Steroids and Opioids

Sterois • Corticosteroids are important therapeutic agents used to treat allergic and inflammatory disorders or to suppress undesirable or inappropriate immune system actions. • Synthetic drugs that closely resemble cortisol • Physiologically, steroids are normally produced by adrenal cortex through cholesterol metabolism and are grouped into: Glucocorticoids- Mainly hydrocortisone (Cortisol) Mineralocorticoids-Aldosterone Androgens – Dihydroepiandrosterone (DHEA) and estrogen (sex hormones) Glucocorticoids • Cortisol is the prototype and is synthesized from cholesterol mainly in ona fasciculate of the adrenal glands. • Normally 20mg of cortisol equivalent of 5mg of predinsolone is secreted daily. • It stimulates glucose production from proteins (gluconeogenesis) and may stimulate fat acid synthesis leading to fat deposition osing for lcocorticois • Hydrocortisone is the agent of choice for physiologic replacement. Usual dosing strategies to mimic normal cortisol production is 20 mg each morning and 10 mg at 4:00 pm. • During periods of stress, doses of up to 300 mg daily may be required to prevent signs and symptoms of adrenal insufficiency, including hypoglycemia, hypotension, and cardiovascular collapse.