What Are Medical Steroids?

Medical steroids may have a couple of differing definitions. First, they may refer only to steroids that are anabolic or that are similar in composition to hormones like testosterone, which is primarily produced in the male body. In this context, the adjective "medical" is used to differentiate between prescribed steroids and unauthorized steroid use for things like body building or performance enhancing, which are discouraged by the medical community. Alternately, medical steroids could refer to all steroids including corticosteroids that may be used to treat medical conditions.

In this second definition, medical steroids include corticosteroids, which may be used as anti-inflammatory drugs. A number of conditions are treated with corticosteroids including severe asthma, allergies, autoimmune diseases, transplant rejection, and inflammatory bowel or intestinal conditions like Crohn’s disease. Medications like prednisone and budesonide (Entocort®) are some of the most common corticosteroids used and they may be taken orally, injected, or inhaled depending on the condition they treat.

Another common member of the medical steroids that is a corticosteroid is hydrocortisone or cortisol. Hydrocortisone is available in weak strength preparations over the counter and might be used in ointment form to treat minor skin irritations. Higher strengths of this steroid are available by prescription and could be used as skin ointment or in different preparations for many medical purposes.

Sometimes the term medical steroids addresses testosterone based steroids that may be abused. Continued concern about doping with anabolic steroids plagues many types of professional sports leagues and there are some severe consequences that may result from using anabolic steroids without medical need. It is just as important to remark that anabolic steroids have many legitimate uses worth exploring.

Different formulations of anabolic steroids might be prescribed to address conditions where males have low levels of testosterone that creates perpetual problems with energy, mood and/or sexual dysfunction. Some conditions arrest puberty in young males and can be treated with testosterone. Diseases that create body wasting or significant weight loss might also be treated with medical steroids; this is particularly the case when people can’t gain weight due to ongoing illnesses like cancer or HIV.

Administration of any form of medical steroids has risks and benefits. Doctors plan use very carefully so that people do not constantly take either anabolic steroids or corticosteroids, unless it's absolutely needed. Using limited doses may help minimize side effects that in corticosteroids include greater likelihood of infections and in anabolic steroids hazard significant changes in mood, adverse effects to the cardiovascular system, and other side effects. Given these risks, many argue that steroids should always be used medically, and never in non-medical settings.

Types of Steroids – A Complete Guide

No one with a television or Internet access in USA is a stranger to the term steroids or what it means to professional athletes. Major league baseball, professional football, pro wrestling, and professional cycling have all come under the microscope. But what are steroids? What do they do? How do they work? In this guide, we’ll go through the types of steroids that occur naturally in our bodies, what they’re used for when they are synthesized for prescription drugs, and how they work as illegal performance enhancing drugs. We’ll look at a few famous cases of steroid use and abuse, and we’ll also touch on the subtle difference between “doping” and using steroids.

So what are steroids, and what do the different types of steroids do? According to Dr. Benjamin Wedro, MD, two types of steroids occur naturally in the body. Corticosteroids, produced in the adrenal gland, include aldosterone, which helps the body manage sodium content, and cortisol, which aids in our stress response and in controlling inflammation. Corticosteroids are often synthesized and prescribed for topical, aural, or intravenous use to treat inflammation, asthma, rheumatoid arthritis, inflamed bowel disease, and other disorders.

Corticosteroids v. Anabolic Steroids
The other type of steroids, androgenic or anabolic, are testosterone-controlling hormones. They regulate the levels of hormones in the testicles or ovaries. Androgenic steroids control the development of male sex traits, while anabolic steroids control and contribute to the growth of muscle mass. This is why patients undergoing female to male sex reassignment are often prescribed androgenic steroids, but not necessarily anabolic steroids. Anabolic steroids are the most known and most controversial steroids, as they are often synthesized and used illegally by athletes to gain more muscle mass for performance enhancement. Some examples of anabolic steroids are Metribolene, Androstenediol, Methyltestosterone, and 1-Androstenediol, but there are many, many more synthesized anabolic steroids in use both legally and illegally.

Now let’s talk about problems with steroid use and professional athletes. The most recent scandal in the news with an athlete using performance-enhancing drugs is the case of Alex Rodriguez. The famous New York Yankees’ third baseman, known for his amazing record and his brief relationship with Madonna, is now known for his alleged involvement in the Biogenesis doping scandal. According to Michael Schmidt of The New York Times, the anabolic steroid in use in this case was Human Growth Hormone, or HGH. Rodriguez is facing a suspension and penalty fees, but anabolic steroid use can land you in a lot more trouble than that. Sprinter Marion Jones won five gold medals in the 2000 Sydney Olympics, only to have them all stripped from her, and then do subsequent jail time, in 2007 when it was found that she had been doping with EPO (Erythropoietin) and a designer cocktail of anabolic steroids.

It should be noted that EPO is not a steroid, but a blood oxygenator. Athletes who use EPO are said to be “blood doping,” a different form of performance enhancement than steroid use. We have refrained from mentioning the famous scandal surrounding Lance Armstrong and his seven consecutive Tour de France victories because Armstrong was an alleged blood doper, using EPO rather than anabolic steroids. One drug test, however, in 1999 came back with a positive for steroids. Armstrong and his team claimed that this was a false positive, as he’d been using a corticosteroid topical cream to treat skin irritation, which was legal in the sport but could create a false positive.

So, there are two general types of steroid. Both corticosteroids and androgenic/anabolic steroids are produced naturally in the body. Corticosteroids are often synthesized and used for inflammation, while anabolic steroids affect muscle growth. So, when you hear about a friend taking steroids for a bad case of poison ivy, don’t expect her to bulk up and lift a car for you. All performance-enhancing steroids are anabolic steroids. There is a whole range of designer anabolic steroids, but they all boil down to increasing the levels of muscle-building hormones in the body.

Treating Eczema with Steroids

Treatment with steroid-based corticosteroids can mean relief from the constant itching and accompanying red, scaly skin patches of eczema.

Yet, many patients and their families are fearful of using steroids due to potential side effects associated with the medications. This fear, or “steroid-phobia,” among patients can be lessened by working with a dermatologist who is trained in prescribing these medications, can monitor patients closely, and knows how to incorporate creative treatment strategies to minimize side effects.

Eczema, a chronic disease in which the skin becomes itchy and inflamed, affects about 15 million Americans. One of the most common forms of eczema is atopic dermatitis, or AD, which can occur on just about any body part. AD takes a physical and emotional toll because it can be painful and physically unattractive, causing skin redness, swelling, cracking, weeping, and scaling.

The majority of patients have a “mild” form of the disease, meaning the AD affects less than 20 percent of the body surface area. Still, left untreated, even the mild form can result in itching and rashes that become a significant and visible reminder of the disease. For people whose AD affects more than 20 percent of their bodies, the disease can be a physically painful problem.

Goals of Treatment
One of the most important goals of eczema treatment is to prevent the development of rashes by avoiding those things that trigger itching. In the mildest form of the disease, simple moisturizers and cold compresses may help relieve and prevent the dry, itchy skin of eczema. However, experts note, once skin inflammation occurs, prevention is less effective and anti-inflammatory agents, such as corticosteroids, become necessary to effectively manage the condition.

It has been shown time and time again that the key to the safe and effective use of these agents is to use them under the watchful eye of a dermatologist experienced in prescribing them. Despite the potential side effects, studies have shown that severe side effects are rare when dermatologists prescribe long-term continuous low-potency corticosteroid treatment for up to 10 years, or intermittent mid-potency topical treatment for moderate to severe eczema. It is important that dermatologists carefully monitor patients using corticosteroids for any period of time. Another essential element of successful treatment is that patients consistently take or apply their medications as prescribed by their dermatologists.

Topical Corticosteroids: Types and Uses
Corticosteroids, including nonprescription and prescription forms, are widely used in the treatment of eczema. This class of substances is related to a natural hormone that can diminish an inflammatory response. In particular, glucocorticosteroids (GCSs), which have been used since 1951 for a wide variety of inflammatory skin diseases, offer very effective anti-inflammatory properties.

For the treatment of mild to moderate inflammatory skin diseases, dermatologists usually first use topical GCS therapy, meaning patients apply the medication to their skin. These preparations include less potent nonprescription and more potent prescription forms. Topical types of the medication can be delivered to the skin in many different forms including as an ointment, lotion, cream, and foam.

The medications are classified according to their potency, or strength. Topical hydrocortisone, which is a low-potency GCS available in non-prescription and prescription forms, is used on areas of sensitive skin, such as the face or in the skin folds. Mid-potency GCSs, such as flurandrenolide and betamethasone dipropionate in lotion form, are prescribed by dermatologists and are appropriate for lesions on the torso. Prescription-only high-potency topical GCSs, such as fluocinonide, betamethasone dipropionate, in lotion, cream or ointment form, and clobetasol propionate, are reserved for short treatments of up to two weeks for stubborn lesions, as well as rashes on the palms of the hands or soles of the feet.

Dermatologists strive to use the mildest forms of topical medications possible in order to minimize potential side effects. However, they might use a higher-potency corticosteroid for a short period to address an acute situation; then continue with milder forms.

Dermatologists generally use the topical form of corticosteroids to treat atopic dermatitis rashes that do not have open or crusted sores. They might use the higher-strength preparations for tougher-to-treat thickened skin, and scaly or oozing rashes. The creams, lotions, ointments, or foams are usually applied one to two times a day, depending on the patient’s age and the strength of the preparation.

Corticosteroid treatments usually significantly clear intermittent rashes in two to three days. Dermatologists may use topical corticosteroids for only a short time — until the rash is cleared. In general, intermittent treatment with high potency topical corticosteroids will last seven to 10 days; while low- to mid-strength corticosteroid treatment can last two to three weeks.

Oral/Systemic Corticosteroids: Treatments of Last Resort
Dermatologists usually will not prescribe oral or injected (systemic) forms of corticosteroids unless the atopic dermatitis, or other chronic eczema, is severe or topical agents have not worked. Still, the oral medications have their places in treatment. For example, they are often effective in reducing inflammation and itching, and a high initial dose can eliminate rashes quickly. In addition to recalcitrant severe chronic disease, oral/systemic steroids may be indicated to treat widespread acute eczema, such as severe allergic contact dermatitis to poison ivy. Systemic corticosteroids include: methylprednisolone, hydrocortisone, prednisone, and prednisolone.

These medications are not recommended for use during pregnancy due to studies that show birth defects, such as cleft lip and cleft palate, may be associated with the use of systemic corticosteroids during pregnancy. 

Typhoid Fever

Typhoid fever is an acute contagious disease associated with bacteria of the genius Salmonella. The agent can be kept in the ground and in the water from 1 to 15 months. It dies when healed and under the action of the usual detergents.

The only source of incidence is infected person and the carrier. The rods of Typhoid fever are transmitted directly by dirty hands, flies, waste waters. Most dangerous are outbreaks connected with taking infected foods (milk, cold meat, etc).

Symptoms and course
Incubation period lasts from 1 to 3 weeks. In typical cases the Typhoid fever starts gradually. The diseased experience such symptoms as weakness, rapid fatigability, moderate headache. In the next days those symptoms do increase, the temperature of the body raises up to 39-40 "С, appetite do lowers or totally disappears, the sleep is interrupted (sleepiness by day and insomnia by night). Also patient can have stool retention and windiness. Till 7-9 day of the disease rush may appear on the upper parts of abdomen skin or on lower parts of the chest. The rush is represented by small red spots with sharp edge having diameter 23mm rising over skin surface and are called roseolas. A new roseola may appear in the place where a roseola disappeared.

The next symptoms are common for patients: restraint, face paleness, decrease in heart rate, lower blood pressure. Also may appear specific bronchitis. The tongue  may be dry and cracky, covered with muddy brown fur, edges and tip of the tongue having no fur. Also may appear rude curmurring of the intestinum cecum and pain of right iliac region, liver and spleen may get increased. The number of leukocytes in peripheral blood is lowered.

To recognize the Typhoid fever is very important to detect early symptoms such as high body temperature lasting more than one week, headache, lowering of physical activity, breakdown, sleeping disorders, appetite disorders, specific rush, sensitivity during palpation of the right part of the abdomen, the increase of the liver and spleen. In laboratory are used next analysis for diagnosis updating: immunofluorescence method and serologic testing.  

Treatment
For the treatment is used antimicrobial agent called laevomycetin which is prescribed 0,5-0,75gr 4 times per day for 10-12 days. Intravenous is injected 5% glucose solution or normal saline 500-1000gr. In severe cases are injected corticosteroids. Patients should remain at bed rest minimum 7-10 days.

Preventive Measures
1. sanitary inspection of food processors, water systems, canalization
2. early detection of patients and their isolation
3. disinfection of rooms, clothes, utensils
4. fight with flies
5. after disease dispensary observation
6. specific vaccination