BiologySciences

What is cortisone ?

What is cortisone ?

Above each individual’s kidney lies the small, pyramid-shaped adrenal gland.

The adrenal gland consists of two parts, each with a specific function. The central part is called the adrenal medulla (or medulla) and the outer portion is called the adrenal cortex (or cortex).

These two parts of the gland produce different hormones that are essential for life. The adrenal medulla produces mostly adrenaline and noradrenaline. The adrenal cortex secretes androgens (e.g. testosterone, DHEA), mineralocorticoids (e.g. aldosterone) and glucocorticoids.

The main glucocorticoid hormone secreted by the adrenal glands is called cortisol (or hydrocortisone). This hormone plays a crucial role in the regulation of major body functions (glycemic metabolism, immune system, inflammation). Given the importance of these functions in everyday life, cortisone is a vital product of the human body.

The anti-inflammatory properties of this natural hormone intrigued physicians upon its discovery as natural cortisone was found to be an effective way to treat certain inflammatory or allergic diseases. Doctors successfully synthesized drugs that imitated the effects of natural cortisol. Today, these “synthetic glucocorticoids” are prescribed as prednisone and prednisolone.

How does it work?

Oral corticosteroids are well absorbed by the body after ingestion (80%) and rapidly enter the blood stream (peak blood level is reached 1-2 hours after the dose is taken).

Prednisone must be converted into prenisolone by the body in order to function. However, doctors often prescribe prednisone instead of prednisolone because it is not absorbed as well by the patient. For reasons that are specific to your disease and its evolution during treatment, your doctor may prefer to prescribe either one for your particular case. Other types of steroids may even be considered by your physican depending on your condition.

The mechanisms of action of corticosteroids are numerous and complex. After they are absorbed by the body, they act in cells through a specific receptor. You can find this receptor in all human cells. However, their number varies with different cell types.

Once the steroid has been set at this receptor, it becomes active and is capable of regulating many cell activities.

Steroids are mainly used for their anti-allergic and immunosuppressive properties as they weaken the immune system. They also limit the creation of specific cells (including certain white blood cells) which serves as a useful quality for the treatment of many diseases.

Who is treated?

Broncho-pulmonary and rheumatologic diseases are the most common conditions that need prescription of oral corticosteroids as part of their treatment.

Asthma.

Chronic obstructive pulmonary disease.

Rheumatoid arthritis.

Cancer. Eczema / atopic dermatitis.

Crohn’s disease.

Ulcerative colitis.

Connective tissue (such as systemic lupus).

Sarcoidosis.

Addison’s disease.

Other vasculitis (such as Wegener’s granuloma).

Myasthenia.

Kidney disease.

Corticosteroids therapies.

The main routes of administration of corticosteroids are :

– Oral (by ingestion through the mouth) e.g., prednisone, prednisolone, methylprednisolone, betamethasone, hydrocortisone, dexamethasone.

Parenteral (intravenous or intramuscular) e.g., methylprednisolone, triamcinolone, dexamethasone.

Inhalation (e.g. aerosol in asthma) e.g., beclometasone, budesonide, flunisolide, fluticasone.

Topically (e.g. application to skin) e.g., beclometasone, betamethasone, clobetasol.

In addition, corticosteroids may also be administered by intra-articular, ocular, nasal, rectal (enema), in ear or spinal methods.

Cortisone Side Effects.

Cardiovascular

Congestive heart failure (in susceptible patients), hypertension, myocardial rupture following recent myocardial infarction, thromboembolism.

Gastrointestinal

Peptic ulcer with possible perforation and hemorrhage, perforation of the small and large bowel (particularly in inflammatory bowel disease patients), pancreatitis, abdominal distention, ulcerative esophagitis, nausea.

Musculoskeletal

Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of femoral and humoral heads, pathologic fracture of long bones, tendon rupture, growth suppression in children.

Nervous system

Convulsions, increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment, vertigo, headach.

Ocular

Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.

Metabolic

Sodium retention, fluid retention, potassium loss, hypokalemic alkalosis, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemics (in diabetics), negative nitrogen balance due to protein catabolism, increased appetite.

Reference :

What is Cortisone”, cortisone-info.com

“Cortisone Side Effects”, drugs.com

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