Are there any differences among the different types of systemic corticosteroids?
Corticosteroids differ in their relative amount of anti-inflammatory and mineralocorticoid potency and they are used according to these effects. Among the systemic (oral and injectable) corticosteroids, fludrocortisone (Florinef) has the most significant mineralocorticoid (salt retaining) actions and is best used for this effect despite it's strong anti-inflammatory action.
Other systemically available corticosteroids have mostly glucocorticoid effects, and are used for their anti-inflammatory activities. Examples of these include the naturally occurring hydrocortisone (Cortef) and cortisone, and the synthetic corticosteroids including:
- bethamethasone (Celestone)
- prednisone (Prednisone Intensol)
- prednisolone (Orapred, Prelone)
- triamcinolone (Aristospan Intra-Articular, Aristospan Intralesional, Kenalog)
- methylprednisolone((Medrol, Depo-Medrol, Solu-Medrol)
- dexamethasone (Dexamethasone Intensol, DexPak 10 Day, DexPak 13 Day, DexPak 6 Day).
Among all glucocorticoids, prednisone is not effective in the body unless it is converted to prednisolone by enzymes in the liver. For this reason prednisone may not be very effective in people with liver disease because of a reduction in their ability to convert prednisone to prednisolone.
What are the side effects of systemic corticosteroids?
Corticosteroids have many side effects that can be mild or serious. These side effects are more apparent when corticosteroids are used at higher doses or for extended periods of time. This section lists only some of these side effects of corticosteroids.
- cause sodium (salt) and fluid to be retained in the body and cause weight gain or swelling of the legs (edema)
- High blood pressure
- Loss of potassium
- Muscle weakness
- Puffiness of the face (moon face)
- Facial hair growth
- Thinning and easy bruising of the skin
- Slow wound healing
- Ulcers in the stomach and duodenum
- Loss of diabetes control
- Menstrual irregularity
- "Buffalo hump," a condition described as a rounding of the upper back
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