Side-Effects of Long-Term Treatment With Corticosteroids and Corticotrophin

Treadwell, B. L. J.; Sever, Emily; Savage, Oswald; Copeman, W. S. C.

doi:10.1016/s0140-6736(64)91804-5

Cited by 70 publications

(38 citation statements)

References 6 publications

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“…The reported incidence of hypertension in this latter instance is at least 20%, which is considerably less than described in Cushing's syndrome, although the discrepancy may partly reflect the manner in which blood pressure data were recorded in the early studies of exogenous steroid therapy and the variable definition of hypertension (Savage et al, 1962;Treadwell et al, 1964). It is evident from experimental studies in normal human subjects that ACTH and cortisol both raise blood pressure within 3-5 days (Whitworth et a/., 1983b;Connell et al, 1987b).…”

Section: Glucocorticoid Hypertensionmentioning

confidence: 90%

Hormones and Hypertension

Fraser

Davies

Connell

1989

Clinical Endocrinology

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The importance of changes in hormone secretion in human hypertension is a complex problem and too large to be dealt with in uniform detail in a short review. The subject encompasses not only the effects on blood pressure of primary endocrine disorders but also hormonal changes secondary to increased blood pressure. Some aspects are more fully understood than others and have been the subjects of relatively recent detailed reviews. Where this is the case, the current review has summarized the present position and cited reviews and key papers, in order to reserve space for more controversial and less well understood conditions such as the hypertension of growth hormone, thyroid hormone or glucocorticoid excess. CORTICOSTEROIDSThe human adrenal cortex synthesizes and secretes a large number of steroid hormones, biosynthetically interrelated with each other and with qualitatively and quantitatively different biological activities. The two major categories of compound are the adrenal androgens (androstenedione, dehydroepiandrosterone and testosterone) which, as far as is known, are not important in blood pressure control and will not be considered further (although there exist experimental models of hypertension which may be androgendependent), and the corticosteroids. These C21 steroids of the pregnane series exert two main types of action, mineralocorticoid and glucocorticoid effects, and excess secretion of either has widespread repercussions, particularly for neuromuscular function and the control of salt and water metabolism. Mineralocorticoids act mainly on the distal nephron via specific receptor activation to promote sodium reabsorption (with associated changes in extracellular fluid and plasma volume) and increased potassium and proton excretion, so that excess activity is characterized by hypokalaemia and a metabolic alkalosis. Aldosterone is the major mineralocorticoid in man but deoxycorticosterone (DOC) and corticosterone also have significant activity. More recently discovered compounds-18-hydroxy DOC, 18-oxocortisol and several compounds modified at position 19 (19-hydroxy or 19-nor)-may also contribute to the total mineralocorticoid action of the adrenocortical secretion (see review by Fraser & Padfield, 1985). Cortisol is the major human glucocorticoid. Glucocorticoids promote liver glycogen and protein synthesis but are catabolic in most other tissues, increasing lipolysis and protein R. Fraser et al.breakdown and reducing glucose uptake from the circulation. However, the kidney also possesses specific glucocorticoid receptors and, under experimental conditions, glucocorticoids can be shown to promote both natriuresis and kaliuresis, at least partly by raising glomerular filtration rate (GFR) and also to modulate Na+-H+ exchange in the proximal nephron (Davis & Howell, 1953;Mahnensmith & Aronson, 1985; Kinsella et al., 1985). Excess of either mineralocorticoid or glucocorticoid activity is associated with hypertension.The control of adrenocortical function is similarly complex and the subject of sev...

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Section: Glucocorticoid Hypertensionmentioning

confidence: 90%

Hormones and Hypertension

Fraser

Davies

Connell

1989

Clinical Endocrinology

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“…By using Naranjo causality assessment scale 9 ADRs were possible and 7 ADRs were probable. Our study was consistent with the study of Treadwell.B, et al 12 . who found that corticosteroid causes hypertension, facial mooning, osteoporosis in the subjects who were on corticosteroid therapy.…”

Section: Discussion:-mentioning

confidence: 99%

Evaluation of Corticosteroid Utilization Pattern in Tertiary Care Hospital, Dehradun.

Dabral¹

2018

IJAR

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Background: Corticosteroids are widely used as potent antiinflammatory and immunosuppressive drugs to treat a wide range of diseases. This study evaluates the rational use of corticosteroid amongst hospitalized patients. Objectives: To investigate the utilization and evaluation pattern of corticosteroids in various department of tertiary care hospital. Methodology: A prospective observational study was conducted on 90 patients receiving corticosteroids in the various departments of ShriMahantIndiresh Hospital, Dehradun, Uttarakhand. Patients receiving corticosteroid therapy were included in the study, exclusion of those patients who were of age less than 18, patients with psychiatric disease and those patients not willing to sign on inform consent form. Result: The study involved 90 patients to evaluate the appropriate use of corticosteroids. Majority of patients were of age group >60 years, followed by 41-50 years, 51-60 years, 31-40 years, 18-30 years respectively. Majority of corticosteroids were prescribed to females than males. Prednisolone was the mostly used corticosteroid (34.40%) followed by hydrocortisone (18.9%), budesonide (14.4%), methylprednisolone (11.1%), dexamethasone (11.1%), deflazacort (5.6%) and prednisone (4.4%). Total 16 ADRs were detected in the study. Total 24 drug interactions were found in 90 prescription, the majority of drug interactions were moderate 15 (62.50%) followed by major 5 (20.83%) and minor 4 (16.67%). Conclusion: There was lack of appropriate guidelines for use of corticosteroids and drug interaction reporting, which could be considered an emerging scope of pharmacy. Commonly geriatric population was more prone to diseases, for which steroids were used.

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“…Rhythms of BP and HR in HAM 71 treated with prednisolone which exerts a pressor effect (Treadwell et al 1964;Whitworth et al 1989). Moreover, the 24-hr means of systolic and diastolic blood pressure in our controls were lower than those previously reported (prayer and Weber 1985 ; Zachariah et al 1989).…”

Section: Discussionmentioning

confidence: 99%