Prednisone important precautions and side effects, let us discuss precautions and side effects of prednisone. What is this drug, prednisone? Prednisone is one of the corticosteroids. With the suffix sone, we can identify this drug is a corticosteroid.
But we have another drug, prednisolone, which is having the suffix Solone, which is a related corticosteroid. What is the relation between the prednisone and Prednisolone? Actually, Prednisolone, when it is administered into the body, within the liver, it is going to be metabolized to give prednisolone.
So prednisolone is the active metabolite of prednisone. But still, these two drugs are not equivalent and both are available as corticosteroids. Both of these drugs can be used in the various conditions which are associated with inflammatory disorders such as arthritis.
respiratory disorders such as asthma and COPD, skin disorders like dermatitis, atopic dermatitis, contact dermatitis, and gastrointestinal disorders such as ulcerative colitis, Crohn’s disease. Similarly, in many of the inflammatory disorders, prednisone and prednisolone can be used as corticosteroids. But these two drugs are not equal and they are given as different dosage forms. Now, today in this , we are going to see what are the precautions and side effects of prednisone.
How do this drug is given as immediate release tablet as well as delayed release tablet. It’s also available as a solution. But as a tablet, it is given as immediate release tablet where the drug is immediately released.
And second one is a delayed release tablet where the drug is slowly released to produce the action for long duration throughout the day. And the dose range of prednisone is variable from 5 to 60 mg as the dose depends on the type of clinical indication. At different clinical settings, prednisone can be given at different dosages.
Now, let us the precautions of this drug. One of the important precaution of p ritonisone is that this drug, when entered into the systemic circulation, it can suppress HPA axis, hypothalamus, pituitary, and adrenal axis, resulting in the decreased cortisol levels.
This affects both adults as well as children. In the children, mental retardation can be observed with suppression of HP axis, and it can also result in few of the changes such as hyperglycemia, increased glucose levels, glucosurea, increased excretion of glucose within the urine, and even it can produce symptoms such as Cushing syndrome, resulting in moon phase. All these symptoms are observed with use of prednisone because at high dose, it can suppress the HP axis when it is used for long term.
So during the long term therapy with high dose of prednisone, any development of Cushing syndrome and suppression of HP axis should be thoroughly checked. Second important precaution of this drug is that prednisone can inhibit the activity of pH2 lymphocytes. The pH2 lymphocytes are responsible for immune activation.
When they are going to be suppressed, it result in immunosuppression, resulting in development of the infection such as bacterial as well as viral infections. So with the use of p ritonisone on long term, the risk of infections are increased, and it may also increase the risk of tuberculosis, vascular, or zoster infections in susceptible patients.
So in the compromised patients, this drug should be carefully given. And the report and effect of this drug is observed on the children. Since this drug is a corticosteroid, it can suppress the growth of the children, result in the retarded physical growth as well as mental retardation. That’s why this drug should be carefully used.
in the children and any reduction of growth and development of Cushing syndrome should be thoroughly checked. And the important effect of this drug is on the renal system. It can produce salt and water retention. Within the renal tubules, p ritonicone cause the absorption of sodium as well as water into the systemic circulation, which results in the elevated blood pressure.
At the same time, the potassium as well as calcium are excreted, resulting in decreased bone density as well as hypoglycemia. This hypoglycemia and along with elevated blood pressure may induce fear of the cardiovascular complications. And the report and effect of this drug is on the bone. It can reduce the bone mineral density, which is more pronounced in the postmenopausal women.
This is particularly observed because of improper utilization of calcium with use of prednisone. It can reduce the calcium absorption as well as it can increase the calcium excretion. So calcium levels within the bones are reduced, resulting in the decreased bone mineral density as well as development of osteoporosis.
So in the women, this drug should be carefully given. And on long term therapy, this drug may produce damage to the optic nerve, resulting in ophthalmic side effects. With use of prednisone, intraocular pressure may be increased after six weeks of the treatment. And at high dose, this drug may develop the cataracts as well as glaucoma.
So the patients with already any existing ophthalmic disorders, this drug should be carefully given. This drug can also produce some central effects. Being a corticosteroid, prednisone may produce insomia, lack of sleep, and even it can produce some euphoria, a state of wellbeing which are commonly observed with opiates.
But with the prednisone, again, euphoria can be observed in the patients. And the important precaution is on the gastrointestinal system. With the use of prednisone, it can produce gastrointestinal perforation, resulting in ulceration and bleeding. And again, this effect is observed on chronic use of this drug.
That’s why whenever corticosteroids are prescribed for long term, they can produce gastrointestinal disorders, abdominal extension, abdominal pain, and ulceration in the patients. Now, let us see the side effects of this drug. The important side effects mainly include elevated blood pressure, and it can also increase the weight gain because of fluid retention. And the important side effect is the insomia, lack of sleep.
It can also produce euphoria and dyspepsia, abdominal distension, abdominal pain can be observed with this drug. Even it can increase the appetite, which further increase the weight gain. And it can also induce the acne and gastric ulceration and perforation can also be observed with this drug.
So these are the various precautions and side effects produced by prednisone. Even this drug is used for many of the inflammatory disorders, but still this drug can produce a variety number of side effects. That’s why precaution should be taken with long term use of this drug, particularly at very high dose.
