Corticosteroid creams and ointments. Corticosteroid ointments - what is it, names and prices. Preparations for external and intraarticular use

Corticosteroids are hormones produced in the adrenal cortex. According to the chemical structure, they are steroids. Their synthetic analogues are prescribed for the treatment of a large number of diseases.

Preparations of this group are used in endocrinology, ophthalmology, dermatology, pulmonology, rheumatology and other fields of medicine. They are also used to treat acute, life-threatening conditions. Medicines are available in various forms, which can have both local and systemic effects.

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  Group characteristic

  Corticosteroid hormones are produced in the adrenal cortex from cholesterol. They have an intracellular type of action. After binding to a specific receptor, steroids penetrate into the cell, where they realize their effects at the nuclear level, changing the synthesis of RNA and protein. The adrenal hormones include the following groups:

  • Glucocorticoids, the main of which is cortisol.
  • Mineralocorticoids, the main representative is aldosterone.

  Cortisol has anti-inflammatory and anti-stress effects, increases blood glucose levels, has a catabolic effect on muscles, promotes the breakdown of adipose and bone tissue. Its effect on water-salt metabolism is the retention of sodium and water - a mineralocorticoid effect. Aldosterone maintains normal concentrations of potassium, sodium and a certain amount of extracellular fluid in the human body. Its main target organs are the kidneys. The hormone enhances the excretion of potassium, hydrogen in the urine.

  Synthetic corticosteroids are used for medical purposes. Glucocorticoid preparations are available in the form of ointments, creams, drops, tablets, suspensions, aerosols, powders and injection solutions. They have the following effects:

  • anti-inflammatory;
  • antishock;
  • antiallergic;
  • immunosuppressive;
  • glucocorticoid.

  Mineralocorticoid agents are used for violations of water-salt metabolism:

  • adrenal insufficiency;
  • myasthenia gravis;
  • adynamia;
  • hypotension.

  Hydrocortisone - dosage forms and instructions for use

  Local funds

  Local forms of glucocorticoids are used in dermatology, proctology, ophthalmology, rheumatology, and for the treatment of ENT diseases. The drugs are not absorbed into the blood, and therefore have practically no side effects. They are prescribed in pure form or as part of combined preparations.

  The following forms apply:

  • eye, ear and nasal drops;
  • nasal sprays;
  • creams, ointments, emulsions;
  • rectal suppositories and capsules;
  • suspensions, solutions.

  

  Preparations for external and intraarticular use

  Skin ointments and creams containing hormones are called topical glucocorticosteroids. As a rule, they are easily tolerated and do not cause side effects. Itching, burning and redness in the application area are extremely rare.

  Indications for the use of topical agents:

  • atopic dermatitis in adults and children older than 4 months;
  • various types of eczema - true, children's, microbial, professional, dyshidrotic;
  • simple contact dermatitis;
  • allergic and seborrheic dermatitis;
  • neurodermatitis;
  • psoriasis;
  • hemorrhoids and anal itching.

  List of topical glucocorticoids:

  Combined funds:

  There are also funds for intra-articular, peri-articular administration or applications using phonophoresis for osteochondrosis, inflammatory joint diseases - rheumatic and psoriatic arthritis, osteoarthritis, ankylosing spondylitis. These include suspensions of betamethasone (Betaspan, Diprospan), hydrocortisone, dexamethasone (Dexasone, Dexamed), methylprednisolone (Depo-Medrol), triamcinolone (Triamcinolone, Kenalog).

  

  Glucocorticoids in ophthalmology and ENT practice

  For the treatment of eye diseases and pathologies of the ENT organs, drugs are used in the form of drops and ointments. The indications for their appointment are:

  • allergic conjunctivitis;
  • keratitis;
  • iritis, iridocyclitis;
  • scleritis;
  • blepharitis;
  • uveitis of various origins;
  • optic neuritis;
  • sympathetic ophthalmopathy;
  • inflammation after surgery and eye injuries;
  • allergic rhinitis;
  • sinusitis;
  • nasal polyp;
  • nasopharyngitis, pharyngitis;
  • allergic otitis.

  List of drugs:

  Name	Compound	Release form
  Hydrocortisone	Hydrocortisone	Eye drops
  Dexamethasone, Oftan Dexamethasone	Dexamethasone	Eye drops
  Maxidex		Eye drops, eye ointment
  Ozurdex		Intravitreal Implant
  Dexon		Eye/ear drops
  Nasonex, Dezrinit, Nozefrin	Mometasone	Nasal spray
  Nasobek, Beklonase	beclomethasone
  Tafen nasal	Budesonide
  Tobrason, Tobradex	Dexamethasone, tobramycin	Eye drops
  Polydex		Ear drops
  Polydex with phenylephrine	Dexamethasone, neomycin, polymyxin B, phenylephrine	Nasal spray
  Maxitrol	Dexamethasone, neomycin, polymyxin B	Eye drops
  Sofradex	Dexamethasone, Gramicidin C, Framycetin	Eye/ear drops
  Dex-Gentamicin	Dexamethasone, gentamicin	Eye ointment
  Combined-Duo	Dexamethasone, ciprofloxacin	Eye/ear drops
  Allergoferon	Betamethasone, interferon 2b	Drops eye/nasal

  Inhalants

  For the treatment of bronchial asthma and chronic obstructive pulmonary disease, local inhaled glucocorticoids are used. They are issued in the form:

  1. 1. Aerosols.
  2. 2. Powders.
  3. 3. Suspensions.

  To receive funds, special inhalers, nebulizers are used. Medicines practically do not enter the bloodstream and do not cause systemic effects. The development of undesirable reactions is possible with accidental ingestion of the active substance.

  

  Nebulizer for inhalation with glucocorticoid preparations

  The drugs in this group are described in the table:

  Systemic corticosteroids

  Systemic drugs are available in the form of tablets for oral administration, lyophilisates and solutions for parenteral administration - intramuscular and intravenous injections. The difference between medicinal substances lies in the severity of glucocorticoid and mineralocorticoid effects and their duration.

  Dexamethasone has the strongest anti-inflammatory effect. It also suppresses the function of the pituitary gland to a greater extent. Insignificant mineralocorticoid activity is inherent in all means, except for dexamethasone. Aldosterone is hundreds of times superior to other corticosteroids in this parameter, but it has practically no glucocorticoid effect.

  Classification of corticosteroids by duration of action:

  Indications for the use of drugs:

  • shock caused by various causes (post-traumatic, burn, anaphylactic, cardiogenic shock, and others);
  • cerebral edema;
  • lung diseases - bronchial asthma, sarcoidosis, acute alveolitis, aspiration pneumonia;
  • systemic connective tissue diseases - dermatomyositis, periarteritis nodosa, scleroderma, systemic lupus erythematosus, rheumatoid arthritis and others;
  • multiple sclerosis;
  • acute rheumatic heart disease, rheumatic fever;
  • subacute thyroiditis, endocrine ophthalmopathy, thyrotoxic crisis;
  • adrenal insufficiency;
  • inflammatory joint pathology - rheumatoid, gouty and psoriatic arthritis, ankylosing spondylitis, osteoarthritis;
  • allergic conditions - urticaria, angioedema, allergic rhinitis, reactions to drugs and food;
  • skin diseases - toxicoderma, psoriasis, dermatitis, pemphigus, eczema;
  • inflammatory and allergic eye diseases;
  • acute glomerulonephritis;
  • hepatic coma;
  • violation of hematopoiesis - anemia, thrombocytopenia, lymphocytic leukemia, lymphoma, leukemia;
  • pathology of the digestive system - hepatitis, ulcerative colitis, Crohn's disease.

  Due to the fact that corticosteroids affect all types of metabolism, long-term use of high doses of systemic glucocorticoids can cause undesirable effects. The most common ones are:

  • increased glucose, diabetes mellitus;
  • osteoporosis;
  • edema and arterial hypertension;
  • decreased immunity;
  • exacerbation of gastric ulcer;
  • increased risk of thrombosis;
  • violation of the menstrual cycle;
  • hypercortisolism;
  • neurological disorders.

  List of tablet and parenteral forms of preparations:

  Active substance	Tablet form	parenteral form
  Hydrocortisone	Cortef 5, 10 and 20 mg	Solu-Cortef 100 mg IV/IM
  		Sopolcort N 100 mg/2 ml intravenously/intramuscularly
  		Hydrocortisone 25 mg/1 ml intramuscularly/intraarticularly
  Cortisone	Cortisone 25 mg	Missing
  Prednisolone	Prednisolone 5 mg	Prednisolone (Prednisol, Medopred) 30 mg / ml intravenously / intramuscularly
  		Salt-decortin 25, 50, 250 mg intravenously
  Methylprednisolone	Metipred 4 mg	Metipred 250 mg intravenously / intramuscularly
  		Lemod 125 mg IV/IM
  	Lemod 4 mg	Urbazone 250 mg/5 ml; 1000 mg/10 ml IV
  	Medrol 4, 16, 32 mg	Solu-Medrol 40, 125, 250, 500, 1000 mg IV/IM
  		Depo-medrol 40 mg intra-articular
  Dexamethasone	Dexazon 0.5 mg	Dexamethasone (Dexasone, Dexamed) 4 mg/ml intravenous/intra-articular
  	Fortecortin 0.5, 4 mg	Fortecortin 4 mg/ml, 8 mg/ml intravenous/intraarticular
  	Megadexan 10 mg	Missing
  fludrocortisone	Cortineff 0.1 mg	Missing
  Desoxycorticosterone acetate (DOXA)	Missing	Desoxycorticosterone acetate (DOXA) 5 mg/ml intramuscularly
  Triamcinolone	Polcortolone (Berlicort, Kenacort) 4 mg	Triamcinolone 10, 40 mg intramuscularly / intraarticularly

Corticosteroids are a series of steroid hormones synthesized from the adrenal cortex. According to their chemical composition, they are derivatives of cortisol. The main difference is that they do not contain androgens, estrogens, gestagens and other sex hormones. There are a huge number of types of corticosteroids, but preparations containing these hormones have the greatest activity.

Corticosteroid drugs have anti-inflammatory properties. However, they do not help to remove the pain completely, they only anesthetize. For complete elimination, you need to consult a doctor with a consultation about hormonal medications.

Corticosteroid ointments are drugs that remove pain on the surface of the skin of the human body. They can be combined, that is, they can contain any other elements or substances. Creams are divided into types that affect a person in different ways and have their own levels of exposure:

• the first type is considered the weakest, it contains hydrocortisone;
• the second type is medium or moderate; the composition includes: flumethasone and fluocortolone;
• the third type is strong; contains most synthetic hormones;
• the fourth type is the strongest and most effective.

You can also include combined funds in this series. They are used for dermatitis, lichen, alopecia, various fungi, psoriasis and other viral and bacterial diseases. Creams should be selected for different degrees of skin diseases.

Corticosteroid vs Steroid Creams – Understanding the Differences

Steroids are usually of animal or plant origin. They are derivatives of the isoprenoid series. According to the chemical composition, steroids consist of cholesterol, bile acids, cholic acid and many other organic substances. Steroid preparations have anti-inflammatory properties, the same as corticosteroid ointments.

Steroid drugs are taken for diseases of the joints, skin irritations, bruises and much more. Their action is similar to corticosteroid drugs, only the chemical composition is different.

Steroids are forbidden to be taken by patients with tuberculosis, diabetes mellitus, infectious diseases, gastrointestinal disorders, mild neuroses and pregnancy. It is also forbidden to use in the presence of an ongoing infectious process in the human body, as they contain hormones that are regulated not only by the adrenal glands, which can worsen overall health.

You should take into account the amount of application to the damaged surface, do not overdo it, because you can get burns.

The main difference between corticosteroid and steroid ointments is that the latter are produced using hormones produced not only by the adrenal glands. This allows expanding the use of such drugs.

Remember the pros and cons

When using corticosteroid creams, high results in treatment can be traced. Thanks to their use, a person avoids surgical intervention. These are the main advantages of using drugs.

The disadvantages are the following indicators:

1. The application of corticosteroid drugs to the damaged surface of the body should be carried out regularly. It is important that the treated area is always in this tool. It is necessary to smear for several months.
2. There is no guarantee of obtaining the desired effect, the complications of the affected areas simply stop.
3. With continued use, side effects may occur.

Children should be carefully examined for the use of hormone-containing drugs. You can not personally prescribe even ointments to yourself, as serious complications can arise. For example, you can analyze the disadvantages and advantages of Diprosalik ointment. The active substance of the ointment is betamethasone and salicylic acid. It is used for various lichen, psoriasis, dermatitis, ichthyosis and various skin lesions. Allergy to active substances is considered a contraindication. With irritation, skin itching, redness in the form of bubbles and other skin manifestations occur. It is not recommended to use for a long time.

Thus, the disadvantage of this option is an allergic reaction and a long time of action, and the advantage, as with all, is a reduction in anxiety on the surface of the skin.

Indications and contraindications

The main indications for use are associated only with violations of the upper layer of the epidermis. With such disorders, corticosteroids are used accordingly, which have their own indications, contraindications for use, as well as side effects with single use and with multiple use.

Indications for the use of ointments:

• chickenpox;
• psoriasis;
• hives or prickly heat;
• lichen of various types;
• herpes diseases;
• various allergies.

Only with such violations use ointment.

It is not advisable to use it for various injuries, dislocations, bites, cuts, cuts, burns and other influences, since the action of the drug is based on hormone-containing substances.

Also, contraindications that require special attention to themselves are not excluded. You should not pass by this, and independently decide to use such a drug, because you can disrupt the internal microflora of the body without subsequent proper recovery. Contraindications apply to:

• the general state of human health;
• immunity;
• age;
• pregnancy or breastfeeding.

These four factors are considered the most important things to pay attention to when buying or prescribing such drugs. It is impossible to violate the hormonal background of a pregnant woman or a mother who is breastfeeding a child. In addition, it is possible to disrupt the hormonal balance of a newborn child, which leads to negative consequences.

Side effects play an important role when using corticosteroid creams. Everyone must know what can happen with an overdose or a single use. The main side effects are equated:

• change in the structure of the skin surface at the site of the onset of the disease and its treatment;
• baldness in this place or abundant hair growth;
• change in skin color;
• broken capillaries under the skin;
• with violations on the skin of the face, eye diseases and secondary infections are possible.

Thus, the cream should be applied sparingly to delicate areas of the skin, as another system in the human body can be disturbed. When buying, you should carefully read the instructions.

Examples of effective creams

List of some drugs with corticosteroids in the form of ointments:

1. Advantan. The active element of the drug is methylprednisolone aceponate. It is used as an anti-allergic, anti-inflammatory and antipruritic agent, for various types of dermatitis, including infectious. Produced in the form of a viscous emulsion of white or transparent color with a specific odor. It is applied once a day for 12-13 weeks, and for children no more than a month. Stored for 2 years at room temperature. The price ranges from 550 to 600 rubles.
2. Beloderm. The active substance of the drug is betamethasone. It is used for psoriasis, itching, various types of dermatitis and lichen. It also has an antiviral, vasoconstrictive, antipruritic and antiallergic effect. It is forbidden to use for tuberculosis. Side effects are usually not dangerous to health. Used twice in one day for no more than a month. Keeps for three years at room temperature. The cost is from 130 to 150 rubles.
3. Hydrocortisone. The active substance is the same as the name of the drug. It has anti-edematous and anti-inflammatory actions. Ointment based on hydrocortisone is used for dermatitis and psoriasis. Especially well helps with various microbial diseases. An eye ointment that should not be used by those who are hypersensitive to this active substance. It is applied 2-3 times a day for about 2 weeks. It is stored for two years at a temperature below room temperature, preferably in a pantry or on a balcony. The cost is 30-50 rubles.
4. Kuterid. The active substance is betamethasone. It has the same properties as the analogue, in addition to antibacterial action. Used for dermatitis, herpes, prickly heat, urticaria. Keeps for three years. The price is 130-200 rubles.
5. Locoid. The main ingredient is hydrocortisone butyrate. It has antipruritic, anti-inflammatory and anti-edema effects. It is prescribed for dermatitis. The surface area of ​​application of the agent should not exceed 30%. Stored for 3 years. The price is 350-400 rubles.
6. Sinalar. The most important substance is fluocinolone acetonide. Provides anti-inflammatory action. Used for lichen, rubella, lupus, dermatitis, psoriasis. It is necessary to smear 2 or 3 times a day, the shelf life is not limited at normal temperature. The cost is about 300 rubles.
7. Flucinar. Fluocinolone acetonide is the key ingredient. Antiallergic and anti-inflammatory agent. It is prescribed for dermatitis and lichen. Stored for about 60 months. In pharmacies you can buy from 200 rubles.
8. Celestoderm. The key ingredient is betamethasone. A vasoconstrictor and anti-inflammatory agent that is used for various types of dermatitis, itching, allergies, diaper rash and urticaria. It is a cream of white color, dense homogeneous structure. Keeps for about five years. Most pharmacies provide a cost of 250 and no more than 400 rubles.

The list with the names of corticosteroid hormonal ointments and creams is wider. These drugs are distributed throughout the Russian Federation.

There are preparations for lactating women based on phytohormones. But the doctor prescribes such medicines strictly for the general health of the mother and the newborn child, because the immune system may not be so strong for the existence of such substances in the body.

There are topical corticosteroids, the names of which are given above, but the amount of application and the duration of treatment differ to a lesser extent. For irritations after the ointment, soothe the child's skin with herbal chamomile-based baths, which help reduce redness and itching.

When buying a drug, the instructions describe the actions that should be taken when using it. The use of hydrocortisone ointment and any other should be in accordance with the doctor's prescriptions and instructions.

If it is an eye ointment, apply no more than three times a day. If this remedy is for external use in the area of ​​​​the abdominal part of the body or limbs, then it should be lubricated no more than once or twice (depending on the degree of action on the skin) per day.

All ointments based on corticosteroids are recommended to be used for no more than two months, otherwise hormonal changes in the body and various health disorders occur. In case of a burn, wipe the skin surface dry with a rag, rinse with cool water and apply a wet herbal collection of Siberian flowers for several hours. If this happened in the eye area, then you should rinse your eyes with green tea.

In order to correct side effects, you need to consult a doctor to help the patient use any additional sedatives.

In any case, from all irritations, redness and itching on the skin after these creams, it is recommended to use salt or herbal baths for 20-30 minutes.

Thus, corticosteroid creams have high anti-inflammatory properties that help a person rid the appearance of infectious lesions, itching and redness in a short period of time.

Any dermatological problems require timely diagnosis and comprehensive treatment. It can be both ordinary acne, irritation, and more serious diseases such as psoriasis, eczema, various dermatitis and others. After trying a variety of creams or ointments, many resort to the use of corticosteroid (hormonal) ointments. Especially often they are used by people suffering from chronic dermatological pathologies that often recur and are difficult to treat. In this case, corticosteroid ointments often become the only savior of the skin of these people.

Composition and properties of corticosteroid ointments

The main active ingredients in these ointments are hormonal substances produced synthetically, but which are a complete analogue of corticosteroids produced in the human body and have similar properties. The most common hormonal substances that make up such ointments are Cortisone, Hydrocortisone, Prednisolone, Betamethasone, Clobetasol and others.

The therapeutic effect after the use of these medications is achieved due to the properties inherent in topical hormonal agents. They are able to stop inflammation and allergic swelling of the skin, eliminate itching, which often accompanies dermatological diseases, and anesthetize the affected area of ​​the skin.

Many corticosteroid ointments are made in combination with various substances, which expands their range of action. Additional components are usually:

• antibiotics that fight bacterial agents;
• an antimycotic agent having antimicrobial activity;
• panthenol, which improves trophism and tissue regeneration;
• lidocaine, which has a local anesthetic effect;
• salicylic acid, which reduces the secretion of the sebaceous and sweat glands and has a keratolytic effect.

The combined action of several components of the drug allows you to achieve the best and faster effect, relieving a person from the physical and aesthetic discomfort that accompanies most skin diseases.

Atopic dermatitis - causes, symptoms and treatments

Application area

The main field of application of corticosteroid ointments is dermatology. Indications for use are the following pathologies of the skin:

• allergic and atopic dermatitis;
• psoriasis;
• eczema;
• hives;
• vitiligo;
• lichen planus;
• neurodermatitis;
• lip damage in lupus erythematosus.

Another area of ​​application is urology. In this case, the indication for the appointment of these dosage forms is phimosis (difficulty in exposing the glans penis due to narrowing of the foreskin). A good effect is given by their reception with focal alopecia.

There are also representatives of hormonal ointments intended for the eyes. They are used in the treatment of allergic ocular disease or its involvement in other skin lesions requiring the use of topical corticosteroids.

Atopic dermatitis in children - causes, symptoms and treatments

Contraindications and side effects

As with any other drug, there are situations in which the use of corticosteroid ointment formulations is limited. These include the following diseases and pathologies: open wounds, a pronounced infectious process on the skin, suspicion of an oncological process at the site of application, hypersensitivity to the components of the drug, syphilis or tuberculosis, occurring with damage to the skin.

Of the undesirable consequences that usually occur during application, one can note the occurrence of acne (acne), the appearance of skin stretch marks (stretch marks), atrophy (thinning) of the skin at the site of use of ointments, and infection due to a decrease in the protective function of the skin.

Classes and List of Drugs

In 1993, the European classification of topical steroids was created based on their activity. According to her, all these funds are divided into classes:

1. 1. Weak action (class I) - ointment formulations based on hydrocortisone 0.1-1% and prednisolone 0.5%, fluocinolone 0.002%. Their use is possible for a long time.
2. 2. Medium-acting (class II) - drugs, the main active ingredient of which may be aclomethasone 0.05%, triamcinolone 0.02%, betamethasone valearate 0.025%, fluocinolone 0.006%. You can apply them no more than 4-5 weeks, about 3 times a day.
3. 3. Strong action (class III) - ointments containing betamethasone valearate 0.1%, betamethasone dipropionate, methylprednisolone, mometasone, fluticasone, fluocinolone 0.025%. The use of this class is limited to two weeks 1-2 times a day.
4. 4. Very strong action (class IV) - ointments based on clobetasol. Due to the strength of action, it is not recommended to use ointments based on this corticosteroid for more than 10-14 days. Application to the skin should also be limited to 1-2 times.

Based on the main active ingredient, you can make a list of drugs with specific trade names.

Substances belonging to a subclass are called corticosteroids. Moreover, they are produced not by the gonads, but exclusively by the adrenal cortex; that is why they do not have estrogenic, androgenic or progestogenic activity. Corticosteroid hormones are completely natural substances for the body that perform biochemical processes, regulate life mechanisms, support the immune system, take part in carbohydrate, water-salt and protein metabolism. Details about preparations containing these hormones, about what they are and why they are needed, will be discussed in our article.

Indications for the use of drugs that contain this type of hormones

The corticosteroid drug, which is most often called simply a steroid, is administered artificially, but it plays the same role as the so-called natural hormone: it provides metabolic processes, restores connective tissue, converts starch into sugar, fights various kinds of inflammation. Such drugs are often used in the treatment of diseases such as asthma, rheumatoid arthritis, lupus erythematosus, kidney and thyroid dysfunction, tendinitis. Corticosteroid creams and ointments are often used in transplantation because they protect the body from rejection of transplanted organs.

Contraindications to the use of drugs that contain corticosteroid hormones

Side effects when using corticosteroid drugs can be pronounced headaches, pain in the legs or back, dizziness, degeneration of tissues that are constantly in contact with the drug. The corticosteroid drug may be either a glucocorticoid or a mineralocorticoid. It is produced in the form of tablets, powders, ointments, sprays, drops, gels, capsules. Such drugs are very effective for the treatment of various diseases, for example, they are often prescribed as an alternative to surgery, they are also used to treat children (boys). True, such therapy can last quite a long time, sometimes up to 2-3 months. In this case, the ointment is usually applied 2 times a day.

Types of corticosteroid drugs

So, what are the names of corticosteroid drugs? The list of them is quite extensive, below are just a few of them. For starters - tablets and capsules:

• "Celeston";
• "Kenalog";
• "Metipred";
• "Kenakort";
• "Polcortolon";
• "Medrol";
• "Urbazon";
• "Prednisolone";
• "Corineff";
• "Florinef" and others.

And here is a list that includes ointments, gels and corticosteroid creams:

• "Diprosalik";
• "Dermozolon";
• "Mesoderm";
• "Kremgen";
• "Elokom";
• "Kutiveit";
• "Betamethasone";
• "Triderm";
• "Flucinar";
• "Triacutan";
• "Gyoksizon";
• "Sinoflan";
• "Dermovate";
• "Delor" and others.

It should also be taken into account that often a corticosteroid drug contains anti-inflammatory or antiseptic components, as well as antibiotics.

Other corticosteroid drugs are nasal. Detailed list

Nasal preparations of corticosteroid hormones include such medicines with which chronic rhinitis and purulent processes occurring in the nasopharynx are treated. As a result of the use of such drugs, the ease of breathing through the nose is restored and the possibility of reproduction of microorganisms dangerous to human health living on the mucous membranes is reduced. These drugs include:

• "Flixonase";
• "Nazarel";
• "Nasobek";
• "Nasonex";
• "Rinoklenil";
• "Beclomethasone";
• "Tafen Nasal";
• "Aldecin";
• "Avamis" and others.

It is important to note that this form of drugs has much less negative effects and side effects on the body than injections or tablets.

Corticosteroid drugs in the treatment of bronchi: inhalation

In the treatment of various spastic conditions of the bronchi (mainly bronchial asthma), indispensable drugs are used in the form of inhalations, because this is the most convenient form of therapy for such diseases. It is carried out using the following drugs that contain corticosteroids:

• "Triamcinolone";
• "Flunisolide";
• "Budesonide";
• "Fluticasone propionate";
• "Benacort";
• "Klenil";
• "Beklazon";
• "Beclomethasone dipropionate";
• "Beclospir";
• "Budenitis";
• "Pulmicort";
• "Bekodisk";
• "Depo-medrol";
• "Diprospan" and some others.

This form of the drug involves the following options: emulsion, ready-made solution, powder, which must first be diluted and prepared as an inhaler filler. In this form, the corticosteroid drug does not penetrate into the blood and mucous membranes at all, resistance to a particular substance is avoided, which does not lead to serious consequences of its use. Simply put, addiction to the drug does not develop, or it happens much later compared to if the patient used capsules or injections containing these hormones.

Consequences of corticosteroid treatment

If the patient has been taking drugs with these hormones for less than three weeks, then there will be no significant disturbances in the body. If the use of drugs was carried out for a longer time or more often, then various complications are possible. Therefore, patients are required to have a special card and bracelets for the use of steroids. Side effects with prolonged use of steroids - nausea, anorexia, arthralgia, skin peeling, weight loss, dizziness, drowsiness. In general, these drugs are used in the treatment of many different diseases (asthma, psoriasis, polyarthritis, and many others), but due to the fact that they are dangerous with prolonged use and have the ability to start irreversible processes in the body, their use without the participation of a doctor is strongly discouraged. With long-term corticosteroid therapy, undesirable side effects may occur, especially in cases where the recommended dose is greatly exceeded. Therefore, taking into account all the risks, the doctor must carefully calculate how much and what kind of corticosteroid drug the patient needs, adequately assess all the risks from its use and conduct therapy without exceeding the average recommended duration of taking these hormones (several weeks).

Corticosteroids are hormonal substances produced by the adrenal cortex. They can be divided into two large groups. The first is, which include cortisone and hydrocortisone. The second is mineralocorticoids, represented mainly by aldosterone. For the first time, doctors and scientists started talking about their importance to humans back in 1886. The body needs them to regulate metabolism, control kidney function, puberty, and more.

Classes of corticosteroids

In medicine today, natural hormones are not used; they have been completely replaced by synthetic analogues that have the same effect on the body. Among doctors, they are usually classified according to the degree of activity into:

1. Corticosteroids with low potency, which include hydrocortisone and prednisolone.
2. Corticosteroids with moderate activity, which include flumethasone and fluocortolone.
3. Hormones with strong activity, represented by far the most widely. These are mainly betamethasone and mometasone.
4. Corticosteroids with a high degree of activity, which include only two hormones: clobetasol and chalcinonide.

The drugs listed in the list contain only one active hormone. In addition, there are also combined products, with an additional antifungal or antibacterial component.

Main action

Synthetic corticosteroids have a variety of effects on the body. Its mechanism is tied to the presence of special steroid receptors in cell membranes. In terms of effects, corticosteroids can:

• To have an anti-inflammatory effect due to a violation of the synthesis of inflammatory mediators.
• Influence all types of metabolism, including water-electrolyte, lipid, protein and carbohydrate.
• To have an anti-allergic effect, due to the ability to stabilize cell membranes and prevent the formation of allergy mediators.
• Act on the cardiovascular system, increasing the sensitivity of the walls of blood vessels and the heart muscle to norepinephrine and adrenaline, and thereby affecting the level of blood pressure.
• Stimulate the formation of platelets and red blood cells.
• Suppress the production of sex hormones, as well as reduce the susceptibility of organs and tissues to hormones produced by the thyroid gland.

Indications

Corticosteroids are used where conventional anti-inflammatory, analgesic, or antiallergic drugs are powerless. Between themselves, the two groups of adrenal hormones differ in the severity of their influence on a certain type of metabolism.

Glucocorticoids

This type of hormone has a more pronounced effect on carbohydrate metabolism. Actually, this class got its name because of the ability to increase blood sugar levels by accelerating the synthesis of glucose in the liver. They also affect the metabolism of fats and proteins. The most active of these is cortisol. Use drugs with such hormones:

• With all types, especially in severe cases.
• In case of salt deposits in gout.
• With often causing inflammation in the cartilaginous tissues of the joints, and especially in the vertebral discs.

As a rule, doctors prescribe glucocorticoids only when the use of other anti-inflammatory drugs for two weeks did not give a pronounced effect.

In addition to pathologies associated with the joints, glucocorticoid drugs are often prescribed for problems of other organs and tissues. For example, with autoimmune diseases, bronchial asthma, with certain skin and blood diseases, in cases of severe allergies and with a number of infections.

Mineralocorticoids

Mineralocorticoids are responsible in the body for the regulation of water-salt metabolism and practically do not affect its other types. Unlike their counterparts, this type of hormone is not so popular in medicine. However, they also found their uses. Mineralocorticoids are prescribed for:

• Addison's disease is directly related to insufficient production of these hormones by the adrenal cortex.
• Violations of mineral metabolism.
• Muscle weakness and adynamia.

Contraindications

Despite the high activity of some corticoid preparations, there are no absolute contraindications to their use. However, there are conditions in which doctors prescribe hormones with caution and under close supervision. These pathologies include:

1. Diabetes.
2. Peptic ulcer of the stomach and intestines in the acute stage.
3. Heart failure and a tendency to high blood pressure.
4. In acute renal or hepatic insufficiency.
5. With glaucoma or cataracts.
6. After vaccination with a live vaccine.
7. With chicken pox, tuberculosis and some other severe infections.
8. With a tendency to increased formation of blood clots.
9. Epilepsy and mental illness.

Side effect

The severity of side effects when taking corticosteroids will depend on which class they belong to. Thus, first-class glucocorticoids, such as hydrocortisone, cause side effects more often than, for example, more modern ones - mometasone or betamethasone.

In addition, the severity of effects is directly determined by the dose and duration of use. The higher the dose and the longer the course, the greater the likelihood of their occurrence. Most often, these drugs can cause:

• Edema caused by sodium retention in the body.
• Increased blood pressure and sugar levels.
• Exacerbation of gastritis or peptic ulcer.
• Dermatitis, acne, and in severe cases, atrophy of the skin.
• Inhibition of tissue regeneration, due to which wound healing while taking corticoids is slower.
• Mood disorders, depression, neurological disorders.
• Inhibition of the activity of the adrenal glands and, as a result, a violation of various types of metabolism, an increase in body weight.

In order to reduce the likelihood of side effects, it is important to adjust the dose and duration of hormone intake in a timely manner.

Application features

Doctors advise using corticosteroid drugs starting at six in the morning and no later than two in the afternoon. Such conditions are as close as possible to the physiological norms for the production of adrenal hormones in the blood. The tablets are usually taken with or immediately after meals.

Treatment with corticosteroids, especially for long courses, should be supplemented with drugs to avoid its deficiency in the body, as well as foods rich in proteins. But the consumption of carbohydrates and salt is better to limit.

It does not matter how exactly corticosteroids will be used, locally in the form of ointments or orally as tablets, only a doctor should select a regimen for their administration.

In children

Any hormonal preparations, including corticoids, are prescribed to children only according to absolute indications, when other methods of treatment do not work. At the same time, initially the drugs are prescribed in minimal dosages.

Most often in children's practice, external agents, creams or ointments containing hormones are used, and various dermatitis are the main indications for their use. In children, adverse effects from the use of hormones occur more often and develop faster than in adults. Therefore, even topically, such drugs are used on a small surface of the skin and in short courses.

In pregnant and lactating

Corticosteroids should only be used during pregnancy when the benefits far outweigh the risks. After all, even ointments and creams can have, albeit a small, but systemic effect on the body of a future mother. Such an influence can disrupt the formation of the endocrine system of the baby. Usually, glucocorticoids are used in case of:

1. The risk of preterm birth. Hormones create a stress signal for the baby and thereby provoke an increase in the work of all his organs.
2. Autoimmune diseases in the acute stage.
3. Hereditary hyperplasia of the adrenal cortex in a child.

As for the period of feeding, corticosteroids, especially the latest generation, penetrate into breast milk poorly. Use them during this period, albeit with caution, but you can.

It is necessary to cancel the prescribed drugs gradually. In each case, the doctor selects the scheme individually. It is impossible to violate the withdrawal regimen, as well as the regimen for taking such drugs! Only with full compliance with all medical recommendations, corticosteroids will have their effect and will not harm you.