Corticosteroids readily diffuse into cells and bind to receptor proteins, forming complexes that reduce inflammation by decreasing cytokine production and cellular responses. This process takes approximately 3 hours to have a clinical effect. Intravenous steroids are used for emergencies to gain an hour over oral administration, while oral steroids are preferred for long-term use. Intramuscular depot injections last 3 weeks, intranasal steroids treat local nasal issues with low systemic exposure, and topical ear drops treat external ear conditions. Systemic steroids through various routes of administration treat various inflammatory and allergic conditions.

1. Role of Steroids in otolaryngology Dr T Balasubramanian

2. Introduction Corticosteroids are small lipophilic molecules

3. These molecules readily diffuse across cell membrane into the cytoplasm

4. Inside the cytoplasm these molecules bind to the corticosteroid receptors present there.

5. The steroid-receptor complex acts on transcription factors

6. Action of steroid-receptor complex This activated complex acts on transcription proteins found inside the cytoplasm

7. Causes a reduction in the amount of inflammatory cytokines secreted by the cell

8. Reduces the cells response to inflammation

9. Due to this complex mechanism of action there is a time delay between the administration of the drug and its clinical activity

10. Time delay of 3 hours is common

11. Intravenous steroids Useful during emergencies

12. One hour is gained when the drug is administered intravenously

13. Drugs with minimal mineralocorticoid effect is preferred

14. Methylprednisolone / Dexamethasone are preferred as intravenous steroids

15. Oral steroids Used in patients who need long term administration of the drug