Steroid Pharmacology: Corticosteroids in a Nutshell

We’ve mentioned before in a summary lecture of our respiratory drugs the two main categories – BAM and SLM. B-A-M are the bronchodilators, and S-L-M are anti-inflammatories.

In this article, we’ll be discussing the “S” in our SLM category. The “S” stands for steroids, or it can also be referred to as Solu-Medrol, which is a brand name for methylprednisolone, and the suffix “-son” or “-sone.”

Let’s begin.

The Corticosteroids Team

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).

Mechanism of Action

Corticosteroids help to relieve the lungs of inflammation.

So, going back to the lungs’ anatomy, 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

Therefore, if there are a lot of inflammation happening inside the lungs, the client will get suffocated.

Remember that oxygen is the currency used by the body to live. Without proper access to airflow, there will be no oxygen, and without oxygen, the body becomes broke and dies. Always remember that nine out of 10 issues inside the body are always related to the lack of oxygen.

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

The Inflammation Process

The inflammation process usually happens due to the presence of prostaglandins and histamines. Histamines cause the allergic reaction while prostaglandins cause the 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 the 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 the best they can to fight the inflammation but sometimes, the reaction is so severe that the adrenals can no longer take it.

During episodes of adrenal insufficiency, clients 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.

The Last Line of Therapy

Corticosteroids are considered the last drugs a respiratory client will receive after receiving other medications. Mostly, inflammatory conditions like COPD are given steroids.

Remember that steroids act slower, but the effects are more extensive.  

Side Effects

Every drug has a side effect. As for corticosteroids, one of the major side effects, that 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 clients taking corticosteroid are the following:

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

There you have it, corticosteroids in a nutshell. For our next lecture, we’ll be focusing on leukotrienes and Singulair.