Systemic steroids are also called corticosteroids, glucocorticoids or cortisones. They are synthetic derivatives of the natural steroid, cortisol, which is produced by the adrenal glands. They are called systemic if the steroids are taken by mouth or given by intramuscular injection. Topical (cortico)steroids are applied directly to the skin. Inhaled steroids are breathed in.
Systemic steroids include prednisone, prednisolone, methylprednisolone, beclamethasone, betamethasone, dexamethasone, fludrocortisone, hydrocortisone and triamcinolone.
Systemic steroids work in the same way as natural cortisol, and are prescribed for a large number of serious diseases. Skin conditions treated with steroids include blistering diseases such as pemphigus and pemphigoid, and severe forms of dermatitis.
What is the role of natural corticosteroids?
Natural cortisol has important effects in the body, including regulation of:
- Protein, carbohydrate, lipid and nucleic acid metabolism
- Inflammation and immune response
- Distribution and excretion of water and solutes
- Secretion of adrenocorticotrophic hormone (ACTH) from the pituitary gland.
How do systemic steroids differ?
Systemic steroids differ in dose, mineralocorticoid potency, half-life (duration of action) and how effectively they suppress the hyphothalamic-pituitary-adrenal (HPA) axis (suppression leads to reduced production of natural cortisol).Comparison of systemic steroids*
|Daily dose causing HPA axis suppression (mg)||25–30||20–30||7.5||1–1.5|