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Prednisone

An immunosuppressant used for the treatment of autoimmune disorders. It may decrease inflammation by reversing increased capillary permeability and suppressing polymorphonuclear (PMN) leukocyte activity.

It is an oral steroid with approximately 5 times the potency of endogenous steroids.

A synthetic glucocorticoid drug that is used to suppress the immune system.

Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone.

It is used to treat inflammatory diseases, moderate allergic reactions, some autoimmune diseases, and certain types of cancer.

Usually administered orally, in the form of tablets.

US: C Risk not ruled out in pregnancy, but is generally considered safe to use during pregnancy.

Routes of administration: Oral, Nasal, Rectal, IV

Bioavailability 70%.

Metabolism of prednisolone in the liver.

Elimination half-life 3 to 4 hours in adults. 1 to 2 hours in children.

Excretion-Renal

Common side effects: weight gain, high blood pressure, mood changes, blurred vision, dizziness, and headache.

Long-term use can lead to cataracts, bone loss, thrush, easy bruising and muscle weakness.

Metabolized to prednisolone.

Utilized in many different autoimmune diseases and inflammatory conditions, including: asthma, COPD, rheumatic disorders, allergic disorders, ulcerative colitis and Crohn’s disease, adrenocortical insufficiency, hypercalcemia due to cancer, thyroiditis, laryngitis, severe tuberculosis, urticaria, pericarditis, multiple sclerosis, nephrotic syndrome, sarcoidosis, shingles, lupus, myasthenia gravis, poison oak exposure, Ménière’s disease, autoimmune hepatitis, the Herxheimer reaction, Duchenne muscular dystrophy, uveitis, and as part of a drug regimen to prevent rejection after organ transplant, migraine headaches, cluster headaches and aphthous ulcer.

Used as an antitumor drug in acute lymphoblastic leukemia, non-Hodgkin lymphomas, Hodgkin’s lymphoma, multiple myeloma, and other hormone-sensitive tumors, in combination with other anticancer drugs.

Can be used in the treatment of decompensated heart failure to increase renal responsiveness to diuretics, especially in heart failure patients with refractory diuretic resistance with large dose of loop diuretics.

Can improve renal responsiveness to atrial natriuretic peptide, inducing a potent diuresis.

Short-term side effects, as with all glucocorticoids, include high blood glucose levels.

It’s mineralocorticoid effects are minor.

Long-term side effects include Cushing’s syndrome, steroid dementia, weight gain, osteoporosis, glaucoma and cataracts, diabetes mellitus type 2, and depression.

Associated with:

Increased blood sugar

Emotionql lability.

Difficulty in concentration.

Weight gain

Immunosuppression.

Facial swelling

Depression, mania, psychosis, or other psychiatric symptoms.

Unusual fatigue or weakness.

Mental confusion

Muscle atrophy

Blurred vision

Abdominal pain

Peptic ulcer disease

Arthralgias

Steroid-induced osteoporosis

Stretch marks

Osteonecrosis

Insomnia

Cataracts

Glaucoma

Anxiety

Black stool

Stomach pain

Bloating

Edema

Mouth sores

Dry mouth

Hepatic steatosis

Nervousness

Acne

Skin rash

Appetite gain

Hyperactivity

Increased thirst

Frequent urination

Diarrhea

Reduced intestinal flora

Leg pain/cramps

Sensitive teeth

Headache

Induced vomiting

If taken for longer than seven days, the body may temporarily lose the ability to manufacture natural corticosteroids, that is it causes adrenal suppression.

The drug should not be abruptly stopped if taken for more than seven days, but the dosage should be gradually decreased.

Weaning the drug off may take from a few days to months, depending upon the length of treatment.

When using prednisone on a chronic basis, alternate day therapy may preserve adrenal function and reduce side effects.

May be stopped abruptly in those whose disease is unlikely to relapse and who have received treatment for 3 weeks or less and who are not included in the patient groups described above.

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