Elsevier

Clinics in Dermatology

Volume 4, Issue 1, January–March 1986, Pages 161-169
Clinics in Dermatology

Adverse effects of corticosteroids: II. systemic

https://doi.org/10.1016/0738-081X(86)90020-9Get rights and content

Abstract

Corticosteroids are one of the most widely used group of drugs in the world today. The beneficial effects on the illness being treated must be weighed against the many adverse reactions (Table 1), which may be affected by the route of administration—topical, oral, intravenous, intramuscular, or intralesional. The major adverse reactions through systemic administration will be considered in this chapter.

Corticosteroids are hormones produced and released by the adrenal cortex and controlled by the pituitary through release of adrenocorticotropic hormone (ACTH). Hormonal steroids may be classified as those having important effects on intermediary metabolism (glucocorticoids), those having primarily salt-retaining activity (mineralocorticoids), and those having androgenic and estrogenic activity. The major glucocorticoid in man is cortisol, and the major mineralocorticoid is aldosterone (Table 1).

Glucocorticoid hormones exert their effect by binding to a specific receptor site located on the cell surface and entered by simple diffusion into the cytoplasm of the cell. This complex is translocated to the nucleus, binds to chromatin, and causes formation of specific mRNAs which then mediate the response to the glucocorticoid.1

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