Pharmacology for Dentistry

282 Section 8/ Drugs Acting on Endocrine System

Pharmacological Actions

Corticosteroids are synthesized in the
adrenal cortex under the influence of ACTH.
Glucocorticoids affect the metabolism of
carbohydrates, proteins, fats, calcium and
electrolytes.
Metabolic effects: Glucocorticoids
promote glycogen deposition in liver by
stimulating glycogen synthetase activity and
increasing glucose production from protein.
They also inhibit peripheral utilization of
glucose and increase glucose release from
liver. It produces resistance to insulin.

Glucocorticoids also cause breakdown of
protein and amino acid mobilization from
peripheral tissues. They stimulate the

conversion into glucose (neoglucogenesis) in

the liver.

Glucocorticoids inhibit the uptake of glucose

by fat cells, resulting in increased lipolysis. The

increased insulin secretion in response to

hyperglycaemia also stimulates lipogenesis and

ultimately increase in fat deposition.

The catabolic effect on bone can cause

osteoporosis in Cushing’s syndrome.

Glucocorticoids maintain normal

glomerular filtration rate. The

adrenalectomized animal can not excrete a

water load and tend to develop water

intoxication and this can be treated by

glucocorticoids.

Glucocorticoids also inhibit calcium

Table 8.3.1: Classification of glucocorticoids and mineralocorticoids.

Glucocorticoids

Hydrocortisone (Cortisol; HYCOSON) 100 mg IM used as hydrocortisone sodium succinate

injection. Also used as intraarticular inj. as

hydrocortisone acetate & 1-2.5% topical (skin, ear &

eye; WYCORT)

Prednisolone (EMSOLONE) 5-60 mg/day oral, 10-40 mg intramuscular/intra

articular inj. and 0.25% topical (skin, eye)

Triamcinolone (TRICORT) 8-32 mg/day oral, intraarticular (2.5-15 mg),

intradermal and deep intramuscular injection. 0.1%

topical cream (as acetonide; LEDERCORT)

Dexamethasone (DEXONA) 0.5-5 mg/day oral, 4-20 mg/day IM/IV, 0.1% topical

(skin cream) as dexamethasone sodium phosphate

and trimethyl acetate

Betamethasone (BETNESOL) 0.5-5 mg/day oral, 4-20 mg/day IM/IV, 0.1 topical

cream as betamethesone benzoate (TOPICASONE)

and betamethasone valerate (BETNOVATE)

Beclomethasone (as dipropionate; BECLATE) 0.025% topical (cream)

Fluocinolone (as acetonide; FLUCORT) 0.025% topical (ointment)

Mineralocorticoids

Desoxycorticosterone acetate (DOCA) 10-20 mg IM (once or twice in a week), 0.25 mg SL.

Flurdocortisone (FLORICORT) 0.2-2 mg/day

Aldosterone: It is a mineralocorticoid. Its actions are retention of sodium and reduction of serum potassium.

It acts on distal tubules of kidney to increase sodium reabsorption (details are discussed in chapter ‘Diuretics

and antidiuretics’).