Prednisolone is a dehydrogenated equivalent of hydrocortisone. It provides anti-inflammatory, anti-allergic, desensitizing, anti-shock and immunosuppressive effects.
How Prednisolone works
When using Prednisolone, the effects of the drug are implemented through stabilizing cell membranes, suppression of macrophage accumulation, decreasing leukocyte migration, capillary permeability decrease, which blocks the formation of edema. Prednisolone inhibits phagocytosis, affects the metabolism of arachidonic acid along with the synthesis and release of inflammatory mediators. The immunosuppressive effect of Prednisolone is due to inhibition of the activity of T- and B-lymphocytes, a decrease in the content of complement in the blood, as well as inhibition of the production and effects of interleukin-2.
Prednisolone exhibits a catabolytic effect, increases the level of glucose in the blood, exhibits some mineralocorticoid activity, increases reabsorption in the renal tubules of Na+ and water, and increases the excretion of K+ and Ca2+ from the body, especially when their level in the blood plasma increases. Prednisolone inhibits the synthesis and secretion by the pituitary gland of ACTH and secondary by GCS adrenal glands.
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Usage and dosage
In case of acute adrenal insufficiency, 100-200 mg per dose is prescribed, 300-400 mg per day.
In case of severe allergic reactions, 100-200 mg of Prednisolone is taken per day for 3-16 days.
In case of bronchial asthma, the medicine is prescribed according to the intensity of the illness and the productivity of complex therapy from 75 to 675 mg per treatment period from 3 to 16 days; in tough cases, the dose can be increased to 1400 mg per treatment course or more with a slow dose lowering.
For people with asthma, Prednisolone is taken at a dose of 500-1200 mg/day, decreasing then to 300 mg/day and then pass to maintenance doses.
In case of thyrotoxic crisis, 100 mg of the remedy is taken in a dose of 200-300 mg per day; if it is required, the daily dose can be increased to 1000 mg. The period of usage depends on the therapeutic effect, as a rule up to 6 days.
In case of shock resistant to common therapy, Prednisolone is typically injected at the start of course in a jet manner, after which it is shifted to drip administration. If within 10–20 min the blood pressure does not increase, make the injection of the drug one more time. After the shock state has ended, proceed with drip administration until blood pressure becomes normal. One dose is 50-150 mg (in tough cases, up to 400 mg). The drug should be taken again after 3-4 hours. The daily dose can be 300-1200 mg (followed by dose reduction).
In case of acute hepatic-renal failure, 25–75 mg of Prednisolone per day is taken; if indicated, the daily dose may be increased to 300-1500 mg per day and above.
In case of rheumatoid arthritis and systemic lupus erythematosus, Prednisolone is taken along with systemic usage of the drug at a dose of 75-125 mg per day for no more than 7-10 days.
In case of acute hepatitis, Prednisolone is administered at 75–100 mg/day for 7–10 days.
Side effects of Prednisolone and how to cope with them
Prednisolone is prescribed for a long term (the full course of therapy until the drug is discontinued may last 6-12 months). It is necessary to prescribe additional drugs to prevent side effects of Prednisolone.
1. Prednisolone may cause digestion disorder, nausea, vomiting, and more serious complications like steroid ulcer. In order to protect the mucous membrane of the upper parts of the gastrointestinal tract (esophagus, stomach, duodenum), you should also take the so-called gastroprotective drugs. These are antacid medications, H+ pump blockers, drugs that improve gastrointestinal motility. All doses of drugs are selected individually according to age and body weight.
2. Bone protection. Long-term use of steroids can cause a decrease in bone mass, so-called steroid osteoporosis (rarefaction of bone tissue) can develop, which ultimately leads to bone fractures. But this condition can also be prevented by taking calcium and Vitamin D pills. The doses of drugs is also selected individually.
Another things you need to pay attention to:
- Be sure to monitor blood pressure
- Ophthalmologist observation: vision control, intraocular pressure and lens of the eye.
- With a very long reception of Prednisolone, check the level of glucose in the blood.
- Mental health condition. Children very often become moody, sometimes even aggressive. This condition disappears on its own after discontinuation of the drug.
- Keep track of weight and diet. During the course of Prednisolone, appetite increases very much. However, you can control the nutrition by limiting the intake of easily digestible carbohydrates.
- In order to control and evaluate the effectiveness of gastroprotective therapy, the mucous membrane of the upper parts of the gastrointestinal tract is examined by endoscopy.
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