Adrenal cortex synthesizes : corticosteroids

and androgens.
Corticosteroids : glucocorticoid (carbohydrate
metabolism regulating) and mineralocorticoid
(electrolyte balance regulating).
Cortisol (hydrocortison) is main glucocorticoid,
aldosterone is main mineralocorticoid.
 Effects :
Carbohydrate & protein metabolism
Lipid metabolism
Electrolyte & water balance : reabsorption Na,
excretion K, H and Ca.
Cardiovascular system
Skletal muscle : hypokalemia and hypocalcemia
Blood : polycytemia minor, lymphocytosis
Anti Inflamation & immunosupressive : inhibition
fuction of leukocyte by induce apoptosis programme.
 Absorption : oral, IM, IV
In plasma, corticosteroid is bound by protein
CBG and albumin, only free corticosteroid that
affected to cell.
Toxicity :
1. Withdrawal of therapy
2. Continued use of supraphysiological
glucocorticoid doses
 Therapeutics uses : replacment theraphy and
empirical theraphy.
When glucocorticoid are to be given over long
periods, the dose must be determined by trial
and error and must be the smallest one that
will achieve the desired effect.
Rheumatic Disorder
Effect of anti inflamatory
Starting dose : 5-10 mg/day of prednisone, in
acute condition 20-40 mg/day of prednisone.
Combined with another drugs
In non inflamatory degenerative joint disease
(like OA), glucocorticoids is administered by
local injection (tiamnicolon acetonid 5-20 mg).
Renal Disease
Nephrotic syndrome : first line, prednisone 1-2
mg/kgBB for 6 weeks, followed by a gradual
tapering off the dose over 6-8 weeks.
Allergic Disease
The onset of glucocorticoid in allergic disease
is delayed, acute theraphy with ephineprin.
Iv methylprednisolone 125 mg/ 6 hours can be
administered in severe allergic.
Preterm Infants
Betamethasone 12 mg IM every 24 hours two
doses or dexamethasone 6 mg IM every 12
hours four doses, are used frequently in the
setting of premature labor to decrease the
incidence of respiratory distress syndrome.
Spinal Cord Injury
Large dose methylprednisolone 30 mg/kgBB
followed infussion 5,4 mg/kgBB for 23 hours.
Acute adrenal insufficiency
Hydrocortisone IV bolus 100 mg and continous
infusion at a rate 50-100 mg/8 hours.
Chronic adrenal insufficiency
Hydrocortisone 15-20 mg/day divided into two
doses (10-15 mg on awakening and 5 mg in late
afternoon) or three doses (10 mg on awakening,
5 mg at lunch, 5 mg in late afternoon).