Corticosteroids

Question 1

Corticosteroids: prescribed for

Answer 1

Asthma, eczema, IBD, hypersensitivity reactions, autoimmune conditions

Question 2

Corticosteroids: Examples

Answer 2

Prednisolone, hydrocortisone

Question 3

Corticosteroids: Mode of action

Answer 3

Modulates protein synthesis by binding to DNA. It stimulates the production of a glycoprotein called lipocortin, which inhibits the activity of phospholipase A2 and hence inflammatory mediators

Question 4

Corticosteroids: Contraindications

Answer 4

Active infection, live virus vaccination.

Question 5

Corticosteroids: Side effects

Answer 5

Long-term systemic use increases risk of Cushing’s syndrome, diabetes mellitus, osteoporosis and infections

Question 6

Corticosteroids: Delivery

Answer 6

Available as inhalers, enemas, topical creams, tablets

Question 7

Corticosteroids: withdrawal

Answer 7

Abrupt withdrawal after a prolonged period can lead to acute adrenal insufficiency, hypotension or death

Question 8

Corticosteroids: Alternatives

Answer 8

Anti-inflammatory diet; nutrients and herbs that inhibit inflammatory mediators e.g., EFAs, quercetin, turmeric, ginger.

• Liquorice root has been shown to modify or even increase the body’s levels of cortisol. Liquorice, if given in large quantities with corticosteroids, may cause additive hypokalaemia. Pharmacodynamic interactions are possible with liquorice and fludrocortisone due to mineralocorticoid effects, and with liquorice and medicines that deplete potassium levels such as diuretics