Corticosteroids — Non-endocrine Uses & Long-term Effects

Introduction

• Definition — Corticosteroids are the C21 steroid hormones of the adrenal cortex (plus their synthetic analogues) — functionally split into glucocorticoids (cortisol/hydrocortisone — anti-inflammatory + carbohydrate/protein/fat metabolism) and mineralocorticoids (aldosterone — Na⁺/K⁺/fluid balance).
• Therapeutic era — Opened by Hench (1949) with the dramatic relief of rheumatoid arthritis by cortisone (Nobel Prize 1950); because glucocorticoids act on almost every organ system, starting systemic therapy always demands a deliberate risk–benefit weighing in each patient — the recurring theme of the whole topic.
• Two examinable pillars — The high-yield RGUHS question is built on two pillars — the non-endocrine (pharmacotherapeutic) uses that exploit the anti-inflammatory/immunosuppressive action, and the long-term adverse effects (iatrogenic Cushing syndrome + HPA-axis suppression) that limit chronic use.
• Palliative, not curative — In non-endocrine disease, corticoids are empirical and palliative — they suppress manifestations without removing the cause, favour spread of infection and impair healing; use is justified only when benefit outweighs this hazard.