the adrenal cortex. Unlike other hormones, they are not produced by the gonads. They tend to have glucocorticoid or mineralocorticoid activity to varying degrees.

When glucocorticoid or mineralocorticoid activity predominates, corticosteroids are divided into glucocorticoids and mineralocorticoids. In our case, the main glucocorticoids produced in the human body are cortisone and hydrocortisone.

Also known as corticosteroids are hydrocortisone derivatives that are of semi-synthetic origin, including the following:

Dexamethasone;
Prednisolone;
Methylprednisolone.

From the effects of corticosteroids on the human body, several can be distinguished and presented in the table:

Type of effect of a corticosteroid on the body	Description
Anti-inflammatory	A certain enzyme is suppressed, and as a result, the synthesis of inflammatory mediators is disrupted.
Immunoregulatory and antiallergic	The production of B-lymphocytes and plasma cells of antibodies slows down, and the production of cytokines and lymphokines decreases. The intensive formation of eosinophils is suppressed, and cells already present in the blood are destroyed, and the production of immunoglobulin E is reduced. There is also an increased histamine binding capacity of the blood and the membranes of mast cells are stabilized, which blocks the release of histamine and other allergy mediators from them. This makes it possible to reduce the manifestations of allergic reactions.
Water-electrolyte metabolism	The reverse process of absorption of sodium and water from the lumen of the renal canals into the blood is accelerated.
	The processes of absorption of this element in the intestine slow down, and its release from the bones accelerates.
Carbohydrate metabolism	The production of glucose from non-carbohydrate products in the liver is stimulated (gluconeogenesis). There is a decrease in the permeability of cell membranes to glucose. This causes an increase in glucose levels in the urine and blood - glucosuria and hyperglycemia, up to the onset of steroid diabetes.
Protein metabolism	The processes of protein synthesis slow down and the processes of its breakdown in tissues accelerate. The patient loses weight, muscles and skin atrophy, stretch marks and hemorrhages occur. Slow healing of wounds occurs
Fat metabolism	Fat breakdown occurs mainly in the upper and lower extremities, and they are synthesized in the area of the face, neck, and torso.
The cardiovascular system	The effect occurs by increasing blood pressure, increasing the sensitivity of the walls of the arteries and heart muscle to adrenaline and norepinephrine.
Blood system	The formation of platelets and red blood cells is stimulated, the production of lymphocytes, eosinophils, and monocytes is suppressed.
Effect on other hormones	The production of sex hormones, as well as luteinizing hormone of the pituitary gland, is suppressed. The susceptibility of tissues to thyroid hormones and somatomedin, somatotropin, decreases.

Main indications for the use of corticosteroids

Corticosteroids can be used in the following ways:

Systemic – use is prescribed orally, intravenously, intramuscularly;
Local – the most common method is intra-articular injections.

Speaking about the use of systemic corticosteroids in the field of rheumatology, the following diseases are direct indications for them:

Acute rheumatic fever.
Systemic scleroderma.
Systemic lupus erythematosus.
Systemic vasculitis.

The most common use of glucocorticoids is in the form of intra-articular injections for the following diseases of the musculoskeletal system:

From the list of diseases listed above, the use of corticosteroids is not always indicated. Their prescription is advisable when treatment with NSAIDs for two weeks has not shown positive results. Also, their use occurs in the development of synovitis (inflammation of the synovial membrane of the joint with the formation of effusion in it). This condition in clinical manifestations is expressed by swelling of the joint, limited passive and active movements in the joint.

Contraindications to the use of corticosteroids

As a rule, there are no absolute contraindications to the use of systemic drugs of this type. There are relative restrictions on use, which are:

Diabetes.
Ulcerative formations in the stomach and duodenum.
Heart failure.
Epilepsy.
Arterial type hypertension.
Mental disorders.

The use of corticosteroids by injection into the joint is contraindicated in the following cases of diseases and disorders:

Local or systemic infectious process;
Transarticular fracture;
Severe periarticular osteoporosis;
Diseases of the blood coagulation system;
or bone destruction that cannot be corrected.

Side effects of corticosteroids

With systemic use of corticosteroids for a long time, there is a possibility of a large number of unpleasant reactions. Their development must be anticipated before prophylaxis with appropriate drugs is carried out.

The list of adverse reactions from corticosteroids is quite large, among which the main ones are the following:

Increased body weight;
Atrophy and
Stretch marks, hemorrhage and thinning of the skin, acne;
Osteoporosis and vertebral compression fractures and other pathological fractures manifested against the background of this disease;
Increased blood pressure;
Steroid ulcers in the digestive organs;
Nausea, vomiting, pain in the stomach and esophagus;
Sleep disorders and psychoses, sudden mood changes;
Glaucoma, cataract;
linear growth in children, as well as delayed puberty;
Increased glucose levels and lipids in the blood.

The manifestation of certain negative consequences (sleep disturbance, emotional instability, etc.) appears immediately after the start of therapy and it is not possible to avoid them. The development of others has a later manifestation and their onset may be limited by using small doses of the hormone, as well as by prescribing medications to prevent the complications caused.

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The adrenal cortex performs a secreting function, producing corticosteroids. These are biologically active hormones, including mineral (aldosterone) and glucocorticoids (cortisone).

Natural corticosteroids control the following processes in the body:

metabolism of minerals (retain sodium ions and remove potassium);
the process of puberty;
metabolism of lipids, proteins and carbohydrates;
stress reactions;
the course of pregnancy;
block the production of inflammatory mediators.

Synthetic corticosteroids have properties similar to natural hormones.

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Irina Martynova. Graduated from Voronezh State Medical University named after. N.N. Burdenko. Clinical resident and neurologist of the BUZ VO \"Moscow Polyclinic\".

They can eliminate symptoms of the inflammatory process(pain relief, swelling and redness relief, local temperature reduction). Synthetic molecules of corticosteroids are integrated into the cycle of metabolic reactions natural to the body, removing natural hormones from them, which disrupts the functioning of the adrenal cortex and hormonal balance in general. In this regard, drugs based on synthetic corticosteroids are prescribed by a doctor when non-hormonal medications are not effective.

Release forms of synthetic corticosteroids

Synthetic corticosteroids have the following release forms:

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

Let us dwell in detail on the most popular and prescribed drugs.

Prednisolone tablets

They have a powerful anti-allergic and anti-inflammatory effect. The medication is contraindicated for peptic ulcers of the stomach and intestines, during the vaccination period, for hypertension and a tendency to form blood clots in blood vessels.

The price for a package of 100 pieces is about 120 rubles. Prednisolone may come in a liquid corticosteroid injection form.

Celeston

It has betamethasone as an active ingredient. Tablets are not prescribed for the following pathologies: after myocardial infarction, hypertension, endocrine disorders, glaucoma, severe infections (syphilis, tuberculosis), osteoporosis, poliomyelitis. Inhibits natural immune responses.

The anti-inflammatory effect is 30 times more effective compared to hydrocortisone.

Kenacort tablets

The drug has a stabilizing effect on cell membranes, eliminates symptoms of inflammation and allergies. Do not use for psychosis, chronic nephritis, complex infections and fungal infections.

50 tablets of 10 mg each cost about 200 rubles.

Betamethasone dipropionate is present as an active component. Injections with the drug are effective for the following pathologies: shock of various natures, cerebral edema, acute adrenal insufficiency. "Diprosan" is contraindicated in case of hypersensitivity to the components of the composition, with infectious lesions, with diseases of the digestive organs, hypothyroidism, hypertension, with complex pathology of the kidneys and liver.

1 ampoule of the medicine costs about 200 rubles.

Kenalog

The active component of the drug is . The medicine is distinguished by its gentle effect on the body, the absence of influence on the functioning of the pituitary gland and mineral metabolism in the body.

A box with 5 ampoules of the drug costs about 400 rubles.

The active component of the product is methylprednisolone. Contraindicated for fungal infections and individual intolerance.

Topical corticosteroids for external use

Topical corticosteroids are classified as follows:

weak activity (“ ”, “Lokoid”, “Cortade”);
moderately active (Afloderm, Esperson, Laticort);
highly active (“Kuterid”, “Cutivate”, “Elokom”);
very highly active (Dermovate, Clobetasol).

The most used corticosteroid ointments

Lokoid

The active component hydrocortisone has an antipruritic, anti-inflammatory effect, eliminates swelling.

30 grams of the drug cost about 300 rubles.

Lorinden S

The composition has an antimycotic effect. It is used for allergic and inflammatory processes complicated by a fungal component.

The price per tube starts at 330 rubles.

Fluorocort – triamcinolone-based ointment

It perfectly relieves itching, swelling and redness.

The cost of a tube is about 250 rubles.

Fucidin G

In addition to hydrocortisone, the product contains fusidic acid, which has an antibiotic effect. Compound Suitable for children over 2 years of age.

The cream will cost 450 rubles, the ointment – 400.

The nuances of using topical agents

The choice of remedy depends on the severity, localization and depth of the process. It must be carried out by a doctor;
depending on the dynamics of the process on the skin, a correction is carried out with a change in the drug of choice;
After symptoms are relieved, switch to a hormone-free product.

Inhaled forms of corticosteroids

Corticosteroids in the form of inhalation solutions are effective reduce membrane permeability, limit the release of proteolytic enzymes beyond the lysosomes. High concentrations of the substance are created locally in the walls of the bronchial action, which minimizes the systemic effect.

Nasal corticosteroids effectively eliminate inflammatory and allergic manifestations and are used in the form of inhalations through the nose.

Beclamitozone (Aldecim, Becotide, Beklokort)

The active substance reduces the secretion of prostaglandins and the production of pathological exudate. Contraindications include children under 6 years of age and individual intolerance.

A bottle of 200 mcg of Beclamizone costs 300–400 rubles.

Beclamizon-nasal, Beconase

They are used as nasal corticosteroids, eliminating swelling and hyperemia in the nasal mucosa.

A bottle of Beconase costs about 300 rubles.

Flunisalide (Ingacort)

Effective for bronchial asthma, obstructive bronchitis and chronic rhinitis.

Contraindicated in the 1st trimester of pregnancy, for children under 5 years of age, with fungal infections, active form of tuberculosis.

Major side effects of corticosteroids

If you use corticosteroids for a long time, side effects develop In most cases.

Preparations:

disrupt the ionic composition of biological fluids of the body, promoting alkalization of the blood;
provoke the development of steroid diabetes mellitus;
retain fluid, disrupting the functioning of the heart muscle;
loss of potassium ions leads to muscle weakness, and calcium – to osteoporosis, susceptibility to fractures;
reduce immune responses, increasing susceptibility to infections;
provoke adrenal insufficiency;
increase the risk of developing ulcerative lesions of the stomach and intestines.

Special cases of the use of corticosteroids

Childhood

Topical corticosteroids prescribed to children with caution. The smaller the child, the greater the ratio of surface area to body weight and the risk of developing systemic pathologies (developmental delay, hormonal imbalance, adrenal suppression). Children under one year of age are prescribed ointments that contain no more than 1% active hydrocortisone; Dermatol can be used.

After 2 years, Mometasone is allowed.

During pregnancy

During pregnancy, corticosteroids are prescribed in exceptional cases when the result of use outweighs the possible risks to the fetus.

These are the following situations:

threat of premature birth of a baby;
active form of rheumatism;
intrauterine hyperplasia of the adrenal cortex in the fetus.

Corticosteroids, when used locally for short periods of time, practically do not pass into breast milk.

If the doses of drugs are high, this can cause disruption of the child’s development and suppression of the hormonal system.

For bronchial asthma

Corticosteroids are effective for bronchial asthma. They relieve the symptoms of inflammation, but do not dilate the bronchi. These medications are used during attacks when other means are not effective. After the attack has stopped, the dose of the active component is reduced gradually (by 2 times every 4 days). For bronchial asthma, corticosteroids in inhaled form are indicated. These are: “Beklozon Eco”, “Budesonide Forte”, “Pulmicort”, “Pulmicort Turvuhaler”, “Fluticonazole Propionate”.

For allergies

For complex forms of allergies, corticosteroids are effective; they are prescribed systemically and locally. List of drugs: “Betamethasone”, “Prednisolone”, “”, as well as their analogues.

Intranasal aerosols (Flucatisone, Beconase, Propionate) help with hay fever and allergic rhinitis.

For psoriasis

Corticosteroid drugs

The adrenal cortex produces corticosteroid hormones, which are naturally occurring substances in the body. They participate in most biochemical processes and regulate the basic mechanisms of life, control the immune system, blood glucose levels, as well as carbohydrate, protein, and water-salt metabolism.

What drugs are classified as corticosteroids?

There are two types of substances in question - glucocorticoids and mineralocorticoids. Medicines that contain one type of hormone are corticosteroids. They allow you to achieve effective relief of any inflammatory processes, eliminate pathological swelling, and are effective against allergic reactions.

Synthetic drugs containing corticosteroids are available in the form of capsules, tablets, solutions for intravenous administration, powders, ointments, gels, sprays, drops.

Corticosteroid drugs - list of tablets

List of tablets and capsules with hormones:

The above remedies are effective in the treatment of most infectious and fungal diseases, disorders of the gastrointestinal tract, circulatory pathologies, including cerebral circulation, autoimmune diseases, and neuritis.

Treatment of dermatological ailments necessarily requires the application of external medications in combination with a systemic regimen.

Corticosteroid drugs – ointments, creams, gels:

These medications, in addition to corticosteroid hormones, may contain antiseptic components, anti-inflammatory substances and antibiotics.

For the most part, such medications are used to treat allergic rhinitis and chronic purulent processes in the maxillary sinuses. They allow you to quickly achieve relief in nasal breathing and stop the proliferation of pathogenic microorganisms on the mucous membranes.

Corticosteroid preparations for nasal use:

It should be noted that in this form of release, corticosteroid hormones have fewer side effects and negative effects on the body than in the form of tablets or injections.

During the treatment of bronchial asthma and long-term spastic conditions of the bronchi, the described group of drugs is indispensable. Their use in the form of inhalations is considered the most convenient.

Medicines from this list can be in the form of a ready-made solution, emulsion or powder for dilution and preparation of inhalation filler.

Like nasal corticosteroids, these drugs are almost not absorbed into the blood and mucous membranes, which avoids resistance to the active substance and serious consequences of drug use.

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Medicines to relieve dangerous symptoms and suppress allergic inflammation - corticosteroids: list of drugs and their use for allergies

In severe forms of allergic diseases, non-hormonal ointments and wound healing agents, eye and nasal drops without potent components do not always help. Low effectiveness of therapy leads to increased negative symptoms, deterioration of the patient's condition, intense skin reactions, and the development of bronchospasm.

To relieve dangerous symptoms and suppress allergic inflammation, doctors recommend corticosteroids. The list of drugs for allergies, characteristics of hormonal drugs, features of the effect on the body, rules of use, possible side effects are described in the article.

What are corticosteroids

Potent drugs are produced on the basis of synthetic components that resemble adrenal hormones in composition and action.

Synthetic CS exhibit the same properties as natural hormones:

suppress allergic inflammation;
reduce the volume and area of rashes;
reduce the manifestations of allergies due to rhinitis, conjunctivitis, dermatitis, bronchial asthma, itchy dermatoses, eczema;
stop the effect of drug components to which the patient has an acute immune response.

Types of medications

The list of corticosteroids includes dozens of items. Each potent drug belongs to a specific group and has its own strength of activity and degree of toxicity to the body. Pharmacists offer medications to suppress allergic inflammation and have a complex effect on the body. Many compounds are prohibited for use in children.

Only an experienced doctor selects the appropriate type of CS: the use of drugs on the initiative of the patient often results in severe skin lesions, including atrophy, intoxication, metabolic and hormonal disorders.

Combination drugs:

COP + antiseptics. Lorinden S, Sinalar K, Dermozolon, Flucort C.
CS + antifungal + antimicrobial components. Pimafukort, Akriderm GK, Triderm.
CS + antifungal agents. Candide B, Travocort, Lotriderm, Mycozolon.
CS + antibiotics. Fucicort, Flucinar N, Oxycort, Fucidin G, Sinalar N.

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Classification by fluorine content:

non-fluorinated. Less likely to cause side effects, less toxic. This category of drugs is allowed to be used for up to two weeks on skin folds and the face, on other parts of the body (according to indications) - up to three weeks. Methylprednisolone aceponate, mometasone fluorate;
fluorinated. The drugs contain fluorine, exhibit high anti-inflammatory activity, and side effects are more likely to develop when taken. The duration of therapy is 7 days, no more. Flumethasone, Dexamethasone, Fluocinolone, Betamethasone.

Classification of topical corticosteroids according to the strength of their effect on the body:

weak. Prednisolone, Hydrocortisone;
moderate. Lokoid, Fluorocort, Lorinden, Afloderm,
high. Advantan, Cutivate, Elokom, Celestoderm, Flucinar, Sinaflan, Beloderm;
very high. Dermovate.

The pharmaceutical industry produces two types of corticosteroids that exhibit a prolonged effect: mometasone fluorate and methylprednisolone aceponate. For an active anti-inflammatory effect, it is enough to apply the drug once a day. With other types of CS, the affected surface is treated two to three times a day.

Dosage form

Pharmaceutical companies produce hormonal formulations to relieve severe allergic reactions in the form of:

tablets;
ointments and creams for treating the epidermis;
ready solution for injection and inhalation;
nasal drops and sprays;
suspensions;
powders or suspensions for the preparation of inhalation solution;
eye drops and ointments (used less frequently).

Indications for use

Hormonal drugs are prescribed when non-hormonal compounds are ineffective and in severe cases of acute and chronic allergic diseases. Self-medication with the use of CS is prohibited: Potent drugs often cause adverse reactions; use without taking into account contraindications provokes malfunctions of organs and systems.

Steroid drugs are effective in treating the following diseases:

Contraindications

Most hormonal drugs are prohibited for use in the following cases:

pregnancy;
childhood;
lactation period;
high blood pressure;
severe pathologies of the liver and kidneys;
peptic ulcer.

Possible side effects

Even with strict adherence to the instructions, taking into account age and contraindications, negative reactions of a local and systemic nature are possible:

acne, acne-like rash;
atrophy of sensitive areas of the epidermis (face, fold area);
weaker pigmentation of the affected areas;
menstrual irregularities;
erythema;
striae;
weight gain;
tendency to thrombosis;
excessive sweating;
headache;
neurological disorders;
stomach and intestinal bleeding;
osteoporosis;
hypertrichosis;
suppression of adrenal function, cataracts, glaucoma;
depressive states, frequent mood swings;
steroid diabetes mellitus;
bone necrosis (non-infectious form);
secondary immunodeficiency, development of fungal and bacterial infections;
slow healing of ulcers and wounds.

Rules for the use of topical corticosteroids

Doctors have developed several types of treatment using CS to reduce the negative effects on the body:

Line drawing method.
Tandem therapy.
Step therapy for different areas of the body.
Descending therapy method.

Hormonal drugs for allergic diseases

Before prescribing systemic and local corticosteroids, the doctor studies the clinical picture of the disease and clarifies what medications the patient has taken previously. Age is important (many CS are prohibited for use by children and the elderly).

When treating severe and advanced types of allergic diseases, systemic drugs are prescribed in the form of tablets:

tablets are prescribed to relieve the inflammatory process when a secondary infection is detected against the background of a severe skin reaction - penetration into wounds, ulcers of a bacterial or fungal infection;
Many doctors recommend replacing the tablet form of corticosteroids with local remedies: ointments, creams. When applied to problem areas of the body, hormones penetrate directly into the affected area, but are less absorbed into the blood and gastrointestinal tract, reducing the risk of side effects;
Oral administration of CS is more often recommended for other types of diseases: damage to the gastrointestinal tract, autoimmune pathologies, circulatory disorders.

Corticosteroids for inhalation - list:

Hormonal ointments and creams - list:

Corticosteroids for injection:

Hormone-based nasal products:

Hormonal drops and ointments for allergic conjunctivitis:

Oftan Dexamethasone.
Desonide.
Hydrocortisone ointment or suspension 0.5%.
Maxidex.
Prenatsid.

Local medications for children

Young patients with severe skin reactions are prescribed local remedies:

Advantan. The drug based on methylprednisolone has a fairly “gentle” effect on the child’s body, fights contact dermatitis, copes with itching, rashes, swelling, inflammation, burning in eczema, atopic dermatitis, and allergic dermatoses. With prolonged use, tissue necrosis in the treated areas is possible.
Elokom. The drug is approved for the treatment of children from 6 months, copes well with allergic itching and signs of allergic dermatoses. The local product can be applied to the skin for no more than a week; before discontinuation, be sure to gradually reduce the concentration of the product (mix with baby cream). Hormonal ointment should not be used to treat an area exceeding 1/8 of the body surface.

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use of non-fluorinated types of CS;
it is prohibited to treat more than 1/5 of the body with hormonal ointments;
to reduce the risk of side effects, alternate between non-hormonal drugs and corticosteroids;
prevention of allergic diseases using CS is prohibited: Potent drugs are suitable only for short-term use in the treatment of exacerbations.

Video - expert advice on the specifics of using corticosteroids for the treatment of atopic dermatitis:

She suffered from allergic contact dermatitis. It appeared in response to aggressive detergents, especially dishwashing detergents. It manifested itself in redness, itching, and keratinization of the skin. I tried many corticosteroid creams, but Akriderm SK turned out to be the best for me. I am now in remission. I use only pharmacy moisturizing creams.

Steroid hormones or corticosteroids: list of drugs and rules of use for diseases of the joints and spine

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

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

general characteristics

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

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

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

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

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

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Indications for use

Corticosteroids are “first aid” for sore joints and a weakened spine. Corticosteroids are recommended for patients with poor sensitivity to the effects of nonsteroidal anti-inflammatory drugs (NSAIDs).

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

Steroid hormones are effective in treating the following diseases:

Contraindications

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

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

Potent formulations are contraindicated for the following diseases:

problems with blood clotting;
infectious problems in joints or other parts of the body;
destructive processes in the bones, incurable deformation of the joints;
transarticular fracture;
severe osteoporosis.

Benefits and harms

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

act quickly;
exhibit a powerful anti-inflammatory effect;
reduce pain in the affected joint or spine.

acne, thinning of the epidermis;
damage to muscle tissue;
discomfort in the stomach and intestines;
sudden changes in mood, irritability;
sleep problems;
headache;
increased levels of lipids and glucose in the blood;
growth retardation in childhood, problems with puberty;
osteoporosis, compression fractures of the spine due to calcium leaching;
cataract, glaucoma;
ulcerative lesions in the intestines and stomach;
increase in body weight.

General rules of use

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

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

short course of treatment. The task of corticosteroids is to break the chain of the inflammatory process. The optimal period of use is from one to five days, the maximum period is 3 months. With a longer course duration, irreversible changes often develop in various body systems;
strict adherence to the doctor’s recommendations, a ban on additional injections, and taking pills at the patient’s initiative. Exceeding the dosage and frequency of use of potent hormonal agents negatively affects various parts of the body;
taking into account contraindications. The introduction of hormonal compounds with absolute and relative restrictions provokes problems with weakened organs and systems and increases the risk of side effects;
selection of corticosteroids- the task of an experienced doctor. You cannot give injections, apply ointments or take tablets that have shown high effectiveness in treating diseases of the spine and joint pathologies in relatives (neighbors, colleagues, friends). Potent remedies are selected only individually: unprofessionalism is costly for health.

Review of effective drugs

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

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a highly effective hormonal agent with active anti-inflammatory, antirheumatic, analgesic effects;
active ingredient – betamethasone;
noticeable glucocorticosteroid activity, elimination of negative symptoms in various forms of diseases of the musculoskeletal system;
release form: solution and suspension for injection, tablets;
injections of the drug Celeston are given into muscles, soft tissues, into the joint cavity, intravenously;
for systemic osteoporosis, ankylosis, “dry joint”, polio, acute viral and bacterial infections, the doctor will select another type of anti-inflammatory drug;
Against the background of active action, side effects appear in various organs and systems. A short course duration and adherence to dosage help reduce the risk of negative manifestations;
for acute pain, it is allowed to mix Celeston with local analgesics;
It is not always possible to find the drug Celeston in the pharmacy. If not available, analogues are recommended: Diprospan, Beloderm, Akriderm.

Hydrocortisone

drug for injection with active antiallergic and anti-inflammatory effects. The drug also produces an antishock, immunosuppressive, antipruritic, antiexudative effect;
active ingredient – hydrocortisone acetate (1 ml of product contains 0.025 g of active ingredient);
release form - suspension for injection, color - white with a yellowish tint or white;
hydrocortisone acetate – a group of glucocorticosteroids of natural origin;
the drug is recommended for synovitis, non-infectious arthritis, rheumatic osteoarthritis, osteoarthritis, and other pathologies of non-infectious etiology;
the medicine is injected into the gluteal muscle or intra-articular cavity;
Hydrocortisone suspension has side effects: before starting the course, it is important to take into account contraindications. In particular, hormonal injections are prohibited during pregnancy, breastfeeding, and diabetes;
in case of overdose, gastric bleeding, disruption of the synthesis of own hormones, and the development of Itsenko-Cushing syndrome are possible;
the average price is 150 rubles.

a group of broad-spectrum hormonal steroid drugs;
the composition is effective in the treatment of inflammatory and degenerative-dystrophic processes in parts of the musculoskeletal system;
suspension for injection. Active ingredients: betamethasone dipropionate and betamethasone sodium phosphate;
the combination of active ingredients enhances the therapeutic effect of the drug and provides a prolonged effect;
the drug Diprospan is recommended for use in joint pathologies, diseases of the spine: lumbodynia, sciatica, osteochondrosis, rheumatoid arthritis, radiculitis, gouty arthrosis, and other ailments;
the drug is used once or a short course of treatment is carried out;
Subcutaneous and intravenous administration is prohibited: injections are carried out only into the joint cavity or muscle tissue;
high efficiency, suppression of the inflammatory process. A potent drug has side effects;
the average price for 1 ampoule (drug volume 1 ml, active ingredients 2 + 5 mg/ml) is 208 rubles, for 5 ampoules – 880 rubles.

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

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