What’s the difference functionally between corticosteroids and other medicines?

Question

My understanding at the moment is that steroids are man-made emulations of hormones (substances that send a signal to the body) and other medications such as Ibuprofen work by suppressing existing bodily signals.

Steroids are like your parents telling you to stop spilling your water all over the floor because you’ll slip. (The intensity of their demands increase by dosage)

Other medicines are like your parents passively cleaning up your spills. (Higher dose = parents spending more energy checking for spills and cleaning them up)

What do I have wrong in my understanding and could I please get a good explanation of how common steroids and other drugs work as examples? How does this tie into each substance’s half life?

Thanks!

In: 1

Answer 1

Your characterization of steroids as mimicking hormones, and ibuprofen as suppressing existing signals, is a good enough explanation. However, steroids aren’t unique here. Plenty of drugs mimic existing compounds in the body. For example, psychedelic drugs such as psilocybin mimic serotonin.

There’s also more complexity there than just activating or inhibiting. Our bodies already balance things through activation and inhibition (positive and negative feedback loops). So you might have a drug that inhibits a chemical that inhibits *other* chemicals. Then taking the drug will enhance those other chemicals. By analogy, maybe your younger sibling bugs you a lot, but your parents are playing with them so you can clean.

A third way drugs can work is by making existing chemicals more (or less) effective. An example is Xanax, a benzodiazepine. It doesn’t bind to the GABA receptor where GABA does, but to a different spot, to make it easier for GABA to bind. It’d be like your parents standing in the living room and encouraging you, cheering you on, to clean the kitchen.

Half-life is not super related to whether the drug is activating or inhibiting things. It depends more on other stuff: How fast does the drug get absorbed and travel to its destination? How long does it bind for before falling off? Where is it broken down (anywhere VS liver only VS not at all)? How fast is it filtered out through the kidneys?