Voigt KH & Fehm HL
Clinical pharmacology of systemic glucocorticoid treatment.

Therapiewoche, 31(39): 6230-6240, 1981
ISSN: 0040-5973 Die Therapiewoche (PubMed)

Abstract
Glycocorticoids are very often prescribed and widely used (5 Mill. people in U.S.A.). Because of their strong potency it is necessary to focus the indication and to control the medication carefully. In this article the current ideas of the mode of action and the different kinds of therapeutic application are shortly described. The drugs are derivatives of endogenous cortisol, and therefore display the different functions of the glycocorticoids (metabolic, antiinflammatory-immunosuppressive, endocrine action); application for a longer time may induce the clinical aspect of endogenous Cushing's syndrome. If the adequate application is carefully checked it is possible to minimize the side effects: Replacement therapy for treatment of endogenous cortisol deficiency (primary (Addison's disease) and secondary (pituitary) adrenocortical insufficiency). Intensive short-term therapy using very high dosages for the treatment of potentially lethal conditions (different forms of shock, hypoglycemic coma etc.). Prolonged, high dose therapy. If possible, used in the form of alternate-day or the circadian steroid therapy (daily dose in the morning). Low dose, palliative therapy. Local application of steroids.