Corticosteroids in a Nutshell: Steroid Pharmacology

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1. Corticosteroids Mechanism of Action
2. How do corticosteroids reduce inflammation?
3. Corticosteroids Side Effects

Corticosteroids are considered the last drugs a respiratory patient will receive after receiving other medications. Mostly, inflammatory conditions like COPD are given steroids. Steroids act slower, but the effects are more extensive.  

Corticosteroid medications usually end in either “-son” or in “-sone.” So, this tip alone can help you remember that drugs having those two suffixes are corticosteroids. Some examples would be prednisone and methylprednisolone (Solu-Medrol).

Corticosteroids Mechanism of Action

Corticosteroids help to relieve the lungs of inflammation.

We know that inside the lungs are branches called bronchi, which extend to smaller branches called bronchioles. At the end of these bronchioles are alveoli. Inside these alveoli, a lot of issues can arise.

When there is inflammation along the branches of the lungs, this results in:

• Backing up of airflow
• No airflow at all

If there’s a lot of inflammation inside the lungs, the patient will suffocate.

Oxygen is the currency used by the body to live. Without proper access to airflow, there will be no oxygen. Without oxygen, the body breaks and dies. Always remember that nine out of ten issues inside the body are always related to the lack of oxygen.

Corticosteroids are primarily given to give the lungs sufficient oxygen access.

How do corticosteroids reduce inflammation?

The inflammation process usually happens due to the presence of prostaglandins and histamines. Histamines cause the allergic reaction, while prostaglandins cause pain. The other causes of inflammatory responses are:

• Substance P
• COX-1 and COX-2

The worst part about having an allergic reaction is that the body will experience numerous responses wherein the abovementioned elements will immediately react and cause different manifestations of inflammation.

Adrenal Insufficiency

During an inflammatory response, the adrenal glands usually step up to go against the inflammation and decrease the reaction. However, there will be moments of adrenal insufficiency wherein the adrenals are over-fatigued. This happens when there’s just too much inflammation than the adrenals can tolerate.

The adrenals will do their best to fight the inflammation, but sometimes the reaction is so severe that the adrenals can no longer take it.

During episodes of adrenal insufficiency, patients are given albuterol to help get the prednisone down into the lungs for better absorption. Albuterol is used to dilate the branches of the lungs.

Corticosteroids Side Effects

One of the major side effects of corticosteroids )which is also a favorite topic during nursing exams), is immunosuppression. Corticosteroids, like prednisone, will suppress the immune system, which means that the drug is bound to kill off the white blood cells in the body, like what is happening with chemotherapy.

Other side effects that you have to watch out for with patients taking corticosteroids are the following:

• Increased blood sugar
• Fluid retention
• Increased muscle weakness
• Potassium loss

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