Individual Adrenal Steroids

The relative potencies2 for glucocorticoid and mineralocorticoid (sodium-retaining) effects which are shown in Table 34.1 are central to the choice of agent in relation to clinical indication.

All drugs in Table 34.1 except aldosterone are active when swallowed, being protected from hepatic first-pass metabolism by high binding to

2 Potency (the weight of drug in relation to its effect) rather than efficacy (strength of response): see page 94. If a large enough dose of a glucocorticoid, e.g. prednisolone, were administered, the Na+-retention would be almost as great as that caused by a mineralocorticoid. This is why, in practice, different (more selective, and potent) glucocorticoids, not higher doses of prednisolone, need to be used when maximal stimulation of glucocorticoid receptors is desired (e.g. in the treatment of acute transplant rejections).

TABLE 34.1 Relative potencies of adrenal steroids

Compound (tablet strength, mg)

Approximate relative potency

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