This episode explores adrenal corticosteroids as the pharmacology of adaptive stress. Glucocorticoids and mineralocorticoids are essential for survival-mobilising energy, maintaining blood pressure, and modulating immunity-but their power lies in transience. We trace ACTH control, steroid synthesis, receptor actions, and feedback suppression to understand why both deficiency and excess produce characteristic, system-wide syndromes. Therapeutically, this is a chapter about respect: dosing, timing, and tapering matter as much as the drug itself.

Key takeaways to carry forward:

* Axis control: ACTH as a gatekeeper rather than a throttle.

* Steroid diversity: glucocorticoid vs mineralocorticoid effects and targets.

* Genomic influence: why effects are delayed yet enduring.

* Clinical use and misuse: replacement, anti-inflammatory therapy, and iatrogenic harm.

* Withdrawal logic: adrenal suppression and the necessity of tapering.

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