Corticosteroids, also known as steroids, are a type of anti-inflammatory medication that is commonly prescribed. Their primary application is the treatment of diseases associated with rheumatoid arthritis, such as lupus or vasculitis (inflammation of the blood vessels). Specific corticosteroids include the medications cortisone and prednisone, which are both corticosteroids.
What are corticosteroids and how do they work?
Corticosteroids are synthetic drugs that closely resemble cortisol, a hormone that your adrenal glands naturally produce. Corticosteroids are used to treat a variety of conditions. Corticosteroids are frequently referred to as “steroids.” in the context of this article. Corticosteroids are distinct from the male hormone-related steroid compounds that some athletes use for performance enhancement purposes.
What are some of the different types of steroids?
Cortisone, prednisone and methylprednisolone are some of the corticosteroid medications available. Prednisone is the most commonly used type of steroid in the treatment of certain rheumatologic diseases. It is also the most expensive (like rheumatoid arthritis or lupus).
What method is used to administer steroids?
Steroid medications are available in a variety of forms, each of which differs in terms of how easily they dissolve and how long they remain in the body.
Steroids can be administered locally, to the exact location where a problem is present, or systemically, which means throughout the entire “system” or body, depending on the situation.
Local steroid treatments include joint injections, eye drops, ear drops, and skin creams, to name just a few examples. Systemic steroid treatments include oral medications (taken by mouth) as well as medications that are administered directly into a vein (intravenously or IV) or muscle (myocardial infusion, for example) (intramuscularly). Systemic steroids are transported throughout the body by the bloodstream to various organs.
It is preferable to use local steroid treatments rather than systemic steroids when possible in order to reduce the risk of side effects.
What is the mechanism of action of steroids?
Anti-inflammatory and immunosuppressive effects of steroids are achieved by suppressing the immune system’s activity. Immune response to infection and foreign substances such as bacteria and viruses is facilitated by inflammation, which is a process in which the body’s white blood cells and chemicals work together to protect the body. Certain diseases, on the other hand, are caused by a malfunctioning of the body’s defense system (the immune system). This could result in inflammation that works against the body’s tissues, causing damage to them. Among the signs of inflammation are:
Steroids work by inhibiting the production of chemicals that are responsible for inflammation. This helps to keep the amount of tissue damage to a bare minimum. Steroids also have the additional effect of suppressing the immune system’s activity by altering the way white blood cells function.
When are steroids administered?
Steroids are used to treat a variety of conditions in which the body’s defense system fails to function properly, resulting in tissue destruction. In some cases, steroids may be the primary treatment for a disease. Other conditions may necessitate the use of steroids only in limited circumstances or when other treatment options have failed.
When it comes to treating certain rheumatologic inflammatory conditions, steroids are commonly used. These include:
Systemic vasculitis(inflammation of blood vessels).
Myositis (inflammation of the muscle).
Rheumatoid arthritis (chronic inflammatory arthritis).
Systemic lupus erythematosus(a generalized disease caused by abnormal immune system function).
What are the advantages of steroids?
When inflammation threatens to damage critical body organs, steroids can be lifesaving, and in many cases, they can even save the organs themselves. People with lupus or vasculitis, for example, may benefit from steroids because they can prevent the worsening of kidney inflammation, which can lead to kidney failure. Steroid therapy may be able to eliminate the need for kidney dialysis or transplantation in these patients.
Low doses of steroids may be effective in providing significant pain and stiffness relief for people suffering from rheumatoid arthritis. Higher doses of steroids taken for a short period of time may be beneficial in helping a person recover from a severe flare-up of arthritis.
What criteria will my doctor use to determine whether or not steroids are the best course of action?
The decision to prescribe steroids is always based on the unique circumstances of each patient. Your healthcare provider will take into account your age, physical activity level, and any other medications you are currently using. Prior to beginning steroid treatment, your healthcare provider will make certain that you understand the potential benefits and risks of the medication.
- The potential benefits and risks of steroid use vary depending on the following factors:
- The nature and severity of the disease that is being treated are considered.
- It depends on whether or not there are any other treatment options available.
- The presence or absence of any other significant medical problems is taken into consideration.
The following are some of the possible side effects of steroids.
The likelihood of experiencing side effects is dependent on the dose, the type of steroid used, and the length of time spent on the medication. Some side effects are more severe than others, depending on their severity. The following are some of the most common side effects of systemic steroids:
- Increased desire to eat.
- Weight gain is a problem.
- Mood swings can occur.
- Muscle sluggishness.
- Vision that is hazy.
- Body hair is growing at a faster rate.
- Easily bruised
- Reduced resistance to infection
- Face that is swollen and “puffy”
- Osteoporosis (bone-weakening disease).
- Diabetes is diagnosed when it first appears or worsens.
- High blood pressure symptoms such as the onset or worsening.
- Irritation in the stomach
- Nervousness and restlessness are common.
- Sleeping is a challenge.
- Cataracts or glaucoma are two conditions that can occur.
- Water retention and swelling
These are the side effects that are most frequently experienced. There are no provisions for all possible side effects. If you have any questions about your personal situation, you should always consult with your doctor.
Is it true that everyone experiences side effects?
Not every patient will experience adverse effects. The frequency with which any side effect manifests itself varies from person to person.
If steroid use is limited in duration (from a few days to a few weeks), it is possible that none of the side effects listed will manifest themselves. When steroid injections are given for arthritis, tendonitis, or bursitis on an as-needed basis, the side effects listed here are unlikely to manifest themselves. However, if steroid use is carried out at high doses and for an extended period of time (ranging from a few months to several years), an increase in the number of side effects may be observed. The use of high-dose steroids for an extended period of time is only justified in the case of severe illnesses that pose a serious risk to the patient’s health.
What measures can be taken to reduce the side effects of steroid use?
A number of guidelines are followed by healthcare providers in order to reduce the side effects of steroids:
Steroids should only be used when absolutely necessary.
Keep a close eye on the patient in order to detect any early signs of serious side effects.
If at all possible, use local steroids to treat localized issues.
Use the smallest dose necessary to maintain disease control.
Continue to gradually reduce the dose so long as the disease remains under control.
Monitor your blood pressure and blood sugar levels frequently, and seek treatment if necessary.
Bone density should be monitored, and medications and supplements to promote bone health should be prescribed.
There are other approaches that can be used to avoid certain side effects, and these should be discussed with your healthcare provider on an individual basis.
See also A Guide to Safe Steroid Stacking
Corticosteroids that are commonly used
There are a variety of corticosteroids available, both locally applied and systemically absorbed. The majority of these medications are available in oral, topical, and injectable forms.
Some of the most commonly used generic and brand names are as follows:
Mometasone (Nasonex spray)
Prednisolone (Orapred, Omnipred)
Hydrocortisone (Cortef, Hydrocort)
Prednisone (Deltasone, Prednicot, Cotolone)
According to what you have seen so far, corticosteroids are a highly adaptable class of medications. Dosages vary widely depending on the condition for which you are being treated by your doctor, as well as your overall health. Due to this high variation in doses, they are often taken orally and injected with a needle or through an IV.
Certain medical conditions may have an impact on the ability to use corticosteroid medications effectively. Please inform your doctor if you have any pre-existing medical conditions.
It is especially important to inform them if you have any of the following conditions:
- HIV or AIDS
- herpes simplex infection of the eye
- gastrointestinal problems
- high blood pressure
- any kind of infection (viral, bacterial, fungal)
- a disease of the heart, liver, thyroid, or kidney
- have had a recent surgery or serious injury
Corticosteroids can also have an adverse effect on the effects of certain medications. The likelihood of interactions occurring with steroid sprays or injections, on the other hand, is extremely low.
When taking corticosteroids, you should be cautious about what you eat. Certain steroids should not be taken with food due to the possibility of interactions.
Interactions between tobacco and alcohol and certain medications, including corticosteroids, have also been reported. If you consume alcoholic beverages or smoke on a regular basis, speak with your doctor about the impact this may have on your treatment.
What are antibiotics and how do they work?
Antibiotics are medications that aid in the prevention and treatment of infections caused by bacteria. They accomplish this by either killing the bacteria or preventing them from reproducing or copying themselves.
Antibiotics are defined as drugs that are “against life.” The term “antibiotic” refers to any medication that kills germs within your body. However, the term is most commonly used when referring to antibiotics, which are drugs that are intended to kill bacteria.
A large number of people died from minor bacterial infections such as strep throat prior to the discovery of antibiotics in the early twentieth century. Surgery was also more dangerous. However, since the discovery of antibiotics in the 1940s, life expectancy has increased, surgeries have become safer, and people have been able to survive infections that were previously fatal.
What antibiotics are capable of and are not capable of
The majority of bacteria that live in your body are completely harmless. Some of them are even beneficial. Bacteria, on the other hand, can infect almost any organ. Antibiotics, on the other hand, are usually effective.
Antibiotics are effective in treating the following types of infections:
- Some ear and sinus infections
- Infections of the teeth
- Infections of the skin
- Meningitis (swelling of the brain and spinal cord)
- Throat infection
- Infections of the bladder and kidneys
- Pneumonia caused by bacteria
- Whooping cough
- Clostridioides difficile
Antibiotics can only be used to treat bacterial infections, not viral infections. Viruses are responsible for the common cold, the flu, the majority of coughs, some bronchitis infections, the majority of sore throats, and the stomach flu. Antibiotics will not be effective in treating them. It is likely that your doctor will advise you to either wait out these illnesses or prescribe antiviral medications to assist you in getting rid of them.
It is not always easy to tell whether a virus or a bacterial infection is present. Occasionally, your doctor will order tests before determining which treatment you require.
Some antibiotics are effective against a wide range of bacteria types. They are referred to as “broad-spectrum.” Others are limited to a single type of bacteria. They are referred to as “narrow-spectrum.”
Symptoms and side effects
Because your gut is teeming with bacteria — both good and bad — antibiotics frequently have a negative impact on your digestive system while treating an infection. The following are examples of common side effects:
- Irritable bowel syndrome (IBS)
- Pain in the abdomen
- Appetite sluggishness
- You may also experience other symptoms from time to time, such as:
- Hives are a rash on the skin that is raised and itchy.
- Tightness in the throat or difficulty breathing
If you experience any of these symptoms, you should contact your doctor right away to rule out an allergic reaction to your antibiotic.
As a result, if you are taking birth control pills, antibiotics may prevent them from working as effectively as they should. Consult your doctor about whether alternative birth control methods might be a good option for you. While taking antibiotics, women are at risk of developing vaginal yeast infections. Itching, burning, vaginal discharge (which resembles cottage cheese), and pain during sex are some of the symptoms of this condition. Anti-fungal cream is applied to the affected area.
Antibiotic Resistance is a serious problem
The use of antibiotics is important because they are a powerful germ-fighting tool when used properly and safely. However, it is estimated that up to half of all antibiotic use is unnecessary. Antibacterial resistance has developed as a result of overuse. Bacteria evolve and evolve over time, eventually becoming “super bacteria” or “superbugs.” Antibiotics no longer work on them because of the changes they have undergone. They are a significant threat because there are no medications available to kill them.
The most effective way to aid in the slowing of the spread of super bacteria is to use antibiotics with caution. Here’s how it is done:
- If your doctor tells you that you do not need them, believe him or her.
- They should not be used to treat a viral infection.
- Take only the medications that your doctor has prescribed for you.
- Follow the directions on the label.
- Do not forget to take your medication on time.
- Take them for the full number of days that your doctor has prescribed by him or by her.
- Do not put them off until later.
Combination of corticosteroids and antibiotics
In theory, the use of antibiotics in conjunction with corticosteroids appears to be illogical. In order to recover from infection, the infected tissue will require all of its available resources, including hyperemia, edema, phagocytosis, and the production of antibodies, in order to defend itself against the infecting agents, eventually with the assistance of antibiotics. All of these protective mechanisms are known to be slowed down, if not completely stopped, by corticosteroids, which we know or assume to be true. Consequently, the tissue is left without its natural defenses, allowing the infection to spread unhindered and unchecked. However, whether or not the infection can be stopped by artificial means (e.g. antibiotics) remains to be seen; this will depend on the infecting agent’s susceptibility to the antibiotics used, as well as the possibility of maintaining an effective level of these antibiotics in the affected area.
In practice, however, and particularly in the field of ophthalmology, the use of this combination may be extremely beneficial in certain situations. In the first place, because the ocular tissues are so vulnerable, the defense mechanisms often cause far more damage than the intruders: far too often, a house is burned down in order to kill a mouse. Even in the case of purulent infections, this is the case. For example, antibiotics can be used to stop the progression of panophthalmia, but the patient is left with an eye that is rendered useless due to prolonged vitreous infiltrates. Is such a large-scale infiltration absolutely necessary to defeat the infection? Without a doubt, when antibiotics are employed. In that case, corticosteroids (either directly with prednisone or indirectly with ACTH) can be used to prevent the tissue reaction without putting the patient’s health at risk, resulting in a minimal clouding of the vitreous and the eye emerging from the ordeal in perfect condition.
If the infective agent is susceptible to antibiotic treatment, it appears to be preferable to remove the situation from the organism’s clumsy hands and to bring the situation to a close by our own means; cleanly, quickly, and without leaving a mess behind. According to ophthalmological terminology: without corneal scars, without glaucoma attacks, etc.
According to a study published in the journal CHEST, treating severe community-acquired pneumonia (CAP) with a combination of corticosteroids and antibiotics may be a cost-effective strategy.
In order to compare the costs of corticosteroids plus antibiotics with the costs of placebo plus antibiotics in individuals with CAP, the researchers developed a decision-analytic model that was used in the study. The participants were adult hospital patients with CAP, and the use of corticosteroids was assessed at all levels of severity using the Pneumonia Severity Index throughout the study. Index classes I through III were classified as non-severe, and index classes IV and V were classified as severe, according to the classification system. In order to determine cost-effectiveness, the avoided deaths and incremental cost-effectiveness ratios were calculated, respectively. The researchers modeled cost-effectiveness planes and acceptability curves for a range of willingness-to-pay thresholds when they were unsure of the answer. In this study, the costs and outcomes were calculated for a time horizon of two months, and the analysis was done from a societal standpoint.
The use of corticosteroids in conjunction with antibiotics resulted in a savings of $142,795 for each life saved. For a willingness to pay ranging from $0 to $50,000, the combination of corticosteroids and antibiotics was found to be cost-effective in 87.6 percent to 94.3 percent of simulations, according to the acceptability curves for cost-effectiveness and cost-effectiveness acceptability. Corticosteroids and antibiotics were found to be cost-effective in participants with Pneumonia Severity Index classes IV and V, resulting in a savings of $70,587 and an 82.6 percent chance of being cost-effective. A probability analysis conducted with a willingness-to-pay of $50,000 revealed that corticosteroids plus antibiotics had an 86.4 percent chance of being cost-effective when combined with other treatments.
Additionally, when adverse events were excluded from the analysis, the mean cost for the corticosteroids plus antibiotics group was $38,035.79 and for the antibiotics plus placebo group was $43,398.04 when the analysis did not include adverse events. The corticosteroid strategy has the potential to prevent one death out of every 27 patients treated. This conclusion was reached as a result of the difference in effectiveness between the two groups, as measured by the probability of survival between them (0.9536 for the corticosteroid plus antibiotic group and 0.9168 for the placebo plus antibiotic group).
As the researchers concluded, “Given the significant health and economic burden that CAP imposes, as well as the controversy surrounding the use of corticosteroids in CAP, our analysis provides useful information for clinical decision-makers on the economic efficiency of employing this strategy for the treatment of CAP.”
Can I take any other medications with my steroid prescription?
Before beginning any new medication, consult with your IBD team or pharmacist to determine whether there is a possibility of an interaction with steroids. Likewise, this applies to any over-the-counter medications as well as any herbal, complementary, or alternative medicines or treatments. If you are seeing a doctor or going to the dentist, you should inform them that you are taking steroids.
Anticoagulants (such as warfarin), blood pressure medications, antiepileptic medications, antidiabetic medications, antifungal medications, bronchodilators (such as salbutamol), and diuretics are just a few of the medications that can interact with steroids.
The combination of steroids with aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may increase the risk of developing peptic ulcers, according to some research. Consider asking your IBD team if taking proton pump inhibitors, which can help prevent ulcers, would be beneficial in your situation if you require both medications.
Why is it important to only take antibiotics when they are absolutely necessary?
Antibiotics are critical in the treatment of infections, and they have saved countless lives over the years. However, whenever antibiotics are used, they have the potential to cause side effects as well as contribute to antibiotic resistance, which is one of the most serious threats to public health today.
At the point at which antibiotics are required, the benefits typically outweigh the risks of side effects and antibiotic resistance. However, an excessive number of antibiotics are prescribed unnecessarily and are misused, endangering the effectiveness of these critical medications.
In order to protect ourselves from the harm caused by unnecessarily using antibiotics and to combat antibiotic resistance, it is critical that we all only use antibiotics when they are absolutely necessary.
When are antibiotics unnecessary?
Unnecessary antibiotic use occurs when a person has prescribed antibiotics when they are not required, such as when treating a cold or the flu with antibiotics.
In addition, when a person is prescribed antibiotics for infections that are caused by bacteria that do not always necessitate the use of antibiotics, such as many sinus infections and some ear infections, the use of antibiotics is deemed unnecessary.
What exactly is antibiotic misuse?
Antibiotic misuse occurs when a person has prescribed the incorrect antibiotic, the incorrect dose of an antibiotic, or the incorrect length of time for the administration of an antibiotic.
Consult with your doctor to determine the most effective treatment for your illness.