Glucocorticoids in Dentistry

The term glucocorticoid is used interchangeably with corticosteroids. The word “glucocorticoid” implies that they have a fundamental action on glucose metabolism, they do but it turns out that the corticosteroids used in therapeutics are really anti-inflammatory steroids.


Obvious uses for glucocorticoids are when pts have adrenal insufficiency (such as Addison’s Disease). Very rarely will you find such a pt, who has to have exogenous cortisol-type drugs taken daily. Overwhelmingly, the use in medicine and dentistry is as an anti-inflammatory agent. They are not like NSAIDs; they have a totally different mechanism. They also are used for immunosuppression, for pts who have had an organ transplant or who have some autoimmune disease. There are myeloproliferative diseases in which a variety of steroids are used. Drugs such as triamcinolone and dexamethasone particularly, have a particularly useful role in dentistry.


Forget about the mineralocorticoids, we don’t use these in dentistry.


Steroid synthesis inhibitors could theoretically be used in Cushing’s-like diseases where you want to suppress the production of steroids. Notice the drug ketoconazole, this is a prominent anti-fungal agent with a side effect against the synthesis of steroids.


Another class is that which blocks the steroid receptor, we see spironolactone, which blocks aldosterone action on the kidney. Also we see other drugs such as the controversial RU 486, which is the controversial contraceptive/abortion pill.

Category: Pharmacology Notes