Prednisolone is a glucocorticoid medicine, not too intense in terms of effect, is of a synthetic nature. It is hormonal and is most commonly used for systemic treatment.

Available in tablets, suspensions and injection solutions... The basic active ingredient is prednisone.

The tablet has a flat-cylindrical shape, white color consists of:

• 5 mg of the active ingredient;
• Ca stearate;
• C6H10O5) n - potato starch;
• Lactose monohydrate.

The injection solution is transparent and discolored, rarely has a light shade. It includes:

1. 30 mg prednisolone;
2. Disodium salt of ethylenediaminetetraacetic acid;
3. Hydrogen phosphate Na;
4. Dihydrogen phosphate Ka;
5. 97% ethanol alcohol;
6. Injection water.

The composition of the suspension and solution for injection are very similar.

Pharmacodynamics

There is a suppression of the leukocyte macrophage (tissue) number. The migration of leukocytes to the areas affected by inflammatory processes is limited. The possibility of phagocytosis in a macrophage is disrupted, the synthesis of interleukins of different groups is inhibited.

Lysosomal membranes are stabilized, the concentration of proteolytic enzyme formations in the inflamed area decreases. Vascular permeability also decreases because histamine is released. The work of fibroblasts and the synthesis of collagen fibers are suppressed.

Phospholipase A2 is activated, which reduces the synthesis of prostaglandins and leukotrienes. The release of cyclooxygenase is inhibited, this also suppresses the production of prostaglandins. The number of circulating lymphocytes, basophils, monocytes, eosinophils decreases, because they move from the bloodstream to the lymph and its tissues. Antibody synthesis can be suppressed.

The release of adrenocorticotropic hormone and β-lipotropin is inhibited, while the concentration of circulating β-endorphin does not decrease. Production is suppressed thyroid-stimulating hormone and follicle-stimulating hormone. A vasoconstrictor effect is exerted on the vessels. Has a dose-dependent effect on: metabolic processes of protein, carbohydrate and fat.

Gluconeogenesis is stimulated and the uptake of amino acids by liver and kidney cells is improved, the activity of enzymes of the process is enhanced. The deposition of glycogen increases, the work of glycogen synthetase and the synthesis of glucose molecules from the production of protein metabolism also increase. A high concentration of sugar triggers increased insulin synthesis.

The drug inhibits the uptake of sugar by fat cells, so lipolysis begins. But due to the increase in the amount of insulin, lipogenesis is stimulated, due to which fat still accumulates.

Catabolization occurs in:

• Lymph tissues;
• Connective;
• Muscular;
• Fatty;
• Cutaneous;
• Bone.

Does not greatly destabilize water-electrolyte exchange (Na and H2O ions are retained, and Ca and Ka are removed). The possibility of Itsenko-Cushing's syndrome and osteoporosis significantly limit the duration of prednisolone therapy.

High dosages can increase the excitability of the GM and lower the seizure threshold. It is a mediator of excessive synthesis of pepsin and hydrochloric acid in the gastrointestinal tract, which can cause the appearance of ulcers.

Systemic use leads to the following effects:

1. Antiallergic;
2. Anti-inflammatory;
3. Antiproliferative;
4. Immunosuppressive.

When compared with the rest of the drugs from the group, then the% efficiency of prednisolone is higher.

Pharmacokinetics

Oral consumption of the drug helps it to be well absorbed in the gastrointestinal tract. The maximum concentration level in plasma is fixed for 1-2 hours after use. Possesses high bioavailability. It binds tightly to plasma proteins (about 96%), a large part of it is attached to transcortin and albumin.

It is metabolized mainly in the cells of the liver, kidneys, bronchus and small intestine... Oxidized forms can be glucuronized and sulfated. About 22% of the drug in its basic form is excreted by the kidneys, the rest takes the form of conjugated and free metabolites. The half-life of the drug is 3 hours. Prednisolone can penetrate the placental barrier, passes into breast milk.

In what situations is it assigned?

The range of use of prednisolone is very wide.

It is prescribed for the following phenomena:

• Preventive measures to avoid transplant rejection;
• Prevention and suppression of vomiting and nausea during cytostatic therapeutic;
• Increased calcium concentration due to cancer;
• Eye diseases of an autoimmune and allergic nature: allergic conjunctivitis, ulcerative formations on the cornea against the background of allergies, non-purulent keratitis, iridocyclitis, iritis, anterior and posterior inflammatory processes vascular network sluggish eye, optic neuritis;
• Edema of the brain during surgery, after trauma and radiation exposure, in the presence of tumors in the brain (the drug is used by means of the parenteral glucocorticosteroid group);
• Skin and diseases and disorders of an autoimmune nature: Lyell's syndrome, eczema formations, seborrheic and exfoliative dermatitis, psoriatic crusts, bullous dermatitis herpetiformis, blistering formations;
• Blood and hematopoietic organs: a decrease in the number of leukocytes, suppression of proliferation, myeloma disease, acute myeloid and lymphoid leukemia, malignant diseases lymph and lymphoid tissues, susceptibility to bleeding against the background of thrombocytopenia, secondary thrombocytopenia, different types anemia (autoimmune-hemolytic and erythroid-hypoplastic in congenital form);
• Disorders of the gastrointestinal tract: inflammatory bowel disease, ulcerative colitis in a nonspecific form, local enteritis;
• Nephrotic syndromes;
• Different types of hepatitis;
• Diseases of an autoimmune nature;
• Hypoglycemic disorders;
• Chronic and acute forms of allergies: to drugs, food, serum disease, rhinitis, angioedema, seasonal rhinoconjunctivitis, atopic and contact forms of dermatitis involving large areas of the skin, urticaria, Stevens-Johnson syndrome, acute inflammatory reactions in the skin;
• Subacute thyroiditis;
• Adrenogenital syndrome;
• Congenital adrenal hyperplasia;
• Renal failure of a secondary and primary nature, often prescribed after surgery to remove the adrenal glands;
• Pulmonary and meningitis tuberculosis, additional medications are also taken;
• Leffler's eosinophilic pneumonia and aspiration, inflammatory processes in the connective lung tissues;
• Lung cancer, treatment is carried out in combination with cytostatics;
• Sarcoidosis in severe forms, aggravated alveolitis, fibrous formations in the lungs;
• The presence of bronchial asthma or a predisposition to it;
• Rheumatoid and juvenile arthritis, arthritis against the background of psoriasis and gout, ankylosing spondylitis, osteoarthritis, humeral-scapular periarthritis, bursitis, Still's syndrome, degenerative-dystrophic processes in the places where muscle tissue is attached to bone, inflammatory process in the synovial articular membrane, inflammation of the tendons in a nonspecific form;
• Multiple sclerosis;
• Lupus erythematosus;
• Diseases connective tissue autoimmune type;
• Nodular diseases of small blood vessels;
• Systemic connective tissue disease in smooth and skeletal muscles.

Remember that you cannot set the rhythm of therapy on your own; a doctor must do this. It is possible that the patient will need concomitant therapy or a preliminary clinical examination. Improper treatment can cause very complex and sometimes irreparable consequences.

Contraindications

If therapy is short-term, the only contraindication will be intolerance to individual components of the drug.

How to use?

The tablets are taken orally and are not chewed, washed down with a glass of water. When using the agent, the circadian rhythm of GCS secretion is taken into account: the largest dose is taken in morning time(preferably before 9 o'clock in the morning), and the rest - in the evening. At the end of therapy, the dosage of the drug is reduced gradually, it is impossible to abruptly stop taking the drug.

For adults: with substitution therapy and acute forms diseases, the daily dose can be up to 30 mg. The daily dosage of a supportive nature is up to 10 mg. In some situations, the initial dosage can be up to 100 mg / day, while the maintenance dose is 15 mg / day.

For children: the starting dose per day is up to 2 mg per 1 kg of the child's weight, this amount is distributed over 4 or more doses. To maintain therapy, children need to consume no more than 600 micrograms per kilogram of body weight.

Injections are given intramuscularly (into the buttock, injected deeply) and intravenously. It is recommended to inject up to 46 mg of the product (about 1.5 ampoules). In some cases, up to 60 mg of the drug is administered additionally.

If the patient has any type of shock: up to 300 mg is administered as a drop infusion or intravenously (but very slowly). If the shock is cardiogenic, it is possible to administer 1 or more grams of the drug. In case of psychoemotional disorders, injections are made very carefully, it is more advisable to carry out therapy with prednisolone in tablet form.

The volume of a single dose in young patients: a child from two to 12 months - about 3 mg per kg of weight intravenously or intramuscularly, from a year to 14 - 2 mg per kg intravenously with a duration of at least 3 minutes or intramuscularly. If necessary, the injection of the drug is repeated half an hour after the first injection.

This remedy can have a serious effect on the functioning of the liver and kidneys in both adults and children.

It also contains lactose and its derivatives, so it cannot be used to treat diabetics and those who are intolerant to milk sugar.

Use in pregnant women and children

This remedy negatively affects the course of pregnancy. In the 1st trimester, the remedy is applied only based on vital signs. If the drug cannot be replaced by anything, then patients with a normal current pregnancy can be prescribed the same treatment as women who are not in a position.

Long-term use of the drug during the period of gestation is fraught with a delay in the development of the baby inside the womb and the appearance of a Gothic palate, but these risks are insignificant. In the 3rd semester, it is better for women to completely avoid taking prednisolone, because the fetus may experience an atrophic process in the adrenal glands.

With this phenomenon, replacement therapy is necessary, which is undesirable for the newborn.

During the lactation period, drugs in this group are also taken carefully. This is due to the fact that in small concentrations, prednisone still passes into breast milk. In order to identify the likely symptoms of adrenal suppression, you need to constantly monitor babies who are breastfed (if their mothers are taking prednisone and derivatives containing it).

Treatment procedures for children in the growth phase using glucocorticosteroids are carried out only if there are exceptional indications and under the constant supervision of a pediatrician. If a child has asthma, then the drug cannot be used at the same time with sympathomimetic aerosols.

If a child is undergoing therapy with this drug and at the same time contacts with patients with chickenpox and measles, he is prescribed drugs from the group of specific immunoglobulins.

Side effects

The volume and degree of expression of these effects varies with the interval of admission, the volumes of doses consumed and the ability to adhere to the circadian regime.

• Cardiovascular system - increased heartbeat, violation of sinus rhythm of heart contractions, sustained increase in pressure in the arteries, onset or recurrence of heart failure, ECG failures (similar to an increase in potassium levels). In the presence of an acute and subacute form of a heart attack, necrotic foci grow, scar formation is inhibited, which is fraught with rupture of the muscles of the heart;
• Lymphatic system and blood - the appearance of leukocytes in the urine and the stimulation of bonding in different dispersion systems, which can cause thromboembolism and thrombosis;
• Nervous system (central nervous system and peripheral) - it hurts and dizzy, a false tumor may appear in the cerebellum, convulsions, intracranial pressure increases;
• Subcutaneous tissue and skin in general - regeneration processes slow down, hemorrhages of a point nature, hematomas, hemorrhages in the mucous membranes and different layers of the skin, stretch marks, thinning of the epidermal layer, all sorts of rashes, hypo- and hyperpigmentation, development of purulent lesions appear;
• Connective tissue, bones and muscles - ossification in babies is inhibited (growth zones in the epipheses are closed), osteoporosis begins, bones break down intensely, necrotic processes begin in the femoral head and humerus, myopathy, muscle atrophic processes, tendons can rupture;
• Sensory systems - an increase in pressure inside the eye with grazing optic nerve, the risk of subcapsular cataract and the development of a secondary infection of a viral, bacterial and fungal nature increases. The cornea may change and the eyeball will move forward;
• Digestive tract - flatulence, pain in the epigastric region, the patient vomits and vomits, ulcers and perforation formations appear in the cavities, erosive esophagitis, surges in appetite intensity, hiccups. The activity of liver transaminases and alkaline phosphatase may increase;
• Endocrine system - the indicator of glucose tolerance falls, chronic diabetes mellitus begins or becomes active, the hypothalamic-pituitary-adrenal system is inhibited, the development of children is inhibited, the onset of menstruation in girls. The appearance of Itsenko-Cushing's syndrome is possible;
• General metabolism - an increase in the amount of potassium, the processes of decay of protein formations increase, weight increases, sodium and water are retained, an increase heart rate, myalgia, spasms and weakness of muscle tissue;
• Immune system - anaphylactic shock, angioedema, various types of rashes, scabies, urticaria;
• Psychoemotional disorders - manic-depressive psychoses, hallucinations, causeless paranoia, depression, irritability, sleep disturbances and anxiety;
• With invasions and infections - the body's resistance to third-party pathogens decreases;
• Others: ulcers, swelling in different areas, urolithiasis.

Interaction with other drugs

The simultaneous consumption of prednisolone can stimulate different effects. The most common complexes:

Long-term therapy with prednisolone increases the amount folic acid in organism. It also reduces the absorption of calcium in the intestine and weakens the effect of D-group vitamins.

It is forbidden to mix the drug with others in the same syringe and the same infusion medium. If the solution is combined with heparin, precipitation falls.

The drug is absolutely incompatible with sympathomimetic agents in aerosol format to eliminate panic attacks in children over 12 (paralysis of the respiratory system may develop).

Prednisolone injections is a drug with enhanced biological activity, which is used in emergency situations. Medication injections can have antiallergic, anti-inflammatory and immunosuppressive effects.

The form of the drug used depends on the speed of its effect and the likelihood adverse reactions... Prednisolone tablets are prescribed for long-term therapy, and in ampoules, the drug is used when delay is dangerous. When administered intramuscularly, the drug begins to act after a quarter of an hour, with intravenous injections - after 3 minutes.

Prednisolone injections, according to the instructions for use, are prescribed under the following clinical circumstances:

• Acute allergic manifestations;
• Complication of diffuse toxic goiter that threatens the patient's life;
• Uncontrolled attack of bronchial asthma;
• A state of shock that does not respond to the prescribed treatment;
• Renal, hepatic failure in an exacerbated form;
• Rheumatic ailments;
• Hepatitis;
• Adrenal cortex pathology;
• Prevention of cicatricial formations in case of damage with cauterizing substances.

In addition to emergency, drug injections are included in the composition complex treatment malignant neoplasms, chronic pulmonary, autoimmune and skin diseases, heart pathologies. Prednisolone injections are used in hematology and ophthalmic practice.

The dosage and duration of therapy should be determined by the doctor. It takes into account the severity of the disease, the patient's state of health, concomitant ailments and possible contraindications.

The average dose is 10-30 mg of the drug intramuscularly. Through a dropper, from 30 to 200 mg is administered in emergency situations.

For children, the amount of medication is prescribed at the rate of 1-3 mg per 1 kg of body weight.

The drug is administered intravenously through a dropper or intramuscularly. After cupping emergency, Prednisolone is taken in tablet form.

Contraindications

Prednisolone, according to the instructions for the use of intramuscular injections, is very effective, but it has a whole list of contraindications and undesirable side effects... Injections are not prescribed in case of intolerance or hypersensitivity to the ingredients of the medication. It is used with extreme caution:

1. With immunodeficiency states;
2. During the period of therapy and recovery after viral infectious diseases;
3. In patients with diseases of the digestive tract;
4. After the introduction of the vaccine;
5. Patients with pathologies of the cardiovascular and endocrine systems;
6. With renal failure.

Prednisolone injections for pregnant women and young children are prescribed exclusively for vital signs under direct medical supervision. For the period of treatment with this medication breast-feeding must be aborted. Children under 3 months and older people over 70 years of age are not prescribed the drug.

During therapy with Prednisolone, the following side effects were observed:

• Muscle atrophy;
• Weight gain;
• Decreased ability of the body to process glucose;
• Violation of the adrenal glands;
• Insulin-dependent diabetes mellitus;
• The growth of intracranial and blood pressure;
• Stomach ulcer or duodenum;
• Violation of sinus rhythm;
• Inhibition of sexual development in adolescents,
• Corneal pathology;
• Intense sweating;
• Seizures;
• Migraine;
• Sleep disturbances;
• Depression, confusion.

At the injection site, rashes, itching and other local allergic manifestations are possible.

pharmachologic effect

GKS. Suppresses the function of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of ​​inflammation. Violates the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. Promotes the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of ​​inflammation. Reduces capillary permeability due to the release of histamine. Suppresses fibroblast activity and collagen formation.
Inhibits the activity of phospholipase A 2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.
Reduces the number of circulating lymphocytes (T and B cells), monocytes, eosinophils and basophils due to their movement from the vascular bed into the lymphoid tissue; inhibits the formation of antibodies.
Prednisolone inhibits the release of ACTH and b-lipotropin by the pituitary gland, but does not reduce the level of circulating b-endorphin. Inhibits the secretion of TSH and FSH.
When applied directly to the vessels, it has a vasoconstrictor effect.
Prednisolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, and increases the activity of gluconeogenesis enzymes. In the liver, prednisolone enhances the storage of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose activates the release of insulin.
Prednisolone inhibits the uptake of glucose by fat cells, which leads to the activation of lipolysis. However, due to the increase in insulin secretion, lipogenesis is stimulated, which contributes to the accumulation of fat.
It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. To a lesser extent than hydrocortisone, it affects the processes of water-electrolyte metabolism: it promotes the excretion of potassium and calcium ions, the retention of sodium and water ions in the body. Osteoporosis and Itsenko-Cushing's syndrome are the main factors limiting long-term GCS therapy. As a result of the catabolic effect, it is possible to suppress growth in children.
In high doses, prednisolone can increase the excitability of brain tissue and helps to lower the seizure threshold. Stimulates excess production of hydrochloric acid and pepsin in the stomach, which leads to the development of peptic ulcers.
With systemic use, the therapeutic activity of prednisone is due to its anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.
When outside and topical application the therapeutic activity of prednisolone is due to anti-inflammatory, antiallergic and antiexudative (due to the vasoconstrictor effect) action.
Compared with hydrocortisone, the anti-inflammatory activity of prednisolone is 4 times greater, the mineralocorticoid activity is 0.6 times less.

Pharmacokinetics

When taken orally, it is well absorbed from the gastrointestinal tract. The maximum plasma concentration is observed after 90 minutes. In plasma, most of prednisolone binds to transcortin (cortisol-binding globulin). It is metabolized mainly in the liver.
The half-life is about 200 minutes. It is excreted by the kidneys unchanged - 20%.

Indications

For oral and intramuscular administration: rheumatism; rheumatoid arthritis; dermatomyositis; periarteritis nodosa; scleroderma; ankylosing spondylitis; bronchial asthma, asthmatic status; acute and chronic allergic diseases; Addison's disease, acute adrenal cortex insufficiency, adrenogenital syndrome; hepatitis, hepatic coma, hypoglycemic conditions, lipoid nephrosis; agranulocytosis, various forms leukemia, lymphogranulomatosis, thrombocytopenic purpura, hemolytic anemia; chorea; pemphigus, eczema, pruritus, exfoliative dermatitis, psoriasis, pruritus, eczema, seborrheic dermatitis, lupus erythematosus, erythroderma, psoriasis, alopecia.
For use in ophthalmology: allergic, chronic and atypical conjunctivitis and blepharitis; inflammation of the cornea with intact mucosa; acute and chronic inflammation of the anterior segment of the choroid, sclera and episclera; sympathetic inflammation of the eyeball; after injuries and operations with prolonged irritation eyeballs.
For intra-articular administration: chronic polyarthritis, post-traumatic arthritis, osteoarthritis of large joints, rheumatic lesions of individual joints, arthrosis.
For infiltration into tissues: epicondylitis, tendovaginitis, bursitis, periarthritis of the shoulder scapula, keloids, sciatica, Dupuytren's contracture, rheumatic and similar lesions of joints and various tissues.

Dosage regimen

When taken orally for replacement therapy in 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 - 5-15 mg / day. 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.
When administered intramuscularly, the dose, frequency and duration of use are determined individually. With intra-articular injection into large joints, a dose of 25-50 mg is used, for medium-sized joints - 10-25 mg, for small joints - 5-10 mg. For infiltration administration into tissues, depending on the severity of the disease and the size of the affected area, doses from 5 to 50 mg are used.
It is used locally in ophthalmology 3 times / day, the course of treatment is no more than 14 days; in dermatology - 1-3 times / day.

Side effect

From the side endocrine system: Itsenko-Cushing's syndrome, weight gain. Hyperglycemia up to the development of steroidal diabetes, depletion (up to atrophy) of the adrenal cortex function.
From the side digestive system: increased acidity of gastric juice, ulcerogenic effect on the gastrointestinal tract.
From the side of metabolism: increased excretion of potassium, sodium retention in the body with the formation of edema, negative nitrogen balance.
From the side of cardio-vascular system: arterial hypertension.
From the side of the blood coagulation system: increased blood clotting.
From the side of the musculoskeletal system: osteoporosis, aseptic bone necrosis.
From the side of the organ of vision: steroid cataract, provoking latent glaucoma.
From the side of the central nervous system: mental disorders.
Effects due to immunosuppressive action: decreased resistance to infections, delayed wound healing.
For external use: the appearance of steroid acne, purpura, telangiectasia, as well as burning, itching, irritation, dry skin is possible; at long-term use and / or when applied to large areas of the skin, the development of a resorptive effect is possible.
When applied topically: a slight burning sensation is possible.

Contraindications

Peptic ulcer stomach and duodenum, osteoporosis, Itsenko-Cushing's syndrome, 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.
Infiltration introduction into the lesions of the skin and tissues with chickenpox, specific infections, mycoses, with a local reaction to vaccination.
In ophthalmology - viral and bacterial eye diseases, primary glaucoma, diseases of the cornea with damage to the epithelium. In dermatology - bacterial, viral, fungal skin lesions, tuberculosis, syphilis, skin tumors.

Pregnancy and lactation

During pregnancy (especially in the first trimester), it is used only for health reasons. If necessary, use during lactation should carefully weigh the expected benefits of treatment for the mother and the risk to the child.

special instructions

Not intended for intravenous administration. During the day, it is recommended to use it taking into account the circadian rhythm of endogenous secretion of GCS in the interval from 6 to 8 am.
Use with caution in patients with a history of psychosis; nonspecific infections, subject to simultaneous chemotherapy or antibiotic therapy. In diabetes mellitus, use is possible only with absolute indications or to prevent suspected insulin resistance. In latent forms of tuberculosis, prednisone can be used only in combination with anti-tuberculosis drugs.
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 sugar levels; in order to reduce side effects you can prescribe anabolic steroids, antibiotics, and also increase the intake of potassium in the body (diet, potassium supplements). It is recommended to clarify the need for ACTH administration after a course of treatment with prednisolone (after a skin test!). In Addison's disease, concomitant use with barbiturates should be avoided.
After discontinuation of treatment, withdrawal syndrome, adrenal insufficiency, as well as an exacerbation of the disease, for which prednisone was prescribed, may occur.
Topical should not be applied for more than 14 days. In the case of application with ordinary or rosacea, an exacerbation of the disease is possible.

Prednisolone in the form of tablets, solution for injection, dry substance for injection, eye drops, the ointment is included in the List of vital drugs.

Drug interactions

With the simultaneous use of prednisolone with anticoagulants, it is possible to increase the anticoagulant effect of the latter; with salicylates - the likelihood of bleeding increases; with diuretics - possible aggravation of electrolyte metabolism disorders; with antidiabetic drugs - the rate of decrease in blood sugar decreases; with cardiac glycosides - the risk of developing glycosidic intoxication increases; with rifampicin - weakening the therapeutic effect of rifampicin.

Prednisolone injections - medicinal product, which makes up the group of hormones, glucocorticosteroids. It can be used only after consultation with the attending physician, since injections have a large number of contraindications and side effects. Most often, they are prescribed in cases where the use of non-steroidal anti-inflammatory drugs is not permissible or has not shown the proper effectiveness.

Mechanism of action

Prednisolone is an injection solution that has powerful anti-inflammatory, anti-shock, analgesic and immunosuppressive effects. Once in the body, the drug forms a glucocorticoid receptor. It rapidly penetrates into the cell nucleus, where it interacts with genes. Because of this, major changes occur in the production of proteins and RNA. Prednisolone is valued for its high anti-inflammatory effect, which is due to the following factors:

• The active ingredients increase the production of lipocortin, which prevents the further production of phospholipase. Because of this, the damaged tissue can no longer produce arachidonic acid. All this leads to the impossibility of the synthesis of prostaglandins.
• Active substances interfere with the exchange of COX-2 genes, thereby also reducing the production of prostaglandins.
• Prednisone stops metabolic processes between molecules in blood vessels, due to which neutrophils and monocytes do not penetrate into the focus of inflammation.

Prednisolone is a drug with powerful anti-inflammatory, analgesic and immunosuppressive effects.

Indications for use

Prednisolone is a powerful medicine that should only be used after consulting a doctor. Usually experts prescribe it:

• For postoperative, traumatic, toxic and burn shocks.
• For acute and severe allergies.
• With anaphylactic or blood transfusion shock.
• With cerebral edema caused by radiation therapy, head injury or swelling.
• With severe bronchial asthma.
• For serious skin lesions: psoriasis, dermatitis, bullous dermatitis, seborrhea, Stevens-Jones syndrome.
• With allergic conjunctivitis.
• For serious disorders and congenital anomalies of the adrenal glands.
• With severe uveitis, optic neuritis.
• With a hepatic coma.
• With a thyrotoxic crisis.
• With acute hepatitis.
• At serious illnesses blood and circulatory system.
• With Leffler's syndrome, beryllium.
• With multiple sclerosis.
• With hypercalcemia caused by malignant neoplasms.
• As preventive measures on the rejection of the transplanted organ.
• To reduce inflammation.
• For the prevention of cicatricial narrowing.

Mode of application

Instructions for the use of Prednisolone injections states that it is permissible to use the medicine only after consulting a qualified doctor. This drug has a high effect on the body, therefore, due to improperly selected therapy, there is a high risk of side effects. Prednisolone in the form of injections must be injected into the muscles, joints, or in the form of tissue impregnation. It is very important to treat the skin with alcohol before the procedure in order to kill all pathogenic microorganisms.

To relieve painful joints, it is necessary to inject 25-50 mg into large ones, 10 mg into small ones. With a pronounced syndrome, the procedure can be repeated several times. It is very important to evaluate therapeutic effect after such therapy, in order to, if necessary, either increase the dose of the active substance, or change the medicine. In order for the drug to be correctly distributed over the joint, after injection it must be repeatedly bent and unbent. Lotions from the solution will also help to reduce painful sensations - they are used to treat small areas of affected surfaces.

Deal with different kinds conjunctivitis will be helped by injections or instillation of the drug in the eyes. This should be done in 1-3 drops three times a day for 2 weeks. To prevent the therapy from bringing any complications or side effects, it is necessary to regularly measure the level of blood pressure and administer anabolic drugs. Also, the doctor should send you once every two weeks for a blood, feces and urine test. During therapy, it is necessary to monitor water balance in the body, if necessary, take diuretics.

It should be borne in mind that with prolonged use of Prednisolone can cause a decrease in the level of potassium in the blood. To prevent this, it is recommended to follow a special diet and take this macronutrient in pill form. Otherwise, there is a high risk of osteoporosis - damage to bone tissue, which makes it extremely fragile.

Therapeutic dosage

Keep in mind that prescribing a therapeutic dose of Prednisolone, as well as the duration of its use, can only be prescribed by the attending physician. He must familiarize himself with the results of diagnostic studies, and only then prescribe treatment. Injections can be injected into the body by drip or jet, however, in practice, two of these methods are used at once in one procedure.

Despite the generally accepted dosages, Prednisolone treatment should be prescribed exclusively by the attending physician based on the data of extended diagnostics.

Withdrawal syndrome

With prolonged use of Prednisolone injection solution, the body begins to get used to the components. In addition, the drug affects and alters the functioning of the adrenal glands. With a sharp refusal from therapy with this drug, a person may face malaise, increased fatigue, and high body temperature. Such conditions disappear without additional therapy in a few days. However, if high doses of Prednisolone were abruptly canceled, there is a risk of a hypoadrenaline crisis. It can be recognized by increasing convulsions, vomiting and collapse. If you do not provide a person in a timely manner medical assistance, possible cardiac arrest due to acute cardiovascular failure.

Contraindications

To reduce the risk of complications from taking Prednisolone, you must always remember that there are contraindications. Even in emergency cases, it is forbidden to inject this injection if there is an increased sensitivity to the components of the drug. It should also be borne in mind that the drug contains lactose, to which some people have persistent intolerance. With extreme caution, it is permissible to treat Prednisolone in the following cases:

Prednisolone is a drug that has many side effects. In order to prevent their occurrence, it is necessary to strictly adhere to all the recommendations of the attending physician. The most dangerous are the following consequences:

• Decreased glucose tolerance - especially dangerous for people with diabetes mellitus... Substances entering the body slow down the liver, which disrupts the production of insulin.
• Suppression of adrenal function - this leads to hormonal imbalance. It also inhibits the removal of toxins and toxins from the body.
• Itsenko-Cushing's syndrome is a condition that is observed with a powerful change in hormonal levels.
• The appearance of nausea, vomiting, painful sensations in the abdomen.
• The formation of bleeding inside the gastrointestinal tract: erosive gastritis, perforation of the intestinal walls, ulcers.
• Indigestion in the form of changes in appetite, constipation and diarrhea, flatulence.
• Aggravation of cardiovascular pathologies.
• The appearance of prolonged hiccups.
• Changes in nervous system: TIR, depression, euphoria, paranoia, disorientation.
• Frequent seizures, especially at night.
• Headaches and dizziness.
• Significant increase in pressure inside the eyes.
• Enhancement intraocular pressure, trophic changes in the structure of the cornea.
• Hyperhidrosis, the appearance of a specific body odor.
• Weight loss, muscle tissue atrophy.
• Long-term wound healing.
• The formation of acne and stretch marks on the body.
• Local allergic reactions.

Prednisolone (in Latin INN Prednisolonum) is a unique drug that is a synthetic analogue of the adrenal cortex. It has anti-inflammatory and anti-allergic effects. Pharmacological group- Glucocorticosteroids.

It also reduces the amount of protein in the plasma and performs the synthesis of the protein that binds calcium. Acts as an auxiliary substance and stimulates the formation of cells in bone marrow, retains water, phosphate and sodium, enhances receptor sensitivity, reduces the number of immunosuppressive diseases by reducing them. Another function is to enhance gluconeogenesis.

Composition, release form

The most common forms are ampoules and tablets. The former contain 25 and 30 milligrams and 1 ml. Comes in a pack of three. There are also ampoules with 1 ml of suspension specifically for injection or injection. They contain 25 and 50 milligrams. In a package, there can be from 5 to 1000 pieces. There is also an ointment in tubes, a solution and even eye drops... But the most popular are tablets in packs of one hundred.

For example, in one tablet from the manufacturer Nycomed and Gedeon Richter - 0.005 grams of prednisolone, there are also excipients such as milk sugar, calcium stearate and potato starch.

What is the price?

The aforementioned form of release will cost the patient about 150 rubles, while a 1-millimeter ampoule will cost 100 rubles.

What is it prescribed for, indications for use

It is prescribed for a whole list of diseases: collagenosis, rheumatoid arthritis, polyarthritis, asthma, leukemia, mononucleosis, neurodermatitis, eczema, allergies, adrenal insufficiency, anemia, pancreatitis, collapse and shock, conjunctivitis, blepharitis, inflammation of different parts of the eye, as well as after eye injuries.

Analogues are cheaper

How to replace this medicine? The only more or less common analogs for this drug are called Decorin, Medrol, Deltason. Also in pharmacies you can find such a substitute as Metipred.

Metipred or prednisolone, which is better?

There is no unequivocal answer to the question which is better. Both drugs are good enough to cope with their assigned functions. Consult your doctor before your appointment, and he will individually prescribe one of these drugs.

Methylprednisolone and prednisolone difference

The main difference and differences between these largely similar drugs are side effects... Therefore, some people tolerate prednisolone better than others - methylprednisolone. Another important difference is cost. Here, plus it is worth putting it on prednisolone.

Prednisolone instructions for use

The instruction is individual for each person. Also, an important role is played by the form - tablets or ampoules.

Pills

In an acute condition, you need to drink from 4 to 6 tablets per day - the exact dose is individual. Maintenance dose - 1-2 tablets. With nephrosis and rheumatism, the doses are higher, after which they are gradually reduced.

Intramuscularly in ampoules

It can also be administered intravenously into the bloodstream or intramuscularly, including through the introduction of droppers into the bloodstream. In this case, the infusion should be done as deeply as possible. With shock, the dose is 30-90 milligrams, with repeated administration - 30-60 mg.

During pregnancy

Pregnancy is included in the list of contraindications, therefore, prednisone is prescribed in exceptional cases and is used with extreme caution during pregnancy.

For kids

The calculation for children is as follows - about 1-2 milligrams per kilogram of mass per day. The dose is extended for 4-6 doses.

Prednisolone reviews

Prednisolone forums contain hundreds of reviews on why, when, and from what to ask for a prescription, and why not. Many people ask where the drug went and disappeared from the shelves of their pharmacies. Others answer that prednisone (on Latin- Prednisolonum) of a new generation, and this one is out of production.