Adrenal cortex

Classification

The adrenal cortex synthesizes two classes of steroids. They are as follows:

Glucocorticoids: These steroids regulate the carbohydrates, proteins, and the fat metabolism and are intimately involved in the operation of the processes that enable the body to resist infections and stress.

Example—hydrocortisone and cortisone.

Mineralocorticoids: These steroids mainly influence salt and water balance (and hence, the control of blood volume and blood pressure) by maintaining proper electrolyte balance.

Example—aldosterone, 11-deoxycorticosterone.

i. Cortisone (Cortogen, Cortone)

Synthesis

Properties and uses: It is a white, crystalline powder, insoluble in water, and soluble in alcohol. It is used in rheumatoid arthritis, severe shock, allergic conditions, and chronic lymphatic leukaemia.

Dose: The dosage for adults is 20–100 mg per day by oral or IM.

ii. Hydrocortisone (Hydrocortone, Lortef)

Synthesis

Properties and uses: It exists as white crystalline powder, soluble in water and in alcohol. It is used as an anti-inflammatory agent.

Dose: The dose as injection is 100 mg intramuscular (IM) and as topical cream 1%–2.5% for skin, ear, and eye.

iii. Prednisolone (Prelone, Emsolone)

Synthesis

Properties and uses: It is a white crystalline powder, sparingly soluble in alcohol. It is four times as potent as hydrocortisone.

Dose: The oral dose for adult is 5–60 mg per day. As IM, IV, and intra-articular (IA) injection, the dose is 10–40 mg, and for topical use (skin and eyes), the dose is 0.25%.

iv. Dexamethazone (Dalalone)

Synthesis

Properties and use: It exists as white crystalline powder, soluble in alcohol and insoluble in water. Used as an anti-inflammatory and antiallergic drug.

Dose: Oral adult dose is 500 μg to 9 mg daily. The topical dose for conjunctiva is 1 drop of 0.1% suspension.