Pharmachologic effect

GKS. It has a pronounced anti-inflammatory and anti-allergic effect, has anti-shock and immunosuppressive activity. Affects various types of metabolism: increases the level of glucose in the blood, has a catabolic effect, promotes the redistribution of adipose tissue, can cause osteoporosis, causes retention of sodium and water ions in the body, increases blood pressure. Influences the inflammatory process in the connective tissue and reduces the possibility of scar tissue formation.

Pharmacokinetics is an inactive substance that, after absorption from the gastrointestinal tract, enters the liver and is converted into an active metabolite, prednisolone. Plasma protein binding of prednisolone is 90%. Prednisolone further undergoes biotransformation in the liver, kidneys and bronchi to oxidized forms, which form conjugates with sulfuric and glucuronic acids. It is excreted by the kidneys mainly unchanged.

Indication of the active substance

Rheumatism, rheumatoid arthritis, dermatomyositis, periarteritis nodosa, scleroderma, ankylosing spondylitis. Bronchial asthma, allergic diseases. False croup in children. Addison’s disease, acute adrenal insufficiency, adrenogenital syndrome. Hepatitis, hepatic coma, hypoglycemic conditions, lipoid nephrosis. Agranulocytosis, various forms of leukemia, lymphogranulomatosis, thrombocytopenic purpura, hemolytic anemia. Chorea. Pemphigus, eczema, pruritus, exfoliative dermatitis, psoriasis, pruritus, seborrheic dermatitis, lupus erythematosus, erythroderma, alopecia.

Dosage regimen

Individual. For adults, the initial dose is 20-30 mg / day, the maintenance dose is 5-10 mg / day. If necessary, the initial dose may be 15-100 mg / day, the maintenance dose is 5-15 mg / day. The daily dose should be reduced gradually. For children, the initial dose is 1-2 mg / kg / day in 4-6 doses, the maintenance dose is 300-600 μg / kg / day.

Side effect

From the endocrine system: Itsenko-Cushing’s syndrome, weight gain, hyperglycemia up to the development of steroidal diabetes, depletion (up to atrophy) of the adrenal cortex, negative nitrogen balance.

From the digestive system: increased acidity of gastric juice, ulcerogenic effect on the gastrointestinal tract.

On the part of the water-electrolyte balance: increased excretion of potassium, sodium retention in the body with the formation of edema.

On the part of the cardiovascular system: arterial hypertension.

From the musculoskeletal system: osteoporosis, aseptic bone necrosis.

From the side of the central nervous system: mental disorders, steroid cataract, provoking latent glaucoma.

Others: decreased resistance to infections, delayed wound healing, increased blood clotting.

Contraindications for use

Peptic ulcer of the stomach and duodenum in the acute phase, osteoporosis, Itsenko-Cushing’s disease, a tendency to thromboembolism, renal failure, severe arterial hypertension, systemic mycoses, viral infections, vaccination period, active tuberculosis, glaucoma, productive symptoms in mental illness. Hypersensitivity to prednisone.

Application during pregnancy and lactation

During pregnancy (especially in the first trimester), it is used for health reasons.

Application for impaired renal function

Contraindicated in renal failure.

Application in children

Application is possible according to the dosage regimen.

Special instructions

During treatment (especially long-term), it is necessary to observe an ophthalmologist, control blood pressure and water-electrolyte balance, as well as pictures of peripheral blood and blood glucose levels; in order to reduce side effects, you can prescribe anabolic steroids, antibiotics, and also increase the intake of potassium into the body (diet, potassium preparations).

If there is a history of psoriasis, high-dose prednisone is prescribed under strict medical supervision. In diabetes mellitus, it is prescribed only for absolute indications or for the prevention of suspected insulin resistance.

For nonspecific infections, it is used with caution and subject to simultaneous chemotherapy or antibiotic therapy. In latent forms of tuberculosis, prednisone can only be used in combination with anti-tuberculosis drugs.

In Addison’s disease, concomitant use with barbiturates should be avoided.

After discontinuation of treatment, withdrawal syndrome, adrenal insufficiency, as well as exacerbation of the disease, for which prednisone was prescribed, may occur.

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