Adrenal corticosteroids prednisone

Low-dose corticosteroids (prednisone, prednisolone, or dexametha-sone) are indicated in patients with adrenal hyperandrogenism or acne fulminans. 

Prednisone -corticosteroid -leukocytosis -nausea and vomiting indigestion -anorexia or increased appetite -CNS effects (depression, anxiety, euphoria, insomnia, psychosis, confusion) -fluid retention -hyperglycemia -osteoporosis -acne -adrenal insufficiency with prolonged use... 

IX.b.3.1. Corticosteroids. These reverse symptoms associated with active inflammation, but should be used with caution, if at all, in those suspected of having disease complicated by flstulation and abscesses. Although prednisone has been the standard treatment, the poorly absorbed steroid budesonide has shown equivalence of action whilst having reduced suppression of the pituitary-adrenal axis. The effect of corticosteroids is, in general terms, equivalent to that of an elemental diet. 

Urgent treatment is often begun with an oral dose of 30-60 mg prednisone per day or an intravenous dose of 1 mg/kg methylprednisolone every 6 hours the daily dose is decreased after airway obstruction has improved. In most patients, systemic corticosteroid therapy can be discontinued in a week or 10 days, but in other patients symptoms may worsen as the dose is decreased to lower levels. Because adrenal suppression by corticosteroids is related to dose and because secretion of endogenous corticosteroids has a diurnal variation, it is customary to administer corticosteroids early in the morning after endogenous ACTH secretion has peaked. For prevention of nocturnal asthma, however, oral or inhaled corticosteroids are most effective when given in the late afternoon. 

The interaction between the corticosteroids and phenobarbital is well documented, well established and of clinical importance. Concurrent use need not be avoided but the outcome should be monitored. Increase the corticosteroid dosage as necessary. The extent of the increase is variable. Dex-amethasone, hydrocortisone, " methylprednisolone, prednisone and prednisolone are all known to be affected. Prednisone and prednisolone appear to be less affected than methylprednisolone and may be preferred. Be alert for the same interaction with other corticosteroids and other barbiturates, which also are enzyme-inducers, although direct evidence seems to be lacking. The dexamethasone adrenal suppression test may be expected to be unreliable in those taking phenobarbital, just as it is with pheny-toin, another potent enzyme-inducer. See Corticosteroids + Phenytoin , p.1059. 

The greatest potassium loss occurs with the naturally occurring corticosteroids such as cortisone and hydrocortisone. Corticotropin (ACTH), which is a pituitary hormone, and tetracosactrin (a synthetic polypeptide) stimulate corticosteroid secretion by the adrenal cortex and can thereby indirectly cause potassium loss. Fludrocortisone also causes potassium loss. The synthetic corticosteroids (glucocorticoids) have a less marked potassium-depleting effect and are therefore less likely to cause problems. These include betamethasone, dexamethasone, prednisolone, prednisone and triamcinolone. 

Class corticosteroid, adrenal glucocorticoid, synthetic glucocorticoid Chemical Structure dexamethasone, see Figure 97.1 prednisone, see Figure 97.2... 

Corticosteroid medications, including cortisone, hydrocortisone and prednisone, have great potential in the treatment of a variety of conditions, from rashes to lupus to astiima, but also carry a risk of side effects. Corticosteroids mimic the effects of hormones the body produces naturally in the adrenal glands. When prescribed in doses that exceed the body s usual levels, corticosteroids suppress inflammation. This can reduce the signs and symptoms of inflammatory conditions, such as arthritis and asthma. Corticosteroids also suppress the immxme system, which can help control autoimmxme diseases. 

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