The document discusses the mechanisms, uses, indications, contraindications, and side effects of steroids and non-steroidal anti-inflammatory drugs (NSAIDs). Steroids, which mimic natural hormones, are used for various inflammatory and autoimmune conditions but have significant side effects and contraindications, including infections and gastric ulcers. NSAIDs work by inhibiting cyclooxygenase enzymes to reduce pain and inflammation but can also lead to gastrointestinal, renal, and cardiovascular issues.

1. Understanding
Steroids and NSAIDs
Mechanisms, Uses, and Considerations

2. Steroids Overview -
Mechanism of Action
• Mechanism of Action:
- Steroids are synthetic drugs that mimic the
action of natural hormones, particularly
glucocorticoids.
- Glucocorticoid Activity: Steroids enter cells and
bind to glucocorticoid receptors, leading to the
inhibition of inflammatory pathways and immune
responses.
-Mineralocorticoid Activity: The primary
endogenous mineralocorticoid is aldosterone,
and synthetic steroids with mineralocorticoid
activity can influence fluid and electrolyte
balance.

3. Steroids Overview -
Indications
• Indications:
- Inflammatory Conditions: Rheumatoid
arthritis, inflammatory bowel diseases
(Crohn's disease, ulcerative colitis).
- Allergic Reactions: Severe allergies,
anaphylaxis.
- Autoimmune Disorders: Lupus, multiple
sclerosis.
- Organ Transplantation: Prevention of
rejection.

4. Steroids Overview - Contraindications and
Side Effects
• Contraindications:
• - Active Infections: Steroids can suppress the immune system, worsening infections.
• - Peptic Ulcer Disease: May exacerbate gastric ulcers.
• - Live Vaccines: Contraindicated due to immunosuppressive effects.
• Side Effects:
• - Short-term: Increased appetite, mood changes.
• - Long-term: Osteoporosis, Cushing's syndrome, increased susceptibility to infections.
• Examples:
• - Prednisone: Commonly used, available in various oral doses.
• - Dexamethasone: Often used for its anti-inflammatory and immunosuppressive properties.
• - Methylprednisolone: Used for inflammatory conditions and allergic reactions.

5. NSAIDs Overview - Mechanism of Action
• Mechanism of Action:
Non-Steroidal Anti-Inflammatory Drugs
(NSAIDs) inhibit the activity of
cyclooxygenase (COX) enzymes, reducing
the synthesis of pro-inflammatory
prostaglandins.

6. NSAIDs Overview - Indications
• Indications:
- Pain Management: Acute and chronic pain
conditions.
- Inflammation: Arthritis (osteoarthritis,
rheumatoid arthritis), tendonitis, bursitis.
- Fever Reduction: Symptomatic relief.

7. NSAIDs Overview - Contraindications and Side
Effects
• Contraindications:
• - Gastrointestinal Issues: Peptic ulcer disease, gastrointestinal bleeding.
• - Renal Impairment: May worsen kidney function.
• - Cardiovascular Disease: Increased risk of events, especially with long-term use.
• Side Effects:
• - Gastrointestinal: Gastric ulcers, bleeding.
• - Renal: Impaired kidney function.
• - Cardiovascular: Increased risk of heart attack and stroke.
• Examples:
• - Ibuprofen: Commonly used for pain and inflammation, available over-the-counter.
• - Naproxen: Longer duration of action, also available over-the-counter.
• - Aspirin: Besides anti-inflammatory properties, it has antiplatelet effects.