Probably many of us have either suffered or know someone who has suffered some kind of inflammatory process due to an illness, allergic reaction or asthma. And in many of these cases, the application or use of corticosteroids will have been indicated in order to reduce the inflammation. But these are not a single substance, but a group of drugs with similar properties.

In this sense, we can find several types of corticosteroids , being the most known the ones we are going to see throughout this article.

Corticosteroids: basic concept

Corticosteroids or steroids are a group of drugs that produce a cortisol-like effect secreted by the adrenal cortex. Although cortisol is a hormone linked to stress , it also has a series of highly relevant effects for the maintenance of our health.

Corticosteroids are characterized as steroid-type substances, compounds based on the substance known as sterane that are part of living organisms and are formed by structures of hormones and vitamins. Their function is multiple, having importance among other areas in the metabolism and the secretion and utilization of sugars and fats . the body homeostasis and also linking to the functioning of the immune system. They are powerful anti-inflammatories and suppressors of the immune system, which is ideal for treating allergies, arthritis, asthma or other types of inflammation, whether or not they are caused by the immune system.

When we talk about corticosteroids as drugs, we are talking about drugs of great power and usefulness in the treatment of pathologies such as asthma, arthritis, allergic reactions or inflammatory processes.

However, its administration must be very careful, since apart from its beneficial effects they also generate quite problematic side effects and can pose some danger. These include the risk of hypertension, cataracts, glaucoma or diabetes , although many other side effects may arise. That is why they are generally used for the shortest possible time and mostly in decreasing doses.

Different types of corticosteroids

Although we have commented on some of the basic characteristics of corticosteroids in general, the truth is that within this group of substances we can find different types or classes with differentiated characteristics. Among the most important are the following

1. Glucocorticoids

One of the best known, if not the most popular, type of corticosteroids is glucocorticoids. Within this group we find substances mainly aimed at controlling inflammatory processes .

Its action generates a decrease in the functionality of the immune system, which is essential to treat allergic reactions such as food or drugs. They are also used in situations such as asthma, problems such as osteoarthritis, or even entermetic treatment after chemotherapy in cancer patients.

Known drugs are betamethasone or dexamethasone , although others like cortisone are also considered as such.

2. Corticotropins

Corticotropins are another type of corticosteroid, which are usually used in cases where the body has deficient levels of endogenous corticosteroids. It facilitates the secretion of cortisone by the pituitary gland . Its action tends to be more diagnostic than therapeutic, with the use of glucocorticoids being more common at the treatment level.

3. Mineralcorticoids

Mineral corticosteroids are perhaps the least well known group of corticosteroids in the general population. These substances have the main function of maintaining the chemical balance of the body, acting mainly at the renal level.

Its action generates a greater control of salt and sodium retention and allows to regulate and avoid excessive loss of body fluids through urine . Within this group we find as main representative the fludrocortisone

Two prototype drugs

We’ve talked about the basic types of corticosteroids and mentioned some examples of them. But maybe it can be more visual or some specific drugs are better known. The two cases that we will mention separately are both extremely well known and also have typical properties of mineralcorticoids despite being glucocorticoids .

Cortisone

Probably the best known drug in this group of drugs. Its action is mainly that of a glucocorticoid, being especially used in the treatment of various types of inflammation . However, it also has an action on the metabolism of salt and liquid retention, as well as on the metabolism of carbohydrates, which means that it has properties that link it to mineral corticoids.

It is used in multiple disorders, both at human and veterinary level. Its great utility has been observed in allergic reactions, arthritis, endocarditis, lupus or leukemias among many other conditions. It has also been used occasionally in situations of anorexia or hyporexia, with lack of appetite and thirst, in some anaemias or even to reduce the inflammation caused by different tumours.

Hydrocortisone

Another great example of one of the best known types of corticosteroids is hydrocortisone. Like cortisone it is classified as a glucocorticoid, but it also has regulatory effects similar to those of mineral corticoids. It is usually used as a supportive medication , and is probably one of the least powerful.

Its applications include the treatment of skin rashes, irritations, allergies, itching or even as a cancer support. There are also creams and suppositories in case of anal problems.

Other forms of classification

The above classification is not the only one that exists, and various options can be found depending on the criteria that one wishes to use to group these drugs .

Another of the main ones is that which takes into account its mode of application or presentation. In this sense we can find the following types of corticosteroids: oral (pills), injected (either intravenous, parenteral or intramuscular), inhaled (like the typical inhaler), aerosols or topical (creams). Also suppositories and drops.

Finally, they can also be grouped according to their half-life. In this sense we would find short lived corticosteroids (between 8-12 hours), medium (between 18 and 36 approximately) and long lived (over 36).

Bibliographic references:

  • Corticoides.org. (n.d.). Corticosteroids. Available at: http://www.corticoides.org/
  • Pensabeni, J.T.; Panush, R. (1996). Review corticosteroid usage. Observations at a community hospital. Am J Med Sci.