Prednisone is extensively used in the sphere of health care as an effective anti-inflammatory and immunosuppressant medication that treats a variety of diseases, especially asthma, allergic and rheumatic health disorders, COPD, severe forms of tuberculosis, cancer, and many others. The current paper aims to identify and describe pharmacokinetics, pharmacodynamics, indications, and contraindications of this drug. In addition, much emphasis will be placed on its side effects, off-label use, and the effect on the elderly, children, pregnant females, and, finally, nursing mothers.
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Generic and Brand Names, Pharmacokinetics, and Pharmacodynamics
The generic name of this medicine is prednisone. It has many brand names, including, Deltasone, Prednicot, Rayos, and several others (Liu et al., 2013). Prednisone is classified as a synthetic corticosteroid drug that is used by health care professionals for the treatment of certain types of inflammatory and autoimmune diseases. Researchers provide evidence that its pharmacokinetic variability depends on such factors as age, sex, body weight, overall health, and various disease states (Liu et al., 2013). Responses of patients to prednisone are associated with delayed and indirect processes and mechanisms of drug action that are linked to the synthesis of protein and nuclear transcription (Liu et al., 2013). Prednisone is one of the most commonly prescribed and effective corticosteroids that usually affects the exchange of ion in the kidney. At the initial stage, it is metabolized in the liver, and then its active form called prednisolone continues to cross cell membranes and results in the suppression of immune responses (Liu et al., 2013). Therefore, pharmacokinetics and pharmacodynamics of this drug is very complex and remains the main topic of research controversies and debates.
Indications and Contraindications of Prednisone
Researchers who explore the medical use of prednisone provide evidence that this medicine is extensively prescribed for the management and treatment of endocrine, rheumatic, collagen, allergic, dermatologic, respiratory, ophthalmic, gastrointestinal, and neoplastic diseases in different age groups, including children and adolescents (Liu et al., 2013). It is used for a variety of health problems, especially thyroiditis, pneumonitis, and many others. Moreover, this medicine effectively relieves symptoms of shingles, lupus, Meniere’s disease, and many others (Liu et al., 2013).
Although the prescription of prednisone is definitely the best choice for the majority of diseases, including migraine headaches, autoimmune hepatitis, leukemia, and lymphoma, this medicine is usually not recommended to individuals with systemic fungal infections (Liu et al., 2013). Therefore, it is contraindicated in patients with tuberculosis and viral infections, especially measles and chickenpox in the pediatric population, because it does not only increase the risks of worsening these conditions, but also contributes to the increased amount of fatal cases (Liu et al., 2013).
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Side and Adverse Effects
The most common short-term side effects of prednisone are associated with considerably high glucose levels, especially in individuals diagnosed with diabetes mellitus and fluid retention (Australian Rheumatology Association, 2012). However, they can be easily eliminated by reducing the dose of the medication. Statistical data indicate that this drug leads to a variety of major side effects and adverse reactions, especially weight gain and obesity, depressive symptoms and anxiety, severe muscle and joint pain, stomach pain, weakness and fatigue, immunosuppression, and many others (Australian Rheumatology Association, 2012). Adverse effects of this synthetic hormone do not occur in all individuals who take it and are directly linked to the dose, length, and amount of time this medicine is used. Insomnia and frequent mood changes are also included in the list of common adverse effects. That is why, physicians recommend to use this hormonal drug in the morning in order to minimize chances of insomnia and euphoria at night (Australian Rheumatology Association, 2012). Moreover, it slightly reduces the resistance of the immune system to infections. Changes in physical appearance and skin are also adverse effects of prednisone because observational studies prove that many patients who take this medication observe that the skin is bruised and damaged more easily, and even small wounds take much more time to heal (Armstong et al., 2015). The prolonged use of prednisone may also result in cataracts, the developing or worsening of glaucoma, hyperglycemia, and osteoporosis because it contributes to the loss of calcium and leads to the fragility of bones. In case the intake of this synthetic hormone is not stopped, it may lead to serious adverse effects and reactions, including fever and a flare-up of threatening diseases and infections (Armstong et al., 2015). The severity of the latter, the possibility of the accurate control of the symptoms, and the development of side effects are always considered by physicians while determining the right dose of prednisone (Armstong et al., 2015).
Despite the limited amount of adequate and well-controlled research studies that measure the effects of prednisone on pregnant women, numerous tests on animals prove that the long-term use of prednisone puts the healthy development of the offspring at risk (Liu et al., 2013). Moreover, infants born to women who have taken substantial doses of prednisone should be thoroughly observed by physicians for signs and symptoms of hypoadrenalism (Liu et al., 2013). The use of the drug should be limited in nursing mothers because it can penetrate into milk and result in the suppression of the healthy growth of a child. Because of the increased risks of serious adverse reactions and complications in nursing infants caused by the use of prednisone by nursing mothers, physicians should decide whether the latter should continue or stop treatment by this medicine, taking into consideration the importance of the synthetic drug (Liu et al., 2013). Adverse effects and reactions stimulated by prednisone in the pediatric population are similar to those in the elderly and adult individuals (Liu et al., 2013). Like older adults, physicians should carefully observe children and adolescents with effective and regular measurements of weight, blood pressure, accurate clinical evaluation of the presence or development of infections, mild and severe psychological disorders, cataracts, and many other symptoms (Liu et al., 2013). A significant decrease in the growth velocity of children is one of the most threatening complications caused by the use of prednisone. However, although clinical experience proves that there are no substantial differences in responses of organisms of the elderly and adult individuals, selection of the right dose for older adults should be determined with caution, considering their overall health state (Liu et al., 2013).
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Off-Label Use of Prednisone
Nowadays, prednisone is extensively used by physicians for a variety of off-label purposes. Although the main purpose of this synthetic hormone is to suppress the functioning of the overactive immune system, it is used for effective management of pulmonary fibrosis and seizures (Liu et al., 2013). In addition, present researchers in the field of health care investigate the effects of prednisone on leukemia and lymphoma because the amount of pediatric and adult patients diagnosed with these life-threatening diseases has increased drastically (Armstong et al., 2015). According to several clinical trials, this synthetic corticosteroid drug is often used in solid organ transplantation because it is an integral element of the induction and maintenance of normal immunosuppressive regimes (Liu et al., 2013).
Prednisone is an effective synthetic hormone that is used for the management and treatment of various diseases. The most common side and adverse effects of this medicine are associated with a considerable weight gain, thinning and fragility of bones due to the loss of calcium, skin problems, increase in blood cholesterol, anxiety, depression, trouble sleeping, frequent mood changes, development of diabetes, hyperglycemia, and many others. However, the role of this synthetic hormone is fundamental because it is prescribed to different age groups who suffer from a variety of health problems, especially inflammatory and autoimmune disorders.