Prednisone
Prednisone is a synthetic corticosteroid drug which is
usually taken orally but can be delivered IM (intramuscular i.e an injection)
and can be used for a large number of different conditions. It has a mainly
glucocorticoid effect. Prednisone is a prodrug that is converted by the liver
into prednisolone, which is the active drug and a steroid.
Uses
Prednisone is particularly effective as an immunosuppressant
and affects virtually all of the immune system. It can therefore be used in
autoimmune diseases, inflammatory diseases (such as severe asthma, severe
poison ivy, and Crohn's disease), various kidney diseases including nephrotic
syndrome, and to prevent and treat rejection in organ transplantation.
Prednisone tablets are furthermore used in the
pharmaceutical industry for the calibration of dissolution testing equipment
according to the USP (United States Pharmacopeia).
History
Prednisone was invented in the early 1950s when Arthur
Nobile at Schering demonstrated that the side effects of cortisone such as
water retention, high blood pressure and muscle weakness could be removed by
oxidisation of the drug through exposure to microbes. The drug was introduced
by Schering in the mid-1960s.
Dependency
Adrenal suppression occurs if prednisone is taken for longer
than 7 days, a condition which means the body is unable to synthesize natural
corticosteroids and becomes dependent on the prednisone taken by the patient.
For this reason, prednisone should not be stopped abruptly if taken for longer than
seven days, but needs to be reduced slowly; this reduction may be over a few
days if the course of prednisolone was short, but may take weeks or months if
the patient has been on long-term treatment. Abrupt withdrawal will lead to an
Addisonian crisis, which may be life-threatening.
Side effects
Short-term side effects, as with all glucocorticoids,
include high blood glucose levels, especially in patients who already have
diabetes mellitus or are on other medications that increase blood glucose (such
as tacrolimus), and mineralocorticoid effects such as fluid retention.
Additional short-term side effects include insomnia and rarely mania. Long-term
side effects include Cushing's syndrome, weight gain, osteoporosis, glaucoma,
type II diabetes mellitus, and depression upon withdrawal.
Ocular side effects of glucocorticoids include glaucoma and
cataract formation. While most commonly associated with topical or intraocular
administration, these ocular complications may also occur with oral,
intravenous, or even inhaled administration.
Major
depression, mania, or other psychiatric symptoms
unusual fatigue or weakness
blurred vision
abdominal pain
peptic ulcer
infections
painful hips or shoulders
osteoporosis
acne breakouts
Minor
weight gain and stretch marks
facial swelling
nervousness
acne
rash
increased appetite
insomnia
hyperactivity
Source: wikipedia GFDL
