Glucocorticoids

They enter cells and bind the glucocorticoid receptor; the activated complex moves to the nucleus, binds glucocorticoid response elements and changes which genes are read. Inflammatory cytokines and NF-kB signaling are damped, lymphocytes and eosinophils fall, and gluconeogenesis and protein breakdown rise. With long use they suppress ACTH release and so the adrenal glands' own output.

• PrednisoloneUsually taken once in the morning, which limits sleeplessness; long or high-dose courses need a steroid card and a slow taper.
• DexamethasoneAlmost free of mineralocorticoid (salt-retaining) effect at anti-inflammatory doses, unlike hydrocortisone; widely used for cerebral edema and as an antiemetic in cancer care.
• HydrocortisoneThe first choice for cortisol replacement in adrenal insufficiency; unlike dexamethasone, it has clear salt-retaining activity.

• Asthma attacks and flare-ups
• Rheumatoid arthritis and other inflammatory diseases
• Severe allergic conditions
• Adrenal insufficiency (replacement)
• Crohn's disease and ulcerative colitis flares
• Brain swelling around tumors (cerebral edema)

• Adrenal suppression; stopping suddenly is dangerousKnown forSerious
• Cushingoid features: moon face, central weight gainKnown for
• Infections, with their signs maskedKnown forSerious
• Osteoporosis and fracturesSerious
• Cataracts
• Glaucoma (raised eye pressure)Serious
• High blood sugar
• Raised blood pressure with salt and water retention
• Mood changes, depression, insomnia, psychosis
• Peptic ulcerSerious

What the class has in common. Each drug's card has its own, and Known for marks what an exam expects you to know.

• After long or high-dose courses, taper slowly and give extra steroid during illness, injury or surgery, as the adrenals are suppressed.
• Avoid live vaccines on immunosuppressive doses; take care with latent TB, hepatitis B, and exposure to chickenpox or measles.
• Contraindicated in systemic fungal infections, except to control a life-threatening drug reaction.
• They raise blood glucose, so diabetes treatment may need increasing, and they can weaken warfarin's effect.

Written for biofideX in plain words, after checking these references:

• Prednisolone sodium phosphate orally disintegrating tablets: label (DailyMed)
• Dexamethasone tablets: label (DailyMed)
• Glucocorticoid (NCI Thesaurus)
• Steroids (NHS)

For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.