Cortisone preparations (glucocorticoids) are medications that contain cortisone.
They relieve swelling, redness, itching and allergic reactions.
Cortisone preparations are very strong drugs.
In addition to the beneficial effect used to treat diseases, they sometimes have very serious side effects.
Cortisone-containing medications require a prescription.
Even if the use is not included in the drug indications, some corticosteroids may be prescribed for the following conditions:
- Bell’s palsy (prednisolone)
- Severe cough in children (dexamethasone).
Cortisone preparations are available in the following dosage forms:
- Prolonged-release tablets
- Prolonged-release capsules
- Injection solution
The role of cortisone
Cortisone is a drug with the same functions as cortisol, a hormone produced in the adrenal cortex (above the kidneys).
Cortisol plays an important role in controlling the balance of salt and water in the body and regulates the metabolism of carbohydrates, fats and proteins.
In stressful situations, the body sends chemical substances to the adrenal glands to make this hormone.
How do corticosteroids work?
The steroids inhibit inflammation and the activity of the immune system.
Typical characteristics of inflammation are redness, warmth, swelling and pain.
The cortisone-containing agents act on the immune system by inhibiting the production of substances (prostaglandins) that trigger allergic and inflammatory reactions.
In inflammation, the white blood cells protect the body from infections and foreign organisms, such as viruses and bacteria.
In some diseases, however, the body’s defense system (immune system) does not function correctly.
Then the inflammation is directed against the body tissues and causes damage.
Cortisone preparations can cause leukocytosis, which means an increase in white blood cells.
Compared to the nonsteroidal anti-inflammatory drugs (NSAIDs), the corticosteroids have a stronger effect, but also more side effects.
The effect occurs quickly with both anti-inflammatories.
There are also natural remedies that can be used as an alternative to cortisone; these include, for example, blackcurrant and turmeric, which have the same effect on the adrenal cortex as cortisone-containing agents.
How are the steroids administered?
The corticosteroids are available in different dosage forms, which differ in release times and duration of residence in the organism.
Steroids can be administered as follows:
- Local Application directly to the inflamed area in the form of cream or ointment, for example, in atopic dermatitis;
- systemic, that means for the whole “system” or body.
Examples of local steroid treatment include joint injections, eye drops, ear drops, and skin creams.
Systemic treatments with steroids include:
- oral intake of medication (swallowing),
- Injection directly into the bloodstream (intravenously) or into the muscle (intramuscularly).
The systemically administered steroids enter the bloodstream and reach the different parts of the body.
It is taken during or immediately after meals to avoid irritation of the stomach.
If taken only once a day, it should take place in the early morning, before nine o’clock, in liquid form (suspension); the liquid must be shaken well before drinking.
If the drug is taken for a long period of time, it must not simply be discontinued without the doctor’s consent.
The dose should be reduced gradually.
Some cortisone preparations in comparison
Dexamethasone is used to treat arthritis, asthma, severe allergies, inflammatory bowel disease and skin diseases.
Eye drops with this active ingredient are used for allergic conjunctivitis.
According to the National Institutes of Health, it can also be given for adrenal dysfunction.
Hydrocortisone is available as a spray, liquid, lotion, gel, cream or oil and is applied to the skin.
Suppositories, enemas, fatty ointments and creams are used for itching.
This medicine may relieve skin irritation, rash and itching.
The possible side effects of cortisol are:
There is no evidence that taking cortisol during pregnancy causes harm to the child, but it can only be taken under medical supervision.
Betamethasone (trade name: Celestone) is a cortisol derivative and is used therapeutically in:
- inflammatory skin diseases,
- Sore throat
- chronic autoimmune diseases such as Crohn’s disease,
- rheumatoid arthritis,
- psoriatic arthritis,
- together with antibiotic also for otitis media.
Some patients have experienced that this medicine causes severe nervousness.
Methylprednisolone (Medrol (CH), metysolone (D)) is used to treat inflammation caused by conditions such as arthritis, ulcerative colitis (chronic inflammation of the colon lining), lupus, difficulty breathing, psoriasis and allergies.
is used to treat endocrine disorders, connective tissue diseases, skin diseases, allergies, breathing difficulties, blood diseases, chronic inflammation of the colon mucosa and eye diseases.
According to the University of Maryland Medical Center, more than 10 percent of those treated in the clinical trials experienced sleep disturbances, appetite increase, irritability and indigestion.
is used for inflammation caused by asthma, ulcerative colitis (chronic inflammation of the colon mucosa), arthritis, psoriasis, lupus, skin diseases and allergies.
Johns Hopkins University indicates that this drug may have various undesirable side effects.
Possible side effects of prednisone include: weight gain, high blood pressure, bone loss (osteoporosis), mood swings, bruising, sleep disturbances, stretch marks of the skin, acne, lens opacity (cataract) and glucose intolerance.
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