Prednisone (Deltasone, Orasone, Liquid Pred)

Category:

  • Miscellaneous

Description:

  • Corticosteroid (systemic)

Indications:

  • Anti-inflammatory or immunosuppressant agent in the treatment of a variety of diseases including those of hematologic, allergic, inflammatory, neoplastic, and autoimmune origin

Contraindications:

  • Systemic fungal infections

Precautions:

  • Pregnancy category B; compatible with breast feeding

  • Psychosis, acute glomerulonephritis, amebiasis, cerebral malaria, child < 2 years

  • Elderly, AIDS, tuberculosis, diabetes mellitus, glaucoma, osteoporosis

  • Ulcerative colitis, CHF, myasthenia gravis, renal disease, esophagitis

  • Peptic ulcer, ocular herpes simplex, live virus vaccines, hypertension

Adverse Reactions (Side Effects):

  • CNS: depression, headache, mood changes, psychosis, seizures, vertigo

  • CV: CHF, hypertension, tachycardia, thromboembolism, thrombophlebitis

  • EENT: blurred vision, cataracts, increased intraocular pressure

  • GI: abdominal distension, diarrhea, GI hemorrhage (esophagitis, peptic ulcer) increased appetite, nausea, pancreatitis

  • HEME: leukocytosis

  • METAB: Cushingoid syndrome, decreased glucose tolerance, decreased testosterone levels, growth suppression in children, HPA axis suppression, hypocalcemia, hypokalemia, metabolic alkalosis, sodium and fluid retention

  • MS: aseptic necrosis of femoral and humeral heads, fractures, muscle mass loss, osteoporosis, weakness

  • SKIN: acne, bruising, ecchymosis, petechiae, poor wound healing, striae, suppression of skin test reactions, thin fragile skin

Dosage:

Administered orally (tablet, solution)

  • Adult:   PO 50-60mg daily divided 1-4 times daily

    • Physiologic replacement: PO 4-5mg per square meter daily

    • Hepatic disease: Conversion to active metabolite, prednisolone, may be impaired; use prednisolone at same dosage

  • Child:   

    • Anti-inflammatory/immunosuppressive: PO 0.05-2 mg/kg/day divided 1-4 times

    • Acute asthma: PO I-2 mg/kg/day divided 1-2 times daily for 3-5 days

    • Asthma, long-term therapy: PO <1 year 10mg every other day, 1-4 years 20mg every other day, 5-13 years 30mg every other day, >13 years 40mg every other day

Drug interactions:

  • NSAIDs: increased risk of GI ulceration

  • Antidiabetics: increased blood glucose in patients with diabetes

  • Salicylates: enhanced elimination of salicylates; possible subtherapeutic salicylate concentrations

  • Cyclosporine: possible increased concentrations of both drugs, seizures

    

 
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