Glukokortikoidi v nefrologiji I: Farmakologija in stranski učinki

Abstract

Glucocorticoids have been used in clinical medicine since 1940’s. Despite their long-time use they are still subject to active ongoing research. We describe the mode of action, pharmacology and side effects to facilitate proper prescription of these drugs. Glucocorticoids exert genomic and non-genomic effects, the latter become important at higher doses. The nomenclature of dosage ranges and the principles of dosage adjustments are given. Glucocortioid use is associated with frequent and relevant side effects in numerous organ systems. Prophylactic treatments for osteoporosis and infections are described. The suppression of hypothalamic-hypophyseal-adrenal hormonal axis determines the need for gradual glucocorticoid withdrawal and supplementation after discontinuation. Finally, glucocorticoid withdrawal syndrome is described.