Corticosteroids (Glucocorticoids)

Endocrine & Metabolic

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Examples

prednisonehydrocortisonedexamethasonemethylprednisolone

Prefix / Suffix: -sone, -solone

Physiology

Cortisol from adrenal cortex regulates inflammation, immune response, glucose, and stress response. Synthetic forms suppress inflammation and immunity.

Mechanism of Action

Bind glucocorticoid receptors to suppress inflammatory and immune responses, alter glucose/protein/fat metabolism, and inhibit cytokine production.

Indications

Inflammatory and autoimmune diseases (RA, lupus, IBD)
Asthma and COPD exacerbations
Allergic reactions, anaphylaxis
Adrenal insufficiency (replacement)
Organ transplant immunosuppression
Cancer (some)

Side Effects / Adverse Effects

Hyperglycemia
Weight gain, moon face, buffalo hump (Cushingoid appearance)
Osteoporosis
Increased infection risk (immunosuppression)
Peptic ulcers
Mood changes, insomnia
Adrenal suppression with long-term use
Cataracts, glaucoma

Contraindications

Active untreated infection
Live vaccines (during high-dose therapy)
Hypersensitivity

Nursing Considerations

Take with food to reduce GI upset
Take in the morning to mimic natural cortisol rhythm
Never stop abruptly after long-term use — taper to avoid adrenal crisis
Monitor blood glucose (hyperglycemia common)
Monitor for signs of infection (may be masked)
Calcium and vitamin D supplementation for osteoporosis prevention
Wear medical alert bracelet if on long-term therapy
Stress dose may be needed during illness or surgery

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.