[Chemistry and pharmacology of glucocorticosteroids]

The glucocorticosteroids are derived chemically from androsterone or pregnane. Their natural models are cortisone and cortisol (or hydrocortisone), characterised by the presence of oxygen or an oxydryle group at 11, of a --CO -- CH2OH group in the 17 position and of an-OH group in the 17 position. Their anti-inflammatory power dominate their pharmacodynamics: it goes hand in hand with their power to increase gluconeogenesis. They have an immunodepressant effect whose power seems to be proportional the their anti-inflammatory action. The use of hydrocortisone in the treatment of shock remains empirical. The mechanism of their anti-allergic effect remains debated. Glucocorticosteroids disturb lipid and protein metabolism, water and electrolyte balance, the central nervous system, and gastric secretion; they inhibit the secretion of ACTH. Their pharmaceutical forms are numerous: they are adapted to the oral route and to the parenteral routes (i.m., i.v., i.r., intra-articular) and to external use (cutaneous and mucosal applications).