Mechanism of action
Corticosteroid (short acting).
Binds to intracellular glucocorticoid receptor and changes gene expression which leads to decrease of leukocyte migration, suppression of inflammatory mediators and inhibition of macrophages and antigen presenting cells (APCs).
Indications and dose
Pharmacokinetics
Onset of action: 2–4 hours
Duration of action: 8 hours
Half-life of elimination: 2 hours
Metabolism: Hepatic, tissues
Elimination: Kidneys
Relative potency
Hydrocortisone 1x
Predniso(lo)ne 4x
Methylprednisolone 4-5x
Dexamethasone 30x
Medicinal forms
Tablets – 10 mg, 20 mg
Oral solution – 10 mg/5 ml
Solution for injection/infusion (100 mg/ml), 1 vial = 100mg in 1ml
Powder for solution for injection/infusion (100 mg)
Side-effects
Endocrine:
- cushingoid faces, hirsutism, weight gain, menstrual irregularity
Immunosuppressive:
- increased susceptibility to infections
- suppression of clinical symptoms and signs
Musculoskeletal:
- osteoporosis
- tendon rupture
- myopathy
Fluid and electrolyte disturbance:
- sodium and water retention
- hypokalaemic alkalosis
- hypertension
Neuropsychiatric:
- wide range of psychiatric reactions
Opthalmic:
- increased intra-ocular pressure
Gastrointestinal:
- dyspepsia
- peptic ulceration, haemorrhage
- acute pancreatitis
Dermatological
- impaired healing, skin atrophy, bruising, acne, striae
General:
- leucocytosis
- thromboembolism
- hypersensitivity (anaphylaxis, angioedema)
Withdrawal:
- acute adrenal insufficiency, hypotension, death
- fever, myalgia, arthralgia, loss of weight
References
