Uses of Cortisol: - Severe allergic reactions - Allergic conditions - Asthma - Rheumatic disorder - Skin disorders - Eye disorders - Nephrotic syndrome Rheumatoid arthritis, Multiple sclerosis, Allergic and inflammatory disorders, Nephrotic syndrome, Idiopathic thrombocytopenic purpura, Joint inflammations, Moderate to severe asthma, Infantile spasms Live vaccines; herpes simplex keratitis, systemic infections.

Glucocorticoids

Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.

How to use Prednisolone: Take this medicine in the dose and duration as advised by your doctor. Dissolve it in a glass of water before taking it. Prednisolone may be taken with or without food, but it is better to take it at a fixed time. Administration: Should be taken with food. Adult Dose: Oral Allergic and inflammatory disorders Adult: 5-60 mg daily in 2-4 divided doses. Maintenance: 2.5-15 mg daily. Withdrawal should be gradual after long-term therapy. Poorly controlled, moderate to severe asthma, COPD Adult: Patients with at least 2 exacerbations/yr requiring oral corticosteroids: 40-60 mg daily in 1-2 divided doses; usually given as a short course treatment over 10-14 days until symptom resolution and patient achieves a peak expiratory flow (PEF) of at least 80% of his or her personal best. Rheumatoid arthritis Adult: Initially, 5-7.5 mg daily, adjusted as necessary. Elderly: 5 mg daily. Multiple sclerosis Adult: 200 mg daily for 1 wk followed by 80 mg every other day for 1 mth. Bells Palsy 60 mg PO qDay for 5 days; then taper down by 10 mg daily for 5 days for total duration time of 10 days Child Dose: Inflammation 0.1-2 mg/kg/day PO in single daily dose or divided q6-12hr; not to exceed 80 mg/day Acute Asthma 1-2 mg/kg/day in single daily dose or divided q12hr for 3-5 days Nephrotic Syndrome First 4 weeks: 60 mg/m²/day or 2 mg/kg/day PO divided q8hr until urine is protein free for 3 consecutive days; not to exceed 28 days; dose not to exceed 80 mg/day Subsequent 4 weeks: 40 mg/m² or 1-1.5 mg/kg PO every other day; not to exceed 80 mg/day Maintenance in frequent relapses: 0.5-1 mg/kg/dose PO every other day for 3-6 months Idiopathic thrombocytopenic purpura Child: 1-10 yr: 1-2 mg/kg daily (max: 14 days) or 4 mg/kg daily (max: 4 days).

Efficacy may be reduced by phenytoin, phenobarb, rifampicin. Corticoids may reduce the effects of diuretics, hypoglycaemics, anticholinesterases, salicylates.

Live vaccines; herpes simplex keratitis, systemic infections.

Common - Behavioural changes - Edema (swelling) - Glucose intolerance - Increased appetite - Mood changes - High blood pressure - Weight gain Acne,Adrenal suppression,Delayed wound healing,Diabetes mellitus,GI perforation,Glucose intolerance,Hepatomegaly,Hypokalemic alkalosis,Increased transaminases,Insomnia,Menstrual irregularity,Myopathy,Neuritis,Osteoporosis,Peptic ulcer,Perianal pruritus,Pituitary adrenal axis suppression,Pseudotumor cerebri (on withdrawal),Psychosis,Seizure,Ulcerative esophagitis,Urticaria,Vertigo,Weight gain Potentially Fatal: Acute adrenal insufficiency precipitated by infection, trauma or surgery in patients on long-term therapy or following cessation of such therapy. CV collapse following rapid IV injection.

Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy, should be carefully observed for signs of hypoadrenalism. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion

Precaution: Patients with hypothyroidism, cirrhosis, ulcerative colitis, CHF, convulsive disorders, thrombophlebitis, peptic ulcer, elderly. DM, hypertension, psychological disturbances, osteoporosis; pregnancy, lactation. Adrenal suppression and infection. May cause irreversible growth retardation, glaucoma, corneal perforation. Lactation: Excreted in breast milk; use caution

Adverse effects related to prednisone normally develop only after prolonged use of doses in excess of the normal physiological requirement. Treatment is symptomatic and where possible the prednisone dose should be reduced gradually.

Store in a cool and dry place, protected from light. Keep out of the reach of the children.

Glucocorticoids

Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.

This medicine is not recommended for use during pregnancy unless considered essential by your doctor. It should only be used if the expected benefit to the mother is greater than any possible risk to the foetus. Corticosteroids appear in breast milk and could suppress growth, interfere with endogenous corticosteroid production or cause other unwanted effects.