Corticosteroids: use in endocrinology
The naturally occurring adrenocortical steroids (hydrocortisone, cortisone) have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. They are used as replacement therapy in adrenocortical deficiency states.
Synthetic corticosteroid compounds (eg prednis(ol)one, methylprednisolone) are mainly used for their anti-inflammatory properties. Dexamethasone, methylprednisolone and betamethasone are synthetic compounds with marked glucocorticoid activity and an absence of significant salt-retaining activity. These agents are used for their potent anti-inflammatory effects.
Fludrocortisone has been developed to maximise mineralocorticoid activity. As part of replacement therapy for adrenal insufficiency or congenital adrenal hyperplasia, it allows lower dosage of hydrocortisone or cortisone acetate, with reduction of glucocorticoid adverse effects. Excessive dosage can cause fluid retention and hypertension.
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