Corticosteroids in Emergency Pathologies

Abstract

Ever since their discovery in the fifties of the last century, as an anti-inflammatory drugs for the treatment of rheumatoid arthritis, corticosteroids have found a significant place and wide application in various fields of medicine. Their effects are known to be diverse. The most significant ones are the anti-inflammatory, anti-allergic, and immunosuppressive effects. Furthermore, they affect the hematopoietic system. Corticosteroids produce complex metabolic effects by stimulating glyconeogenesis, increasing the uptake of amino acids in the liver and kidneys, and enhancing lipolysis. Given that natural adrenocortical hormones are synthesized under the influence of stress, it is expected that in the emergency situations, where we face vitally endangered patients whose body is under the stress due to respiratory insufficiency or impaired hemodynamics, corticosteroids do have significant place in the treatment. Thus, these drugs are used in the treatment of acute exacerbation of chronic obstructive pulmonary disease and asthma, in anaphylactic reactions, spinal shock, Addisonian crisis, and sepsis. During the COVID-19 pandemic, corticosteroids found their place in certain stages of treatment, as well as in many national protocols for the treatment of COVID-19 patients. Hence, the use of corticosteroids in the emergency pathologies will be reviewed in this chapter.