Which of the following steroids is the least potent?

• A. Dexamethasone
• B. Cortisone
• C. Methylprednisolone
• D. Prednisone

Answer: (B)

Cortisone is considered the least potent steroid among the options listed. The potency of corticosteroids is primarily determined by their anti-inflammatory effects, which can vary widely based on their molecular structure.

Cortisone itself is a prodrug and must be converted in the body to cortisol to exert its therapeutic effects. This conversion process limits its immediate efficacy compared to other steroids that are active in their administered form. In contrast, dexamethasone, methylprednisolone, and prednisone all exhibit higher anti-inflammatory properties due to their specific structures, which enhance their receptor affinity and reduce the duration of action when compared to cortisone.

As a result, cortisone is often seen as having a lower therapeutic index for severe inflammatory conditions, and clinicians tend to prefer the more potent alternatives available when treating such conditions. This aspect is crucial for healthcare professionals to consider when selecting corticosteroid therapy to ensure effective management of the patient’s condition.