Steroidal hormones produced in the adrenal cortex mainly it is involved in the regulation of physiological activity, such as:

  1. Immune response
  2. Carbohydrate metabolism
  3. Regulation of inflammation
  4. Protein metabolism
  5. Regulation of blood electrolyte level.

Types of Corticosteroids:

1. Glucocorticoid

2. Mineralocorticoid

1. Glucocorticoid

  • Dexamethasone
  • Prednisolone
  • Fludrocortisone


  • Glucocorticoids are used in the treatment of joint pain and inflammation, dermatitis, allergic reaction, asthma, Hepatitis, ulcerative colitis.
  • Used in the treatment of Addison’s disease.
  • Topical formulations are used for skin infection, asthma, and laryngitis.

Side Effects:

  • Anxiety, depression, psychosis.
  • Hyperglycemia.
  • Osteoporosis.
  • Retinopathy.



Pharmacological Action:

Carbohydrate and Protein Metabolism:

  • It promotes glycogen deposition in the liver.
  • It promote gluconeogenesis.
  • Induce protein break down.
  • Increases uric acid excretion.

Fat Metabolism:

  • Glucocorticoids induce lipolysis due to glucagon, growth hormone, adrenaline, and thyroxine.
  • Break down of triglyceride enhanced by cAMP.
  • Loses fat deposited over face, neck, and shoulder producing ‘moon face’, ‘fish mouth’ and ‘buffalo hump’.

Calcium Metabolism:

  • It enhances the renal excretion of calcium.
  • Results loss of Ca++ from bone, leading to negative calcium balance.

Cardiovascular System:

  • Maintain myocardial contractility.
  • It producing minor hypertension.

Skeletal Muscle:

  • Enhances muscular activity.
  • Excess glucocorticoid action leads to muscle wasting and myopathy.


  • Produces euphoria, insomnia, anxiety


  • It increases gastric acid and pepsin secretion.

Blood and Lymphoid Tissue:

  • Destruction of lymphoid tissue.
  • Increasing the no. of RBC by inhibiting hemolysis.
  • Decrease the no. of circulating lymphocytes, monocytes, basophils, eosinophils.

Effect on Immune Response:

  • Blocks the synthesis of cytokines.
  • Block the action of cytokines.
  • Increasing the expression of a gene coding for an enzyme that degrades inflammatory mediators.

Hydrocortisone (Cortisol):

  • Mainly used for the treatment of ulcerative colitis and hormone replacement therapy.


  • It is 4 times more potent than hydrocortisone and more selective. Act as anti-inflammatory, anti-allergic, and used for the treatment of autoimmune disease.


  • Potent and selective glucocorticoid. It is used for the allergic and inflammatory condition, which is long-acting.

2. Mineralocorticoid

  • Aldosterone is the prototype that produces mineralocorticoid effects.
  • By acting on the distal tubule aldosterone enhances the absorption of Na+.
  • A similar effect occurs in the colon, sweat gland, and salivary gland.
  • Deficiency of mineralocorticoid action leads to hyponatremia, hyperkalemia, acidosis.
  • Hyperaldosterinism results in positive Na+ balance increased plasma Na, hypokalaemia, alkalosis.

ACTH Inhibitors:

  • Aminoglutethimide: Which stop/inhibit the conversion of cholesterol to pregnenolone. Used in the treatment of adrenocortical cancer.
  • Metyrapone: 11 beta-hydroxylase enzyme inhibitor – used in Cushing’s syndrome and test of pituitary efficiency.
  • Mifepristone: Progesterone antagonist.
  • Ketoconazole: Inhibit the synthesis of all hormones in the testes and adrenal cortex, used in the treatment of Cushing’s syndrome and hirsutism in females.
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