GKS. Suppresses the functions of leukocytes and tissue macrophages.
Preparation: Prednisolon
The active substance of the drug: Prednisolone.
ATX encoding: S01Ba04
KFG: GKS for local application in ophthalmology
Registration number: P №015942 / 01
Registration date: 05/05/06
Owner reg. Undoj: Warsaw Pharmaceutical Work Polfa S.A. (Poland)

Form of release prednisolone, packaging of the drug and composition.

Eye drops in the shape of a white suspension.

1 ml
Prednisolone acetate
5 mg

5 ml - a bottle-dropper of a colorless glass (1) - packs cardboard.

Description of the active substance.
All the information provided is presented only for familiarization with the drug, the possibility of application you need to consult with the doctor.

Pharmacological action prednisolone

GKS. Suppresses the functions of leukocytes and tissue macrophages. Limits the migration of leukocytes to the inflammation area. Violates the ability of macrophages to phagocytosis, as well as to the formation of interleukin-1. It contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the field of inflammation. Reduces the permeability of capillaries due to the release of histamine. Suppresses the activity of fibroblasts and the formation of collagen.

Inhibits the activity of phospholipase A2, which leads to the suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of the COF (mainly COF-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 displacement from the vascular bed to lymphoid fabric; Suppresses the formation of antibodies.

Prednisolone suppresses the release of the ACTH and -Lipotropin hypophysia, but does not reduce the level of circulating -endorphine. Inhibits the secretion of TSH and FSH.

With direct appliqués on the vessels has a vasoconstrictor effect.

Prednisolone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates glukegenesis, promotes the seizure of amino acids with liver and kidneys and increases the activity of glukegenesis enzymes. In the liver, prednisolone enhances glycogen deposit, stimulating the activity of glycogenacentase and glucose synthesis from protein metabolism. Increased blood glucose content activates insulin allocation.

Prednisolone suppresses glucose seizure with fat cells, which leads to the activation of lipolysis. However, due to an 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, leather, bone tissue. To lesser extent, the hydrocortisone affects the processes of water and electrolyte metabolism: contributes to the removal of potassium and calcium ions, delay in the body of sodium and water ions. Osteoporosis and Itsenco Cushing syndrome are the main factors limiting the long-lasting GKS therapy. As a result of catabolic action, it is possible to suppress growth in children.

In high doses, prednisone can increase the excitability of brain tissues and contributes to a decrease in the threshold of convulsive readiness. Stimulates excessive products of hydrochloric acid and pepsin in the stomach, which leads to the development of peptic ulcers.

With systemic use, the therapeutic activity of prednisolone is due to anti-inflammatory, anti-allergic, immunosuppressive and antiproliferative effect.

With external I. local application The therapeutic activity of prednisolone is due to anti-inflammatory, anti-allergic and anti-appliances (thanks to the vasoconstrictor effect) action.

Compared to the hydrocortisone, the anti-inflammatory activity of prednisolone is 4 times more, mineralocorticoid activity is 0.6 times less.

Pharmacokinetics of the drug.

When taking inside, it is well absorbed from the gastrointestinal tract. Plasma Cmax is marked after 90 minutes. In plasma, most of the prednisolone binds to the transcertin (cortisol-binding globulin). Metabolized mainly in the liver.

T1 / 2 is about 200 minutes. Excreted by the kidneys unchanged - 20%.

Indications for use:

For intake and parenteral use: rheumatism; rheumatoid arthritis, dermatomyomyomy, nodule periateritis, sclerodermia, Bekhterev's disease, bronchial asthma, asthmatic status, acute and chronic allergic diseases, anaphylactic shock, Addison disease, acute insufficiency of adrenal cortex, adrenogenital syndrome; hepatitis, hepatic coma, hypoglycemic states, lipoid nephrisus; Agranulocytosis, various forms of leukemia, lymphogranulomatosis, thrombocytopenal purple, hemolytic anemia; chorea; Bubble, eczema, itching, exfoliative dermatitis, psoriasis, scratch, seborrheic dermatitis, red lupus, erythrodermia, alopecia.

For intra-articular administration: chronic polyarthritis, post-tramatic arthritis, osteoarthritis of large joints, rheumatic lesions of individual joints, arthrosis.

For infiltration administration in the fabric: epicondylitis, tendovaginitis, bursitis, shoulder-painting periatritis, keloids, Ishiagia, contracture Dupuitren, rheumatic and similar to the defeat of the joints and various tissues.

For applications in ophthalmology: Allergic, chronic and nonypical conjunctivitis and blufarite; inflammation of the cornea with intact mucosa; acute and chronic inflammation of the front segment of the vascular shell, sclera and episclages; Sympathetic inflammation of the eyeball; After injuries and operations with long-term irritation of the eyeballs.

Dosage and method of use of the drug.

When taking inside for replacement therapy in adults, the initial dose is 20-30 mg / day, supporting the dose - 5-10 mg / day. If necessary, the initial dose can be 15-100 mg / day supporting - 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 receptions, supporting - 300-600 μg / kg / day.

With a / m or in / in the introduction of dose, multiplicity and duration of use are determined individually.

At intra-articular administration, a dose of 25-50 mg is used to large joints, for the joints of the average value - 10-25 mg, for small joints - 5-10 mg. For infiltration administration in tissue, depending on the severity of the disease and the magnitude of the lesion region, doses are used from 5 to 50 mg.

Locally, ophthalmology is used 3 times / day, the course of treatment is not more than 14 days; In dermatology - 1-3 times / day.

Side effect Prednisolone:

From the endocrine system: impairment of the menstrual cycle, the oppression of the function of the adrenal glands, the syndrome of Itsenko-Cushing, the suppression of the function of the pituitary-adrenal system, a decrease in carbohydrate tolerance, steroid diabetes or latent manifestation sugar diabetes, slowdown in growth in children, delay in sexual development in children.

From the digestive system: nausea, vomiting, stomach steroid ulcer and duodenal gut, pancreatitis, esophagitis, bleeding and perforation of the gastrointestinal tract, raising or decreased appetite, flatulence, IKOT. In rare cases, the increase in the activity of hepatic transaminases and the CFF.

From the metabolic side: negative nitrate balance due to protein catabolism, increased calcium excretion from the body, hypocalcemia, increase body weight, increased sweating.

From the side of the cardiovascular system: loss of potassium, hypokalemic alkalosis, arrhythmia, bradycardia (right up to the heart stop); Steroid myopathy, heart failure (development or strengthening of symptoms), changes on ECG characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute myocardial infarction - the spread of necrosis focus, slowing down the formation of scar tissue, which can lead to the rupture of the heart muscle.

From side bone-muscular system: slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological fractures, aseptic necrosis of the head of the shoulder and femoral bone), tenders of muscle tendons, muscle weakness, steroid myopathy, reduction of muscle mass (atrophy).

From the CNS: Headache, an increase in intracranial pressure, delirium, disorientation, euphoria, hallucinations, manico-depressive psychosis, depression, nervousness or anxiety, insomnia, dizziness, vertigo, pseudo-tube cerebellum, convulsive seizures.

From the body of the vision: rear subcapsular cataract, increase intraocular pressure (with possible damage spectator nerve), trophic changes of the cornea, Exophthalm, a tendency to the development of secondary infection (bacterial, fungal, viral).

Dermatological reactions: petechia, ekkimosis, thinning and fragility of the skin, hyper- or hypopigmentation, acne, strry, tendency to the development of pyodermia and candidiasis.

Reactions caused by immunosuppressive effect: slowing the processes of regeneration, reduced resistance to infections.

In case of parenteral administration: In isolated cases, anaphylactic and allergic reactions, hyper-or hypopigmentation, skin atrophy and subcutaneous tissue, exacerbation after intrasinovial use, arthropathy type of shark, sterile abscesses, when introduced into the foci on the head - blindness.

Contraindications for the drug:

For short-term use on life indications - increased sensitivity to prednisone.

For intra-articular administration and administration directly to the lesion directly: preceding arthoplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including a history), as well as General infectious disease, pronounced osteoporosis, lack of signs of inflammation in the joint ("dry" joint, for example, with osteoarthritis without synovitis), expressed bone destruction and deformation of the joint (sharp narrowing of the joint gap, ankylosis), the unstability of the joint as an outcome of arthritis, aseptic necrosis forming The joint of the epiphysis bones.

For outdoor use: bacterial, viral, fungal skin diseases, skin tuberculosis, skin manifestations of syphilis, leather tumors, percentage period, impaired skin integrity (ulcers, wounds), children's age (up to 2 years, with itching in the anus area - up to 12 years), Rosacea, vulgar acne, perioreral dermatitis.

For use in ophthalmology: bacterial, viral, fungal diseases Eye, tuberculous eye damage, trachom, violation of the integrity of the eye epithelium.

Application during pregnancy and lactation.

During pregnancy (especially in the first trimester) apply only on life indications. If necessary, use during the lactation period should be carefully weighed the expected benefit of the treatment for the mother and risk for the child.

Special instructions for the use of prednisolone.

With caution to use for 8 weeks before and 2 weeks after vaccination, during lymphadenitis after vaccinations BCG., in immunodeficiency states (including AIDS or HIV infection).

With caution to apply in diseases of the gastrointestinal tract: ulcerative diseases of the stomach and duodenum, esophagite, gastritis, acute or latent peptic peptic ulcers, recently created intestinal anastomose, nonspecific ulcerative colitis with a threat of perforation or abscess, diverticulite.

With caution to apply in diseases of the cardiovascular system, incl. After the recently suffered myocardial infarction (in patients with acute and subacute myocardial infarction, it is possible to spread the focus of necrosis, slowing down the formation of scar tissue and as a result of this, the gap of the heart muscle), with decompensited chronic heart failure, arterial hypertension, hyperlipidemias), in endocrine diseases - diabetes mellitus (including violations of carbohydrate tolerance), thyrotoxicosis, hypothyroidism, siconomo-kushing disease, with severe chronic renal and / or hepatic insufficiency, nephroolithiasis, during hypoalbumine and states predisposing to Its occurrence, with systemic osteoporosis, myasthenia, acute psychosis, obesity (III-IV degree), with polio (with the exception of the form of bulbar encephalitis), open and closed-coronal glaucoma.

If necessary, intra-articular administration with caution to apply in patients with common heavy condition, ineffectiveness (or short-term) actions of 2 previous administrations (taking into account the individual properties of the GKS).

During treatment (especially long), it is necessary to observe the eyepiece, control of the blood pressure and water and electrolyte balance, as well as the pattern of peripheral blood, blood glucose; In order to reduce side Effects Anabolic steroids can be prescribed, antibiotics, as well as increase the flow of potassium into the body (diet, potassium preparations). It is recommended to clarify the need to introduce ACTH after the course of treatment with prednisolone (after the skin test!).

With Addison's disease, simultaneous use with barbiturates should be avoided.

After discontinuation of treatment, the absence of cancellation syndrome, adrenal insufficiency, as well as the exacerbation of the disease, was prescribed by prednisolone.

With intercurrent infections, septic conditions and tuberculosis, simultaneous antibiotic therapy is necessary.

In children during the growth period, GKS should be used only in absolute indications and under careful control of the doctor.

Externally should not be used for more than 14 days. In the case of use in ordinary or pink echs, it is possible to exacerbate the disease.

Interaction prednisolone with other drugs.

With the simultaneous use of prednisone with anticoagulants, it is possible to strengthen the antoslude action of the latter.

With simultaneous use with salicylate, the likelihood of bleeding is increasing.

With simultaneous use with diuretics it is possible to aggravate electrolyte exchange disorders.

With simultaneous use with hypoglycemic drugs, the rate of reduction of blood glucose is reduced.

With simultaneous use with cardiac glycosides, the risk of glycoside intoxication is enhanced.

With simultaneous use with rifampicin, it is possible to weaken the therapeutic effect of rifampicin.

With the simultaneous use of hypotensive agents, it is possible to reduce their effectiveness.

With the simultaneous use of Cumarine derivatives, it is possible to weaken the anticoagulant effect.

With the simultaneous use of rifampicin, phenytoin, barbiturates, it is possible to weaken the action of prednisolone.

With the simultaneous use of hormonal contraceptives - an increase in the action of prednisolone.

With the simultaneous use of acetylsalicylic acid - reducing the content of salicylate in the blood.

With the simultaneous use of the prazicvantel, it is possible to reduce its concentration in the blood.

The appearance of hirsutism and eels contributes to the simultaneous use of other GKS, androgens, estrogen, oral contraceptives and steroids of anabolics. The risk of cataract development increases when applied against the background of the GCS of antipsychotic drugs, carbututamide and azatiotric.

Simultaneous administration with M-cholinoblocators (including antihistamines, tricyclic antidepressants), nitrates contribute to the development of an increase in intraocular pressure.

This information is useful for people receiving prednisone. It should be borne in mind - these are general information obtained by a survey of patients (the severity of the disease is not taken into account). With extra weight, prednisone is trying not to assign (only if it is vital, and only under the supervision of specialists). Before the start of the course do ultrasound of the heart. Conduct a survey of gastro intestinal tract For pathologies. During the reception of drugs, weekly weigh, write your weight. And if your weight changes by 10%, then the course can cancel or adjust. To reduce side effects,and also addictive to the medicine, it is drinking individual courses. For example, such: 3 months of reception, then 3 months break. During the drug, once a month, it is necessary to take tests on blood sugar, and the levels of Ca, Na and K. During rest from prednisolone, the organism is restored by polyvitamins, actovegin, group vitamins, coenzyme Q. Also take note - it is forbidden to vaccinate During the treatment of prednisone. You can not throw medicine sharply.

Prednisolone is

the drug related to the group of glucocritosteroids (GKS) - synthetic agents acting similar to the hormones of adrenal cortisol and cortisone. For the first time, these drugs were applied about 60 years ago and caused a real coup in the treatment of various diseases. Then it was called a miracle and panacea, since they instantly removed inflammation, allergies, itching and tissue swelling, had a rapid abnormal action.

But over time, the idea of \u200b\u200bGCS as a miracle dispelled: it was found that they have a number of heavy side effects and contribute to the reduction of adrenal function. Doctors learned how to use medicines from the GCS group with maximum benefit and minimal manifestations of side effects. Side effects after their reception remain only with long-term use in large doses.

How is the cancellation of prednisolone

Prednisolone is prescribed for diseases accompanied by a pronounced inflammatory or allergic reaction - rheumatoid polyarthritis, severe inflammatory processes of ENT organs and respiratory tract, glomerulonephritis, bronchial asthma, heavy allergic skin processes, etc. Prednisolone suppresses the growth of connective tissue, therefore it is prescribed under systemic diseases of the connective tissue. For emergency Prednisolone is used as anti-shock: it quickly increases blood pressure.

What is prednisone, many know, but not everyone is known to the end of his side effects. The entire negative of the drug is associated with its long-term use in large doses (incorrectly selected dose). In order to prepare the body to cancel the drug, its dosage is gradually reduced, allowing the adrenal glands to also gradually restore its function.

With a sharp abolition of prednisone, an acute adrenal insufficiency may develop, manifested in sudden weakness, pallor, dizziness, strong decrease in blood pressure (blood pressure), tachycardia, vomiting, seizures. All this can end with a coma and death. First aid - the introduction of GCS, including prednisolone.

But more often after a long use of prednisone and its correct cancellation, a slight decrease in adrenal functions is developing, which manifests itself near the symptoms. Sometimes (but not always) slightly dark skin - this happens due to the fact that the body stimulates the production of hormones and at the same time it is stimulated by the secretion of the skin pigment of melanin. After restoring the adrenal function, the skin color is restored. But if chronic adrenal insufficiency develops, life replacement therapy will need for the preparations of the GCS group in the individual dosage of a selected doctor.

Some lethargy appears, malaise, decreased appetite and body weight, irritability, indifference, depression and salty food. Everything is fixable if you adhere to the councils of the doctor and lead a healthy lifestyle.

Recovery is subject to not only the function of the adrenal cortex, but also the consequences of other side effects of prednisolone: \u200b\u200bosteoporosis (bone fragility due to calcium loss), a resistant increase in blood pressure, negative effects on the gastrointestinal tract (gastrointestinal tract) with the formation of ulcerative processes, steroid diabetes Reducing immunity and some other symptoms.

How to restore adrenal glands after prednisone - lifestyle and diet

When a decrease in the function of this organ, it is recommended to get rid of bad habits and primarily from smoking - the toxic substances that are formed during smoking depress the function of the hypothalamic-pituitary-adrenal system. Mastering the absence of stress, proper nutrition, food rich in magnesium, potassium, useful fats, vitamins E, C, group V.

To restore the adrenal glands after prednisoloneIt is recommended to use more fish, including oily marine, seafood, low-fat meat, eggs, vegetable oil, vegetables and fruits, fresh juices, sea salt. Prohibited products: Strong tea and coffee, cocoa, coca-cola, alcohol, sweet carbonated drinks, sweets and snob. It should also be limited to the table salt, replacing it partially or completely marine. Normalization exchange processes will help restore adrenal function.

It is necessary to increase physical activity. It is better to perform special gymnastics complexes designed to restore adrenal function. There are exercises and yoga and respiratory gymnastics. And if you want to achieve a decrease in appetite during prednisone, then read.

Restoration of adrenalities of drugsand after prednisolone

This treatment is carried out after the survey conducted and is appointed by the doctor. If the presence of chronic adrenal insufficiency is revealed against the background of atrophy (decrease in the volume) of the adrenal cortex, prescribed lifelong replacement therapy medicinal preparations From the group of glucocorticoid hormones.

But it does not reach it more often, and there is enough non-flame therapy. ? Prescribed vitamins, minerals, proteins and amino acids necessary for the synthesis of natural GKS. In order to mild body work, the following biologically active supplements for food (dietary supplements) are prescribed:

Restoration of adrenal glands - This is not a fast process, accelerate that the following means help:

• vitamins B5.; Tablets are produced in 100 mg tablets, and also part of the combined polyvitamin preparations (complivitis, gentide, etc.);
• vitamins E and with - are used as antioxidants that suppress the formation of toxic free radicals; This improves metabolic processes; Vitamin E a lot in vegetable oils, fish oil, vitamin C - in berries, citrus, cabbage;
• magnesium and potassium - improve the energy potential of cells, the resulting energy goes to the activation of biochemical processes; Magnesium is in the embryos of wheat, bananas, nuts; potassium rich dried fruits and baked potatoes;
• polyunsaturated fatty acids olein, linoleic, linolenic - participate in cholesterol exchange and synthesis of steroid hormones of adrenal glands; Sources are vegetable oils, wheat embryos, fishe fat.

Folk remedies

Perhaps also restoration of adrenal glands folk remedies After prednisolone. Recipes of folk remedies:

• geranian infusion; 5 g (teaspoon) geranium leaves brew 200 ml of boiling water, cover with a lid for 3 - 5 minutes and drink; Drink 2 - 3 cups per day for four weeks; stimulates the work of the adrenal glands;
• snowdrops tincture; take 80 snowdrops without bulbs, put in a glass jar, add 500 ml of vodka and put into a warm place for four weeks, periodically shaking; Take 15 drops three times a day before eating for three to four weeks; stimulates the synthesis of adrenal hormones;
• navy root licorice; 10 g (2 teaspoons) grated on the roots of root to brew 200 ml of boiling water in a thermos for 60 minutes, then strain and drink per day; treatment course - 3-4 weeks; Suppresses the destruction of adrenal hormones in the liver.

Restore the adrenal glands after prednisolone It is possible when conducting a healthy lifestyle, proper nutrition and additional use of natural substances that stimulate the secretion of glucocorticoid hormones.

Answers on questions:

I accept prednisone if you can drink coffee?

Prednisolone increases blood pressure and flushes many necessary substances from the body, besides, it is an anti-deposit drug. Coffee is also a fairly strong diuretic, also increases pressure, and is a shock for internal organs. Coffee exciting the nervous system, maybe provoke or strengthen the feeling of anxiety. Output - from coffee you need to refusei, switch to coffee surrogates (barley, rye, etc.). A mansion is coffee without caffeine, but the laxative effect still remains. Be patient, do not drink during the medical course, look for an alternative.

Sex and reception prednisolone.

There are no strict contraindications. But you must understand that prednisone is still a highly active hormonal drug. In the body there is a hormonal restructuring, in addition to the impact on the urinary and cardiovascular systems, there is a change in mental terms. Few people want to have sex with elevated pressure, depression and constant urges to urination. In addition, women experience strongest stress during a change in appearance when admitting this medication. They begin to shy, wind themch, the result is deplorable - the uncertainty and the absence of sexual attraction. Of course, the physical condition depends on the degree of illness and dose of medication. In heavy cases better refrainso that the body does not relieve, especially if you have heart problems - high blood pressure or arrhythmia. Of course, if you choose the time when the peak of the drug action goes to the decline, and the forces are restored - it will be best option. Men have such time, most often in the morning, women have a thinner nature, so I will have a more individual approach to sex. First, there should be a strong emotional attachment to a partner and mutual understanding. It is advisable to make love before the admission of medicines. As a memo: during the reception of the drug there is a violation of the menstrual cycle.

How does prednisone affect the gender function of a man?

This medicine reduces the immune system and the ability of the body to fight inflammation and with infections. And it means that if the appearance of the drug "sat inside" and the foci of infection did not give trouble, then when admitting medicines can show themselves. Cold, supercooling, bacterial and fungal state, serious problems of the urogenital system. What could be the consequences?

• Estrogens are formed, poorly affecting the quantity and quality of sperm.
• In the testicles are leildig cells that are responsible for the production of testosterone and other androgen. So, prednisone adversely affects the formation of hormones. Up to infertility.
• The testicles can increase in size, which gives discomfort.

How to get rid of edema during the reception of prednisolone?

The most important thing is that it is necessary to do first, it get a referral to a survey to nephrologist. And only after checking your kidney, treatment will be adjusted. As practice shows the attending physician prescribes diuretics, such as hypothiazide, furosemide diuretik; Asparca - to restore electrolyte balance in the body when using diuretics. Diuretic drugs should reduce the load on cardiovascular and reduce the pomotoryness of the body. Do not forget about the additional reception of potassium chloride, potassium and magnesium. Also pay attention to the amount of fluid that is drunk per day, especially before bedtime, reduce if you exceed the norm (fluid rate of about 30-40 ml. Per 1 kg. Body weight).

• Does prednisone affect the pituitary gland?

Of course influences. As a result of the reception of synthetics - glucocorticoids (prednisone, hydrocortisone, and the like) there is oppression and atrophy pituitary and other organs. At the same time, corticotropin production is significantly reduced. Corticotropin is synthesized in the basophilic cells of the front lobe of the pituitaryit affects the synthesis and secretion of glucocorticoids - cortisol, cortisone, corticosterone. As a result, the synthesis of the adrenal glands of progesterone, androgen and estrogen increases. The prednisone does not give a hypophysia to work fully, preventing (suppressing) to it to synthesize corticotropin.As a result, the functional activity of adrenal glands is reduced. How can one minimize the effects of prednisolone on the pituitary gland:

• take a medicine in the morning.
• Take the drug every other day, in some diseases it is permissible.

How less is when taking prednisone?

• In most cases, you have to limit yourself in sweets, potatoes, flour products from purified flour or yeast dough.
• Use small tricks for reduction Appetite. Drink a glass of water in 1 hour before meals- This Tibetan technique allows you to deceive the saturation center, filling the stomach water. Do not miss the opportunity to eat for the season - in the summer there are on zucchini, cucumbers, tomatoes. Winter ideally come grapefruit,which strongly reduces appetite and reduces the edema (removes the extra liquid). Remember the dried fruits, especially with the laxative effect - prunes, raisins. Over time, they will replace you candy.
• If possible, go to the Mediterranean diet - olive oil With lemon, vegetable salads, fish - sea - products.
• Do not take a prednisone on an empty stomach (it is desirable to take in the morning after meals)
• I want potatoes, then at least bang it in the oven in the peel, by the way and do not forget about other vegetables, cook in the sleeve - pumpkin, turnips, eggplants, zucchini, etc. Burning vegetables contain increased content potassium. Do not forget to use mushrooms in the diet.
• Eat in the mornings with liquid strawed oatmeal, it envelops the walls of the stomach (reduces appetite) and protects against ulcers.
• It should instead of tea (black, green), coffee, kissel goes to dairy products (not fat). Compote and natural juices.
• Take enzymes for better food digestibility.
• If, there is no power to limit carbohydrates, then read the Diet Court (with diets carefully, very often improving appearance, get different complications).
• Find yourself sports exercises - an increase in physical exertion will allow less limiting yourself in food.

What time of day to drink prednisone during adrenal insufficiency?

First, the doctor who prescribes you a medicine must be intelligible to tell the prednisiolone reception rule. Another thing, if the doctor does not have proper experience, or in the process of explaining the course of treatment, "on the reservoir", can miss something. Therefore, it is better to prepare in advance and draw up a list of questions for the attending physician.

Main questions:

• Time and dose of taking medication. G. rafik and dose of hormones plays a big role. As a rule, the morning dose is the largest, let's say 4 in the morning, at lunch 2, dinner 1.
• How to prepare your body (which, and when to eat).
• How to reduce side effects, assume erosion gastritis or ulcers.
• What is recommended and, which cannot be done during the disease.
• What the body's reaction can be expected during the course of treatment, and what to do in each case. This is an exemplary list of questions, but it can be repelled and complemented.

Let us dwell on the reception time. The most optimal, drink the maximum dose early in the morning, this is associated with the activity of adrenal glands ( It is necessary to take into account the circadian rhythm of the production of glucocorticoids, so it is more dangerous to give 5 mg of prednisone in the evening than 20 mg in the morning). In the evening, from a larger dose there is a sleep disorder. Even, the reception time depends on the dose if it is a big start to drink up to 6. For example - 6h \u003d 6 tab.12h \u003d 6 tab.18h \u003d 2 tab. Someone is prescribed to drink 1 time per day, it all depends on the disease. But in most cases, drink the entire dose, or most of it up to 13 hours.To reduce the side effect, the almagel can be prescribed, omeprosol, omens or similar. For example - for 20 minutes. Before eating, take an almagel or omens, then eat and accept prednisone, in conclusion to wash with a kiel or milk. Obrozol can be prescribed in the morning or before bedtime. The diagram should pick up the doctor, these examples are only for familiarization.

Reception of prednisone must be monitored by regular gastroscopy.

Prednisolone and tachycardia.

Tachycardia from the reception of prednisolone is manifested in many patients. Even if you have no problems with pressure before receiving the drug, then because of its side effects, tachycardia may appear. After adjusting the course of treatment or its cancellation, tachycardia is in most cases terminated. Also, the pressure increases if by mistake or overpower, for example, make medicines affecting pressure. It even seemed such a harmless dietary dietary supplements as licorice increases pressure. Therefore, tachycardia can begin from other factors (diet, stress, ...), review your lifestyle. To stabilize pressure can assign Enalapril,or other similar medicines.

The root of licorice when leaving prednisone.

There are standard schemes in order to fail the reception of prednisolone. The basic principle - you go quiet, you will be on. A sharp decline in the dose or a refusal to hormonal drug leads to the deplorable results, manifests itself in all its glory - failure syndrome.About the root of licorice and the reception of it, in order to help the adrenal glands "Run", many doctors (especially developed countries) are skeptical. At this time, there is no hard evidence based on long-term scientific research, on the effects of licorice root on the hormonal background. There are also practitioners who recommend taking licorice root. They believe that licorice is a natural corticosteroid. When receiving prednisolone, the adrenal glands are suppressed and do not produce hormones, and the licorice neatly launch the necessary processes. In addition to licorice, it is recommended to take vitamin C, which is involved in the synthesis of steroids. Now it is not necessary to be messed with decoctions based on the root of licorice. There are tablets, with the main active substance - Ammonium glycyrrizinat, which is a monosightened ammonium saline of glycyrrhizic acid obtained from naked licorice from the roots. As an example, drug - Glyciram.

Scheme Treatment prednisolone, adrenal insufficiency.

General. The concept of the scheme includes:

• Number of prednisolone
• The number of concomitant drugs, according to your diseases and relief of therapy.
• Time of receipt
• Examination tests. Consultation of the doctor and adjustment of the scheme on the basis of analyzes.
• Course duration.

Due to the seriousness of the disease, the treatment regimen prednisone must be drawn up by an experienced doctor, after the necessary analyzes. If it does not scare a lot of letters and there is a desire to find out how Russian medicine should relate to the treatment of prednisone adrenal insufficiency, then you are here.

Will the side phenomena pass after the end of the prednisolone?

By themselves, the consequences of prednisone pass, although not always. The most common problem is the appearance of overweight. There may also be trouble with bones (fragility, fragility), muscle atrophy, ethnicity. And much more, in annotations to the medicine, it is described in detail that you can wait. This is due to violation of the hormonal background, which makes it difficult to normalize the functions of the body. With small or disposable doses of medication, as a rule, violations are not observed. You must understand that at the beginning of treatment may be mistaken with a dose. The overestimated dose has a negative impact by the authorities. Only do not reduce the number of prednisone, the doctor is obliged to adjust the reception rate, or justify the prescribed dose. After smooth cessation of the drug, according to the idea, everything should normal. Therefore, for reducing or lacking, the following aspects are needed:

• The doctor rheumatologist must choose an adequate course of treatment based on laboratory surveys and observations over the course of the disease.
• On your part - you need to perform the instructions of the doctor. It is also better to limit yourself in some "joys of life" - to comply with the diet and regime, to do therapeutic physical education.

Immunity and prednisone.

How does prednisone affect the immunity? The answer to this question does not hide from you. If you carefully read the annotation to the medicinal product, then you will immediately understand everything. Prednisone has pronounced immunosuppressive action.To complete the picture, make an immunogram before accepting medication, during, after graduation. Such a number of immunograms will give an understanding that affects immunity - disease or prednisone. Not a big reservation - if you take prednisone with no large doses and short courses (up to 10 days), it practically does not affect the immune system, for example, with strong allergies and edema. The main conclusion is the prolonged use of the drug damages immunity, with a short course - the risk is minimal. Therefore, prednisone must be prescribed in difficult cases when general therapy is unable to cure.

Diet after the end of the reception of prednisolone.

Many mistakenly believe that if the diet can be taken from the medicine, you can change. Of course, if there is a desire to repeat the relapse and thereby return the whole nightmare, then please. While the body is restored, do not allow shake in the lifestyle. And about the diet, there is to solve you. Now gaining popularity of the SUS diet - " Special (Specific) Carbohydrate Diet"In the English version SCD. - (Specific Carbohydrate Diet). To familiarize yourself with the Sousse, follow the link.

Prednisolone injections are a drug that constitutes a group of glucocorticosteroid hormones. It is permissible to apply it only after consulting with the doctor attending, since injections have a large number of contraindications and side effects. Most often, they are appointed in cases where the use of nonsteroidal anti-inflammatory funds is not permissible or did not show due efficiency.

Mechanism of action

Prednisolone is a solution for injections, which has a powerful anti-inflammatory, anti-shock, painkillers and immunosuppressive actions. Finding into the body, the medicine forms a glucocorticoid receptor. It rapidly penetrates the core of the cell, where interacts with genes. Because of this, there are serious changes in the development of proteins and RNA. Prednisolone is valued for a high anti-inflammatory effect, which is determined by the following factors:

• The active ingredients increase the production of lipocortin, which prevents the further development of phospholipase. Because of this, damaged tissues can no longer produce arachidone acid. All this leads to the impossibility of prostaglandin synthesis.
• The active substances prevent the exchange of COG-2 genes, thereby decreasing the production of prostaglandins.
• Prednisolone stops metabolic processes between molecules in blood vessels, due to which neutrophils and monocytes do not penetrate the focus of inflammation.

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

Indications for use

Prednisolone is a powerful medicine, which can be used only after consulting a doctor. Usually specialists prescribe it:

• With postoperative, traumatic, toxic and burn shocks.
• With sharp and heavy forms of allergies.
• With anaphylactic or hemotransphusion shock.
• With a brain edema caused by radiation therapy, head injury or tumor.
• With severe form bronchial asthma.
• With serious lesions of the skin: psoriasis, dermatitis, bullous dermatitis, seborrhea, Stevens-Jones syndrome.
• With allergic conjunctivitis.
• With serious violations and congenital anomalies of adrenal glands.
• With severe uveitis, nerupt the visual nerve.
• With a liver coma.
• With thyrotoxic crisis.
• With acute hepatitis.
• For serious diseases blood and blood system.
• With lefball syndrome, beryllium.
• With multiple sclerosis.
• With hypercalcemia caused by malignant neoplasms.
• As preventive measures to replancing a transplanted organ.
• To reduce inflammation.
• For the prevention of scar narrowings.

Mode of application

Instructions for use of injections Prednisolone states that use the drug is permissible only after consulting with a qualified doctor. This medicine has a high impact on the body, therefore, due to incorrectly selected therapy, there is a high risk of developing side effects. Prednisolone in the form of injections must be administered inside the muscles, joints, or in the form of impregnation of tissues. It is very important to handle the skin with alcohol before the procedure to kill all pathogenic microorganisms.

To relieve the soreness of the joints, it is necessary to introduce 25-50 mg to large, 10 mg - in small one. With a pronounced syndrome, the procedure can be repeated several times. It is very important to estimate the therapeutic effect after such therapy so that, if necessary, either increase the dose of the active substance, or change the medicine. To make the drug correctly in the joint, after the introduction it must be repeatedly bend and blends. Loosen the painful sensations will also help the rims from the solution - they are treated with small sections of affected surfaces.

Cope various species Conjunctivitis will help injections or injection of the drug in the eye. It is necessary to do it 1-3 drops three times a day for 2 weeks. So that the therapy does not bring any complications or side effects, it is necessary to regularly measure the level of blood pressure and introduce anabolic preparations. The doctor must also send you 1 time in two weeks for blood test, feces and urine. At the time of therapy, it is necessary to follow water balance In the body, if necessary, take diuretic.

It should be borne in mind that with long-term use, prednisone can cause a decrease in blood potassium levels. To prevent this, it is recommended to comply with a special diet and take this macro-element in the form of tablets. Otherwise, there is a high risk of osteoporosis - damage to bone tissue, which is why it becomes extremely fragile.

Medical dosage

Consider that it may exclusively attending the treatment of its prednisolone, as well as the duration of its application. He must familiarize himself with the results of diagnostic research, and only then appoint treatment. Pricks can be administered inside the body drip or stake, however, in practice, two of these methods are used for one procedure.

Disease	Dosage	Duration
Acute insufficiency of adrenal glands	100-200 mg	From 3 days to 2 weeks
Bronchial asthma	75-675 mg	From 3 days to 2 weeks
Astmatic crisis	150-1200 mg	Once
Thyareoxic crisis	200-300 mg	1 Week
Toxins poisoning	75-400 mg	1-2 weeks
Breeding Logs and Gastroy	120-350 mg	1 Week
All types of shocks	300-1200 mg	1 Week
Acute renal and liver failure	300-1500 mg	1 Week
Rheumatoid arthritis	75-100 mg	1 Week
Acute hepatitis	75-100 mg	10 days

In cases where the prednisone in the bloodstream is not possible, it is permissible to introduce it intramuscularly. To stop acute states, doctors prescribe the tablet form of this medication. To avoid cancellation syndrome, the ending treatment is accompanied by a decrease in the therapeutic dose. It is strictly forbidden to drastically terminate the use of this medicine - the risk of serious complications is great.

Despite the generally accepted dosages, an exceptionally attending physician should be prescribed by prednisone on the basis of expanded diagnostics.

Cancellation syndrome

With long-term use of a solution for injection prednisolone, the body begins to get used to the components. In addition, the drug affects and changes the functioning of adrenal glands. With a sharp refusal of therapy with this drug, a person may encounter ailment, high fatigue, high body temperatures. Such states pass without additional therapy in a few days. However, if there was a sharp abolition of high doses of prednisolone, the risk of a hypo-adrenalin crisis occurs. It can be recognized by increasing cramps, vomiting and collapse. If there is no medical care in a timely manner, a heart stop is possible due to acute cardiovascular failure.

Contraindications

To reduce the risk of complications due to the reception of prednisolone, it is always necessary to remember the presence of contraindications. Even in emergency cases, it is forbidden to introduce this injection if there is an increased sensitivity to the components of the drug. It is also necessary to take into account that lactose is present in the medication, for which some people have resistant intolerance. With particular care to carry out prednisone treatment is permissible in the following cases:

Prednisolone - a drug that has a lot of side effects. To prevent their occurrence, it is necessary to clearly adhere to all recommendations of the attending physician. The following consequences are the greatest danger:

• Reducing glucose tolerance - especially dangerous for people with diabetes. The substances entering the body slow down the liver work, which is why insulin is disturbed.
• The oppression of adrenal function - this leads to a violation of the hormonal balance. Also inhibits the conclusion of slags and toxins from the body.
• Itsenko-Cushing syndrome is a state that is observed with a powerful change in the hormonal background.
• The emergence of nausea, vomiting, painful sensations in the abdomen.
• Education of bleeding inside the gastrointestinal tract: erosive gastritis, perforation of the intestinal walls, ulcers.
• Violation of digestion in the form of changes in appetite, constipation and diarrhea, meteorism.
• The aggravation of cardiovascular pathologies.
• The appearance of long-lasting Icotes.
• Changes in the nervous system: TIR, depression, euphoria, paranoia, disorientation.
• Frequent convulsive seizures, especially at night.
• Headache and dizziness.
• Significant increase in the pressure inside the eye.
• Increased intraocular pressure, trophic changes in the structure of the cornea.
• Hyperhydrosis, the appearance of specific smell from the body.
• Reducing body weight, muscle tissue atrophy.
• Long healing of wounds.
• Education of acne and Strya on the body.
• Local allergic reactions.

The pharmacological drug quickly reduces the severity of symptoms, significantly accelerates the recovery of patients. But with long-term use of high doses of glucocorticosteroid, the side effects of prednisolone are manifested - an increase in blood pressure, the destruction of bone tissue, an increase in body weight. To avoid the development of such negative consequences, all medical recommendations should be followed to which proper nutrition refers during reception and cancellation drug.

Characteristic features of the drug

Manufacturers produce a drug in various dosage forms, each of which is intended for therapy of a certain disease. On the shelves of pharmacies prednisolone is presented in the form:

• eye 0.5% drops;
• solutions for 30 mg / ml and 15 mg / ml used for intravenous, intramuscular and intra-articular administration;
• tablets containing 1 and 5 mg of the active substance;
• 0.5% ointment for outdoor use.

Warning: The lack of medical control when taking prednisolone will cause the development of protein deficiency in systemic bloodstream. This will lead to the production of excessive progesterone and the manifestation of its toxic properties.

Endocrinologists, ophthalmologists, allergists and neuropathologists prescribe glucocorticosteroid only in cases where the use of other drugs has not brought the required results. During treatment, patients regularly rent biological samples for laboratory studies. If the use of prednisolone provoked negative changes in the operation of the cardiovascular or endocrine system, the drug reception stops or used daily and one-time dosages are adjusted by the attending physician.

Pharmacological action of the drug

Regardless of the method of using prednisolone, immediately after the penetration of the active substance of the drug in the human body, a powerful anti-inflammatory effect is manifested. In its development, several biochemical mechanisms are involved:

• The drug suppresses the action of the enzyme acting as a catalyst for special chemical reactions. Their finite products are prostaglandins, synthesized from arachidonic acid and mediators related to mediators. inflammatory process. Blocking prednisone phospholipase A2 is manifested in the relief of pain syndrome, swelling and hyperemia;
• After entering the human body of an alien protein, an immune system is activated. To eliminate the allergic agent, special white blood tales are produced, as well as macrophages. But in patients with systemic diseases, the immune system gives a distorted response, reacting negatively to its own organism proteins. The effect of prednisolone consists in the oppression of the accumulation of cellular structures that ensure the occurrence of the inflammatory process in the tissues;
• Answer immune system The introduction of an allergic reaction agent is to produce lymphocytes and immunoglobulin plasma cells. Specific receptors Antibodies are associated, which leads to the development of inflammation to eliminate alien proteins from the body. The use of prednisolone prevents the development of events for such a negative scenario for patients with systemic pathologies;
• The therapeutic properties of glucocorticosteroid include immunosuppression, or a decrease in the functional activity of the immune system. Such an artificial state, provoked by prednisolone, is necessary for the successful therapy of patients with systemic diseases - rheumatoid arthritis, severe forms of eczema and psoriasis.

With prolonged use of any dosage form of the drug, water and sodium ions begin to absorb in the kidney channels. Protein catabolism is gradually increasing, and destructive-degenerative changes occur in bone tissue. The negative consequences of treatment with prednisolone include increasing the level of glucose in the bloodstream, closely associated with the redistribution of fat in the subcutaneous tissue. All this becomes the reason for reducing the production of the adrenocorticotropic hormone, and, as a result, reducing the functional activity of adrenal glands.

Warning: For the full restoration of the body of patients after the use of prednisolone, it is often required for several months during which doctors prescribe additional preparations and compliance with a gentle diet.

When the glucocorticosteroid is required

Despite the numerous side effects of prednisolone for most patients with systemic diseases, it is a preparation of first choice. The negative consequence of its admission is to suppress the activity of the immune system, in this case leads to a long remission of pathology. Prednisolone has high therapeutic effectiveness in the treatment of the following diseases:

• anaphylactic shock, angioedema swelling quinque, serum disease;
• rheumatoid arthritis, ankylosing spondyloarthritis, psoriatic arthritis;
• acute gubric arthritis, dermatomyositis, systemic vasculitis, mesoarteritis, nodule periatheritis;
• bubbles, mycotic lesions of the skin, seborrheic and exfoliative dermatitis, herpetyiform bullous dermatitis;
• hemolysis, idiopathic thrombocytopenic purpura, congenital aplastic anemia.

Prednisolone is included with doctors in the therapeutic schemes of malignant neoplasms, chronic hepatitis various etiology, leukemia, tuberculosis meningitis. The drug is also used to prevent the transplant rejection by the immune system.

Since the hormonal agent is prescribed only for the treatment of serious, severe treatment with other medications of pathologies, then contraindications to its reception a little:

• individual sensitivity to the main substance and auxiliary ingredients;
• infections provoked by pathogenic fungi.

The prednisone is prescribed only with the life-threatening states with patients with ulcerative lesions of the gastrointestinal tract, specific endocrine pathologies, as well as pregnant and women who feed the baby with breasts.

Side effects of the drug

In the process of research, the relationship was established between the reception of certain doses of prednisolone and the number of side effects arising. The drug adopted in a small dose for a long time provoked less negative consequences compared to the use of significant doses for a short period. Patients diagnosed such side effects of prednisolone:

• girsutism;
• hypokalemia, glucosuria, hyperglycemia;
• impotence;
• depression, confusion;
• nonsense, hallucinations;
• emotional instability.

The course reception of the drug often becomes the cause of increased fatigue, weakness, drowsiness or insomnia. The decrease in the functional activity of the immune system leads to frequent relapses of chronic pathologies, viral and bacterial infectious diseases.

Recommendation: The side effects of prednisone can manifest themselves everything immediately, but more often arise gradually. This should be uncompromising to inform his attending physician. It compares the seriousness of side effects with the need to receive glucocorticosteroid, will cancel the drug or will recommend continue therapy.

The cardiovascular system

Long-term reception of high doses of prednisolone provokes the accumulation of fluid in tissues. Such a state leads to a narrowing of the diameter of blood vessels and an elevation of blood pressure. Hypertension is gradually developing, usually systolic, often accompanied by stealing heart failure. These pathologies of the cardiovascular system were diagnosed in more than 10% of patients who took the glucocorticosteroid drug.

Endocrine system

The use of prednisolone is often caused by addiction to glucose and increasing its serum content. People, hereditly predisposed or prone to the development of diabetes, are in the risk group. Therefore, this endocrine pathology refers to contraindications to the reception of glucocorticosteroid. It can be assigned to such patients only on life indicators. It is possible to prevent the decrease in the functional activity of the adrenal glands possible by a gradual decrease in the dose of prednisolone and the reduction of the multiplicity of its use.

Gastrointestinal

The use of glucocorticosteroid in therapy of various pathologies is contraindicated to patients with ulcerative damage to the stomach and (or) duodenal. The long-term reception of prednisolone can provoke destructive-degenerative changes in the mucous membranes and deeper layers of the gastrointestinal tract. Also, solutions for parenteral administration and tablets cause dyspeptic disorders - nausea, bouts of vomiting, excess gas formation. Cases of development of pancreatitis, spinning ulcers and intestinal bleeding were noted.

Musculina

In patients, the previous time of the prednisone, the consequences were expressed as the appearance of myopathy. This is a chronic progressive neuromuscular disease characterized by primary muscle damage. A person has a weakness and depletion of the proximal muscles due to the absorption of calcium suction in the intestine, the trace element necessary for the optimal functioning of the musculoskeletal system. Such a process relates to a reversible, the severity of the symptoms of myopathy is reduced after the end of receiving prednisolone.

Cancellation syndrome

The sharp cancellation of prednisolone can provoke severe consequences up to the development of collapse and even coma. Therefore, doctors always inform patients about the inadmissibility of glucocorticosteroid passing or unauthorized cessation of treatment. The appointment of high daily dosages often leads to the wrong functioning of adrenal cortex. With the abolition of the drug, the doctor recommends the patient receiving vitamins C and E to stimulate the operation of these pair bodies of the endocrine system.

The dangerous consequences arising after the termination of therapy prednisolone also include:

• return of symptoms of pathology, including pain syndrome;
• headaches;
• harsh fluctuations in body weight;
• worsening mood;
• disps disappointments.

In this case, the patient must resume the reception of the drug for several weeks, and then under the supervision of the doctor gradually reduce one-time and daily dosage. During the abolition of prednisolone, the doctor controls the main indicators: body temperature, blood pressure. The most informative analyzes include laboratory tests of blood and urin.

Diet in the treatment of glucocorticosteroid

Doctors categorically prohibit the reception of prednisolone on an empty stomach. If a person does not have the ability to eat, and the tablet should be taken urgently, then you can drink a glass of milk or fruit juice. The diet in the prednisolone treatment is necessary to minimize the effects of glucocorticosteroids, reducing the severity of their symptoms. During coursework, patients should include products with large content potassium. These include:

• dried fruits - raisins, kuraga;
• baked with peel potatoes;
• efficious products - low-fat cottage cheese, kefir, ryazhenka, varets.

Since the reception of prednisolone provokes a strengthened catabolism of proteins, daily menu The patient must contain protein products: meat, river and sea fish, seafood. It is worth a preference to stew vegetables, fresh fruit, nuts. The less fats and used when cooking, the use of prednisolone will be the use of prednisolone.

But it is possible to more correctly treated, but the reason?

The preparation of "assault" therapy. Side effects of prednisolone

Medical preparation Prednisolone refers to a group of synthetic glucocorticoids, which has all the properties inherent in the compounds of this group. Prolonged use of the drug in high doses causes side effects of prednisolone.

The preparation of "assault" therapy

Prednisolone - the drug of the hormonal group

The prescriptions of the drug are exclusively produced in emergency cases when the main therapy does not lead to a proper result, or treatment begins to take a protracted character. With a not account, the clinical picture of the appointment is carried out by a short course using high doses of the drug. The long-term use of a large amount of prednisolone is able to cause a protein deficiency in a blood plasma, which threatens toxic emission of free progesterone. The reasons why prednisone belongs to the group of hormonal drugs:

1. The deficiency of progesterone in the protein plasma, as a rule, leads to violations of the growth functions and sexual development of adolescents during the ripening period, or in transition.
2. Prednisolone causes an increase in blood sugar in patients suffering from diabetes.

In addition, the drug is capable of simultaneous actions to enhance the decay and the neoplasm of fat cells that are deposited in tissues, which leads to a sterely obesity process.

Excess prednisiolone leads to a disruption of mineral exchange, since the drug is able to withdraw potassium from the body, thereby reducing the contractile ability of myocardium. This leads to myocardia and the risk of infarction.

Prednisolone displays calcium from the body, which leads to osteoporosis, or sulking bones. Bones become fragile, and can break from light bruise.

The actions of the drug in the cells of the body are delayed water and sodium, causing serious swelling.

The preparation of prednisolone is carried out in various formsAccording to the formulation: powder, solution for injection, injection-suspension, oral fluid, suspension for oral administration, oral syrup, oral tablets, soluble pills for oral administration.

Clinical observations of prednisolone

In patients who received an average of 10 mg per day prednisolone for several months, was registered by 50% less damage to infectious diseases compared to patients who were on average 20 mg per day of the drug. It was noted significantly less than the number of episodes of aseptic necrosis with a tendency to less complications in patients with low doses of drug intake.

Prednisolone - Release form: Solution for injection

At the same time, side effects of prednisolone were observed, manifested when using minimal doses, but their manifestation was presented in minor quantities. Doses, more than 10 mg per day, were associated with an increase in the number of side effects that are manifested in a significant group of patients. The side effects of reception of prednisolone can be divided into those related to short-term therapy for up to three weeks, and manifestations after long-term therapy, conducted over three weeks.

Short-term courses of the drug included consequences associated with an increase in the accumulation of the weight parts of sodium and the accumulation of fluid. It can include hyperglycemia, glucose intolerance, hypocalemia, gastrointestinal disorders with the formation of an ulcer, reversible inhibition of the hypothalamic-pituitary-adrenal axis. From psychomotoric and nervous system Patients had a sharp change of mood - from Euphoria to insomnia.

Among the patients taking large doses of prednisolone, frequent cases of nervousness, anxiety, mania of several modifications, catatonia, depression, delight, hallucinations and aggressive behavior were registered.

Long-term use of the drug, led to such long-term side effects as the depressed appearance and confusion of consciousness, girsutism or virilism, impotence, impaired menstrual cycle, ulcerative disease, cataract and an increase in intraocular pressure, the development of glaucoma, myopathy, osteoporosis, up to the compression spinal compression fractures .

Metabolic side effects of prednisolone

When observing the metabolic side effects of the prednisiolone, hypernatremia, hypokalemia, fluid delay in the body, the negative nitrogen balance and the increased concentration of urea nitrogen in the blood were recorded. During the research, it turned out that glucocorticoids significantly reduce the secretion of thyrotropin.

Side effects on the cardiovascular system

Prednisolone: \u200b\u200brelease form - ointment

From the cardiovascular system, a hypertonic syndrome was observed, resistant heart failure due to long-term storage of fluid in cells, as well as the direct effect of reducing vessels. Studies have shown that patients may develop systolic hypertension. It was prone to 12% of the total number of observed patients. As it turned out, hypertension was associated with long-term therapy with corticosteroids and, as researchers believe, due to fluid delay. In some cases, changes in blood pressure occurred in connection with the old age of patients.

Side effects on the endocrine system

From the endocrine system, side effects included glucose tolerance and hyperglycemia. Diabetes, as a symptom, can develop in people prone to this disease, or suffering from heredity factor. Hypothalamic-pituitary-adrenal suppression can be extended to the calendar year after long-term therapy prednisolone. The observed effect of the manifestation of Izsenko-Cushing disease was most likely related to therapy chronic disease. In addition, garisutism or virilism, impotence and impairment of the menstrual cycle can also be a display of therapy with the use of prednisolone in chronic diseases.

Corticosteroid therapy may cause glucose intolerance by reducing sugar utilization in liver tissues and increasing glucose exit. Patients with long therapy may exhibit significantly more high level Glucose in blood serum, if the analysis was taken on the day of reception of prednisolone. For example, it was noted in patients with diabetes mellitus, requiring treatment with a modified diet using regulating glucose levels and sugar-based drugs.

Adrenal suppression can be maintained to twelve months after long-term corticosteroid therapy. The adrenal suppression can be reduced, a decrease in the use of corticosteroids up to once a day or every two days. Padnisolone treatment can be used as additional corticosteroid therapy during stress, infectious diseases, operations, or serious injuries.

Side effects on the gastrointestinal tract

From the gastrointestinal tract, the side effects of the use of prednisolone included gastrointestinal disorders, nausea, vomiting and the occurrence of ulcerative disease. The manifestations of pancreatitis were also observed, and in isolated cases, the manifestation of gastrointestinal bleeding and perforation of the stomach walls was also observed. The most frequent side effect of the drug prednisolone is the perturbation of the gastrointestinal tract, with the manifestation of nausea, vomiting, stomach disorders, and anorexia. Rare manifestations of ulcerative illness, as researchers suggest, were associated with long-term therapy with corticosteroids.

Side effects on the immune system

Side effects on the musculoskeletal system

On the side of the musculoskeletal system under therapy with corticosteroids, the manifestations of myopathy were observed in the form of weakness and depletion of the proximal limbs and muscle belts. As a rule, such processes are reversible after the termination of therapy. Corticosteroids suppressed suction calcium in the intestine. The increasing increase in the excretion of calcium with urine leads to resorption of bone tissue and bone loss. The loss of bone tissue is more than 3% in one year, it became a demonstration of prednisolone when appointing 10 mg of the drug per day.

Women, in the postmenopause period, are especially exposed to risk of loss of bone density. Elderly patients, 16% of the total number of people under study, received corticosteroids for 5 years. These people enter a group of risk of obtaining a spinal compression fracture, since they had loss of bone tissue. According to studies, loss of bone mass in women with concomitant therapy for the use of prednisolone of 7.5 mg per day in combination with tamoxifen, occurs in two years from the start of the reception of drugs.

The side effects affecting the musculoskeletal system, included myopathy, osteoporosis, compression and spinal fractures, as well as aseptic necrosis. Aseptic necrosis is the most common factor in damage to the head of the femoral bone.

Side effects on organs of vision

Prednisolone - Release form: Tablets

From the side of the visual system, an increase in eye pressure and the development of cataracts occurs. In renal transplantation, patients who were prescribed prednisolone in the dosage of 10 mg per day, in 33% of patients received the development of rear subcapsular cataracts. The average cataract development time is 26 months. In this case, the cataract developed less than a year. Increased intraocular pressure was observed in 5% of patients. Also, to the side effect by the authorities, glaucoma was included.

Other manifestations of side effects

Other side effects included:

1. Cancellation syndrome glucocorticoids. It is observed as a result of a sharp discontinuation of prednisolone. As a rule, it causes adrenal suppression syndrome.
2. Rheumatoid arthritis, or glucocorticoid derivation syndrome. Syndrome may be observed after the cessation of corticosteroids. His manifestation is not associated with insufficiency of adrenal glands.
3. Patients are experiencing anorexia, nausea, vomiting, lethargy, headache, fever, arthralgia, malgia and the effect of postural hypotension. Symptoms are allowed when recovering corticosteroid therapy.
4. Psychiatric side effects include psychosis, behavioral changes, and a pseudotomorotic state.
5. Hematologic side effects include thrombocytopenia, lymphoprodium, and platelet changes as a result of Thrombolic events.

Medical preparation Prednisolone is a very serious preparation appointed in the most difficult cases when general therapy is not able to resolve the situation. But due to the fact that the prolonged use of the drug can lead to very aggressive consequences, prednisone is prescribed symptomatically, short course and not a very short period.

Personal experience in the use of glucocorticosteroids (corticosteroids), will share with you in the video material:

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Side effects after prednisolone

The prednisolone prednisolone in the humorous show, the prednisolone actually represents a very serious medicine, the use of which is possible only to appoint a doctor. In almost every case, after prednisone, side effects are observed, especially if the drug was accepted for a long time.

What is the prednisone applied

Prednisolone is intended for the treatment of a number of diseases, among which the bronchial asthma should be noted, allergic reactions, dermatitis, rheumatoid arthritis, dermatomyositis, with acute adrenal insufficiency, with a thyrotoxic crisis, with a shock resistant to standard therapy, with renal and hepatic insufficiency, with acute hepatitis , with poisoning migration fluids with the burns of the digestive tract and the upper respiratory tract.

Treatment with the drug is appointed only by a doctor, although the drug in the pharmacy can be bought without a recipe. Despite the availability of the drug, it is worth mentioning caution when applying the drug. To begin with, it makes sense to familiarize himself with side effects and contraindications, and then decide whether or not to use this drug.

However, another reason for consultation with the doctor is that the doctor appoints a medicine only on the results of the tests, which means it really understands that this medicine does not bring harm to you. And otherwise, there will be no major disease, but the consequences after side effects.

Form release

The drug is produced in the form of tablets, ointment for outdoor use and in the form of ampoules for injection. For injections, the drug is produced in ampoules one millilitone thirty mg / ml. Three, five and ten ampoules in a special plastic pallet. Pallets are placed in the box one-two. The amount of ampoules and pallets is indicated on the package. Prednisolone in tablets is available in a cardboard box for a hundred tablets in each, the dosage is equal to five milligrams. India manufacturer. The drug should be stored at a temperature not higher than 25 degrees Celsius.

Side effects

Side effects after prednisolone can be from the most diverse systems and human organs. Most often, primarily prednisolone affects the endocrine system and the metabolism.

As a result, in disruption of metabolism, the organism is contaminated with various slags and substances obtained along with food. Poorly absorbed carbohydrates and others harmful substancesthat in the future can lead to overweight.

Prednisolone is dangerous in that its actors can destroy proteins. It is especially scary for children and adolescents, because due to the lack of protein, the child lags behind in development, adolescents have a violation of puberty. In the future, girls with such violations may have problems with pregnancy and menstrual cycle, as well as high risk of developing various sexual diseases. If the delay in the development of the genital organs occurred at the boy, then the consequences are no less terrible. These include problems with sex life, which will lead to the risk of infertility.

The long-term use of prednisone is reflected in the operation of the adrenal glands, it can also be reflected in the menstrual cycle in women, as well as on the genital functions of men.

From the side of the cardiovascular system, the use of the drug may reflect on the work of the heart muscle, violations heart Rhythm, as well as the development of heart failure. Especially high the possibility of developing this side effect in people who are prone to obesity and leading a low-wear lifestyle.

People who have previously experienced heart problems, the drug is generally prohibited, so do not risk.

If you take the drug without a doctor's prescription, without his knowledge, the doctor will not suffer responsibility for the consequences.

The side effects of the use of prednisolone are also reflected in the central nervous system, the gastrointestinal tract, the musculoskeletal, on the organs of vision, hearing, the skin. Eyes begin to get item, in the worst cases, a serious impairment of vision is possible. The skin becomes dry and pulled, small rashes appear. Problems with digestion are due to non-stomach, diarrhea, or vice versa obstruction, that is, constipation. Perhaps dizziness and unshakful gait. In case of overdose, poisoning is possible.

If after taking the drug yourself, without a doctor's prescription, you have found signs of listed side effects, it is necessary to immediately terminate the adoption of the drug and contact the hospital, since in this case the delay can lead to serious complications.

The consequences of the use of the drug inspiring, therefore, before agreeing to the treatment with this drug, it is necessary to familiarize themselves with its instructions. And once again it is worth mentioning the need for advice with the doctor.

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Prednisolone: \u200b\u200bhow to cancel the drug

What is prednisone

Under prednisone is understood as the medicine and the acting component of the drug. The substance is a synthetic substitute for natural cortisone hormones and hydrocortisons produced in the human body of adrenal cortex.

The synthetic analogue acts more aggressively than endogenous substances: it is stronger than the cortisone 4-5 times, the hydrocortisone is 3-4 times. Such activity and explains the high efficiency of the drug, as it copes with many diseases, which are passing out other medicines. After administration, the prednisone has several actions at once: eliminates inflammatory processes, suppresses allergic reactions, prevents the formation of exudate, counteracts toxic effects, removes the shock condition of the body.

But this high performance and powerful influence on flowing internal processes provoke various negative states.

Prednisolone is produced in various forms: tablets, ointments, injection solutions. Due to this, the drug is shown in many serious diseases.

It is prescribed under the damage to the joints, severe lesions of the respiratory organs, the exacerbations of bronchial asthma, various pathologies of connective tissue, lesions of the skin. Prednisolone perfectly removes anaphylaxis, traumatic and burn shock. A hormonal agent and for the treatment of organs of vision is used.

Features of therapy with hormonal means are determined by the doctor, depending on the pathology, the dosage and duration of use are calculated separately for each patient.

Side effects and rules of cancellation of prednisolone

The main risk of long-term treatment prednisolone lies in the fact that the drug, replacing the human hormone, gradually reduces the ability of the adrenal glands to synthesize the production of natural human hormones. Due to the constantly external arrival of an artificial hormone substitute, the amount of endogenous is less and less formed.

Therefore, in the case of a sharp or insufficient well thought-out cessation of treatment with glucocorticosteroid, a situation is created when the external source of dried, and its own - has not yet earned. The formed hormone vacuum becomes a shock for the body and provokes its stormy reaction. It is especially dangerous to act in such a way that prednisone was taken inside a long course.

Knowing about this feature, doctors usually act carefully, assigning small doses of the drug, but for which it is possible therapeutic effect. The same applies to the duration of the course: it is stopped as soon as the patient's condition is normalized. But all this should be under the permanent control of the doctor who knows how to reduce prednisone, and in no case cannot be independently stopped drinking tablets.

In order not to provoke a shock reaction (t. N. Cancellation syndrome) It is necessary to give adrenal glands to properly restore and begin to synthesize hormones in an amount in which the biochemical processes flow in normal mode.

On the cancellation syndrome, you can judge the following signs:

• Increased or high body temperature
• Muscular and articular pains
• Chills, fever
• Weakness, lethargy.

Such signs are only a lightweight version of the response, but the consequences are much more serious. As a result of a sharp decrease in prednisone and, all the more complete abolition of the drug, adrenal glands can and completely refuse.

Therefore, prednisone must be canceled gradually, to slightly reduce the dosage of the injected drug. At the same time, it is necessary to constantly monitor the functioning of various organs. If at some stage of the cancellation, the patient's condition occurs, the doctors return the previous scheme for receiving prednisolone, and after stabilization of the state, they again begin to reduce the dosage.

The most dangerous is the state when the dose of prednisolone becomes equal to the level of natural hormone. In this case, the number is reduced even slower.

Duration of denial of medication in different people occupies a different amount of time: from a few weeks to months, or even years. But after the complete cancellation of prednisolone, the processes running them can occur in the body for several years. Therefore, it is necessary to regularly attend a doctor for examination.

Weight problems after treatment prednisolone

It is possible to recover after treatment prednisolone - one of the most hotly discussed topics among patients. It is important to note that the drug itself does not affect the appetite. But the substance launches various processes in the body, affects the level of hormones, which contribute to the mass collection. To prevent growth in volumes, warn weight increase needed with the first dive pills

Nevertheless, the most frequent complaints during treatment hormonal drug And after its end - a quick set of extra kilograms and the inefficiency of applied diets and sports. The main questions on numerous forums and discussions on the Internet - how to keep in the same weight or how to lose weight after prednisone.

In fact, there is not a single universal diet that would come up with absolutely every person, since everyone has different food habits, the constitution of the body, the rate of metabolism, the power mode, the rhythm of life, the love of sports, the presence or lack of dependence on sweet and much Other. In addition, it is necessary to take into account the preceding a long-term set of weight, preference in nutrition, the ability to limit itself.

Therefore, any woman who complains of extra kilograms after the medicine, dreams of returning forces, best turn to a nutritionist. With this approach, the specialist will analyze the most important nuances, will discern what substances is missing, and what - in excess. It is important to understand what to warn the weight gain is already in the process of treatment, and not when the arrow on the scales crawled up. And do it all taking into account the characteristics of your disease.

Features of nutrition during and after treatment

The basic recommendations for weight loss to those women who consider their weight large, concluded on the Council to debug their nutrition in such a way as to speed up metabolism and at the same time do not apply irreparable harm to the absence of vital important vitamins and other nutrients.

• It is recommended to start the morning from a glass of water: from the evening to prepare 1 l of water, omit into the container slice of lemon and several twigs of mint. In the morning, measure the glass and as much as possible, small sip, drink. Stretch the process is recommended for 20 minutes.
• During the day, drink a sufficient amount of clean water, not forgetting it to do it half an hour before meals. The liquid accelerates metabolic processes, contributing to a better combustion of calories.
• Distribute food throughout the day to several techniques (better than 5-6), there are fractional, small portions. The last meal should be no later than 2-3 hours before sleep.
• Powered when taking prednisone should include green leaf vegetables, cabbage dishes, vegetable salads. It is better to completely remove sugar completely from the power, while it is necessary to track its content in purchased products, as it is secretive at most of them.
• Eliminate fatty, fried diet. White flour products are better replaced by whole grain bread, limit solid cheeses, rice and potatoes.
• Those who feed on correctly, regularly loads themselves physically, it is recommended to arrange an unloading day once a week. Cute hunger is allowed low-calorie food. For example, cook a mixture from pre-closed wild rice and green Masha (2 tablespoons). Such food can be eating small portions throughout the day. Drinking water is allowed in unlimited quantity. On other days it is useful to replace the meat with a high-quality protein cocktail, replacing it one meal.

Prednisolone is a serious hormonal medicine that requires respectful relationship. In addition to the tremendous benefit, which gives, the drug can cause both unwanted effects, which requires a lot of time and strength. And if there is no desire to drink a tool only from fear to recover, then first of all it is necessary to analyze the benefit that prednisone gives, and only after that think about the figure. With a normal approach, the ability to keep the weight during treatment or lose weight after it, every person has.

Prednisolone: \u200b\u200bwhat is this drug, for which it is assigned, as applied

Prednisolone is a systemic and local drug based on hormones that has a mean by duration effect. It is an analogue synthesized by adrenal hormone hydrocortisone.

The active ingredient of the medication is several times more active than the natural hormone. The drug deviates an allergic reaction or prevents its occurrence, has an anti-inflammatory and anti-shock effect, reduces the activity of the immune system.

Prednisolone - What is it?

Prednisolone is a synthetic drug based on glucocorticosteroids.

It has an anti-allergic effect, suppresses the activity of immunity, extinguishes the inflammatory response, makes beta-adrenoreceptors more sensitive to phenylethylamine.

Actively participates in the transformation of metabolic processes in the body. How does the drug affect the metabolism?

1. Metabolism of proteins. Reduces the concentration of globulins in the blood, activates the production of albumin livers and kidneys, contributes to the splitting of proteins in muscle tissues.
2. Metabolism of lipids. Enhances the production of triglycerides and fatty acids, controls the accumulation of fats in certain parts of the body, increases blood cholesterol.
3. Metabolism of carbohydrates. It activates the splitting and absorption of carbohydrates in the digestive tract, increases the volume of sugars coming from the liver into the blood, stimulates glucose synthesis from other organic compounds.
4. Water saline exchange. Prevents the loss of sodium and water by the body, delays the splitting and absorption of calcium in the digestive tract, contributes to the elimination of potassium, normalizes the mineralization of bones.

Chemical composition and dosage forms

Prednisolone is issued by many pharmaceutical enterprises. In preparations from different manufacturers, the concentration of the active substance is the same, but the auxiliary components may vary. Prednisolone is implemented in four dosage forms.

1. Pills. White, cylindrical, flat. One tablet includes 1 or 5 mg of active substance.
2. Solution for intravenous and intramuscular injections. Transparent or a bit muddy. In one millilitress of the fluid contains 15 or 30 mg of the active substance.
3. Ointment. It is intended for outdoor use, has white. One gram of the drug contains 5 mg of the active ingredient.
4. Eye drops. White liquid. In one millilitress, the medicine contains 5 mg of the active substance.

What are prednisone prescribed for?

What are the tablets and use injection solutions? With the help of these dosage forms, the following diseases are cured:

• any kind of allergies;
• korea Sidenchem, rheumatism, rheumokart;
• inflammation of the joints and the near-hand fabrics;
• scattered encephalomyelitis;
• diffuse pathology of connective tissues;
• malignant formations in pulmonary fabrics;
• sarcoidosis, fibrosis;
• pneumonia, tuberculosis, tuberculous meningitis;
• adrenal insufficiency;
• hereditary hyperplasia of adrenal cortex;
• autoimmune pathology;
• hepatitis;
• subacute granulomatous thyroiditis;
• inflammatory reactions in the digestive tract;
• hypoglycemia;
• proteinuria;
• malokrovia, leukemia, other diseases of blood and blood formation organs;
• swelling of the head and spinal cord;
• eczema, psoriasis, toxic epidermal necroliz, herpetyiform dermatitis;
• conjunctivitis, ophthalmia, front will whip, keratitis, choroiditis and other eye diseases;
• hypercalcemia provoked by oncology.

The injections of the drug are made in critical situations: with expressed allergy symptoms or anaphylactic shock. Through Ukolov, the medicine is introduced to the patient for several days, then it is necessary to take tablets.

The drug in tablet form is often discharged with bronchitis and bronchial asthma, it also contributes to the successful advent of grafts.

Why do prednisone ointment appoint? Outdoor used to eliminate allergic dermatitis and inflammatory skin pathologies of non-infectious origin. By ointment, the following diseases are cured:

For what appoints eye drops Prednisone? Drops are used to eliminate inflammation of non-infectious origin. The drug is treated below eye illnesses:

Tablets Application Instructions

With hormone-plating therapy, adult patients must take 4 - 6 tablets per day, with supporting therapy - 1 - 2 tablets.

In some cases, the daily dose can be 100 mg of the active substance, that is, 20 tablets are a maximum.

The dosage for children is selected by the pediatrician, is caused by the age of the child and the intensity of the pathological process.

Typically, 0.15 mg of active substance per kilogram of body weight is prescribed from two months to year per day, this amount is divided into three receptions. Children under 14 years old take 1 mg of active substance per kilogram of body weight.

Take the drug preferably in the morning. It is impossible to drastically complete the use of medication, the daily dose should decrease gradually.

Due to the sharp discontinuation of the medication, renal failure may occur.

After the first week of receiving the drug, the daily dose is reduced by 20%, during the second week it is necessary to reduce the dose of 2 mg daily.

Instructions for applying ointments

Ointment smears sick skin three times a day. The minimum therapeutic course is 5 days, the maximum - 2 weeks.

Instructions for the use of injection mortar

The medicine is introduced into the muscles or veins. The daily dose for an adult patient is from 4 to 60 mg of the active substance. Children drug Solution It is introduced into the buttock, dosage and duration of treatment are set by a doctor. Typically, 25 mg of the active substance per day, children from 12 years to 50 mg are prescribed from 6 to 12 years.

Pharmacokinetics

The tablet quickly splits in the intestines, the active substance is completely in the blood after an hour and a half after the reception. The metabolism of the active substance is carried out by a compound with sulfuric and glucuronic acids mainly in the liver, in a slight degree in the kidneys.

The used substance is derived from the organism with urine and bile.

Application during pregnancy, in childhood and old age

What action on the body of pregnant women, old people and children is prednisolone?

1. During pregnancy, especially in early time, the use of the drug is allowed only in extreme cases. Glucocorticosteroids are able to accumulate in breast milk, Therefore, during the lactation period, the use of medication is prohibited.
2. In the elderly, the reception of glucocorticosteroids is often accompanied by pronounced side effects.
3. In children, glucocorticosteroid drugs are able to slow down growth. Therefore, prednisolone pediatricians are prescribed by a reduced rate in a minimal current dose.

What is harmful to the drug?

Since prednisone is a hormonal agent, then it starts to act a few days after the first reception. The patient is forced to take the medicine for a long time, which inevitably leads to the occurrence of side effects.

Prednisolone causes a rather serious harm to the body: suppresses immunity, negatively affects the work of cardiovascular, endocrine, reproductive, digestive, central nervous system. The consequences of treatment with the drug are the following:

• hypokalemia;
• arrhythmia;
• bradycardia;
• thromboembolia;
• heart failure;
• hyperglycemia;
• arterial hypertension;
• glycosuria;
• muscle cramps;
• psychosis;
• hypercorticism;
• increased intracranial pressure;
• the oppression of the work of the hypothalamus, pituitary glands, adrenal glands.

Contraindications

Since the drug gives multiple side effects, it is prohibited to take it into numerous categories of patients. Prednisolone is contraindicated with:

• ulcerative disease;
• renal and liver failure;
• polio;
• syphilis;
• tuberculosis;
• diabetes;
• hypertension;
• virus skin and eye diseases;
• depression and disorders of the psyche;
• myopathy;
• herpes;
• lymphadenitis;
• osteoporosis;
• hypercorticism;
• deep mycosis;
• cataract and glaucoma.

Injection cannot be done if the drugs of the drug are amazed by infection.

Prednisone - ambiguous

The use of prednisolone can adversely affect the organs of vision. This is expressed in the cataract and the emergence of latent glaucoma.

Dosage form"Type \u003d" Checkbox "\u003e

Dosage form

Tablets 5 mg

Structure

One tablet contains

active substance - prednisone 5 mg,

auxiliary substances: magnesium stearate, talc, corn starch, monohydrate lactose, starch premaritalized.

Description

White tablets, round shape, flat on both sides with beveled edges, with engraving "PD" and "5.0" and the risk between them.

Pharmacotherapeutic group

Corticosteroids for system use. Glucocorticoids. Prednisolone.

ATH code H02Av06.

Pharmacological properties"Type \u003d" Checkbox "\u003e

Pharmacological properties

Pharmacokinetics

Suction:
Prednisone when taking inside quickly and completely absorbed from the gastrointestinal tract (the presence of up to 85% of the dose), bioavailability is lower at higher doses. The maximum concentrations in the blood plasma are achieved by about 1-2 hours. However, the maximum biological effect is achieved much later (as a rule, not earlier than 4-8 hours).
Eating slows down the achievement of the maximum concentration of prednisolone in the blood plasma, but does not affect the overall bioavailability.

Distribution:
As a rule, the binding of prednisolone is 90-95%, which advantageously occurs with corticosteroid-binding globulin (transcertine), as well as with albumin plasma when translate is coming.
Only 5-10% prednisone are in unrelated form and biologically active.

Metabolism:
Prednisolone is the main active prednis metabolite. Prednisone is primarily metabolized in the liver; 25% is excreted unchanged through the kidneys.

Elimination:
The biological half-life is 18-36 hours. The half-life of blood plasma is 2 to 4 hours, which is reduced by drugs that induce liver enzymes.

Pharmacokinetics in special groups of patients:

In patients with severe liver diseases (hepatitis, cirrhosis), the clearance of prednisolone is lower, and the half-life is longer. Free active fraction can significantly increase in patients with liver diseases associated with hypoalbumine. In patients with severe liver disorders, bioavailability may also decrease.

Pharmacodynamics:

Prednisolone 5mg in tablets is a corticosteroid with glucocorticoid, anti-inflammatory, as well as mineralocorticoid activity, albeit to a lesser extent. Like other corticosteroids, prednisone nicomed induces several mechanisms, including anti-inflammatory activity, immunosuppressive properties, and antiproliferative effects. Other mechanisms include influence on carbohydrate exchange, fat distribution, hematological parameters, calcium excretion, growth, mood and suppression of the hypothalamic-pituitary adrenal system. The threshold dose of the development of Cushing syndrome is 7.5 mg / day.

1. Anti-inflammatory effect is achieved by reducing the formation and reduced activity of inflammation mediators (quinine, histamine, liposomal enzymes, prostaglandins and leukotrienes), reducing the initial manifestations of the inflammatory process. Prednisolone reduces the migration of cells in the affected areas, reduces the extension of the vessels and the increased permeability of the vessels in these zones. The vasoconstrictor effect reduces the vascular permeability as a result of which the movement of the blood serum across the walls of the vessels in the intercellular spaces is reduced and as a result decreases, swelling and complaints of patients.

2. Immunosuppressive properties reduce the response of the hypersensitivity reactions of slow and immediate types (types III and IV) by braking the toxic complexes of antigen antibody, which cause allergic vasculitis in the walls of the skin vessels, as well as by oppression of lymphokins, target cells and macrophages (causing allergic contact dermatitis with joint action).

3. Antiproliferative effects reduce inflammation, pronounced by the formation of crusts on the skin, resulting from the increased polypripal activity of white blood cells - lymphocytes and excessive formation of small capillaries in the surface skin layer, with dermatological diseases (such as psoriasis).

Indications for use

Pharmacodynamic therapy

Rheumatic diseases, including collagenoses

Allergic diseases (hay fever, bronchial asthma, urticaria, medicinal allergies)

Respiratory diseases: chronical bronchitis (appointed together with antibacterial treatment)

Fibrosis of the lungs, sarcaidosis

Ulcerative Ileit / Colitis

Proliferative glomerulonephritis (lipoid nephrisosis), nephrotic syndrome

Sharp heavy dermatoses (ordinary bubble, erythrodermia, Lyleel syndrome)

Thrombocytopenic purpura, chronic lymphudine with an autoimmune phenomenon (hemolytic anemia, thrombopement)

Tumors (applied in combination with chemotherapy)

Replacement therapy

Primary adrenal failure (Addison disease) and hypocituitarism (Shikhan syndrome)

Method of application and dose

At the beginning of therapy, any corticosteroid must be taken into account and follow the following guidelines. The initial dose must be appropriate to achieve the desired therapeutic effect And it will depend on a clinical response. Periodically, it is necessary to evaluate this dose, since the severity of the underlying disease can change, or complications may develop under therapy. The dose should be gradually reduced to a minimum value, while ensuring and maintaining a satisfactory clinical response to treatment. There may be an increase in dose during long-term therapy or in case of exacerbation of the underlying disease.

If long-term therapy is prednisolone (usually more than 3 weeks) should be discontinued, cancellation must be made gradually and step by step to avoid "cancellation syndrome". A sharp cessation of therapy may result in death. Dose should be reduced within weeks or even months depending on the dose value, the length of therapy, the main disease of the patient and the patient's individual reaction for treatment. It is unlikely that a sharp cancellation of treatment with prednisolone Nomed, conducted less than 3 weeks, will lead to the clinically significant suppression of the hypothalamic-pituitary-adrenal system in most patients, but it should be borne in mind that the reaction to corticosteroids and portability of their cancellation may vary widely. Thus, it is necessary to consider the issue of a gradual reduction of the dose when canceling drugs after short courses or when taking higher doses and in patients with other risk factors for the development of adrenocortical failure.

Dosing mode with a gradual dose reduction must be selected individually. Most patients have a well tolerated dose of prednisolone Nomed for 2.5 mg every 3-7 days before the dose of prednisolone Nomed 5-10 mg / day. Higher doses should be reduced gradually within 9-12 months.

With a gradual reduction of the dose, the evening dose must be missed first, and then the doses that should be taken at noon, after lunch or in the evening, that is, with such a result, to ultimately, only the morning dose will be accepted after 10 days. Long periodic treatment of glucocorticoid therapy (1 dose every other day in the morning) showed its effectiveness due to the lack of suppression of adrenal cortex.

Method of application: It is accepted inside with a small amount of liquid, after eating.

Adults: The usual dose ranges from 5 to 60 milligrams / day, depending on the disease that the treatment is directed. In general, the whole daily dose should be accepted in the morning between 6 and 8 hours. (Circadian therapy - when prescribed, daily secretory rhythms should be taken into account).

Doses for special groups of patients

Dosage in patients with hypothyroidism: patients with hypothyroidism may require a reduction in dose.

Dosage in patients with impaired liver function: in patients with impaired liver function, severe undesirable reactions are more likely due to low binding to proteins due to hypoalbuminemia. A dose adjustment may be needed.

Dosage in patients with impaired kidney function: patients suffering renal failure, Dose adjustment is not required.

Dosage in elderly patients: dose correction is not required, but it should be noted that the long-term use of corticosteroids in elderly patients can cause aggravation of diabetes mellitus, hypertension, congestive heart diseases, osteoporosis or depression.

Doses for children: no experience in children. It is believed that children are especially at risk with respect to growth delay, so the testimony for the use of the drug requires a particularly strict assessment of the state of children.
In children during the period of growth, treatment mainly must be periodic or with interruptions. A gradual decrease in the dose to a dose that provides a satisfactory clinical response and a minimum of side effects is necessary.

Anti-inflammatory or immunosuppressor effects: usually the dose of prednisolone is 0.1-2 mg / kg / day. The dose can be broken by 1-4 reception per day. The smallest efficient dose is usually determined by the clinical response.

The aggravation of bronchial asthma: usually the dose of prednisolone is 1-2 mg / kg / day; This dose can be broken by 1-2 reception / day for 3-5 days.

Replacement therapy: The usual dose is from 4 to 5 mg / m2 / day.

Nephomical syndrome: the usual dose is 2 mg / kg / day ( maximum dose 60-80 mg / day), which is given in 2-4 reception.

Side effects"Type \u003d" Checkbox "\u003e

Side effects

Very often (\u003e 1/10), often (\u003e 1/100,<1/10), нечасто (>1/1000, <1/100), редко (>1/10000, <1/1000), очень редко (<1/10000), не известно (не может быть оценено на основе имеющихся данных).

In general, the frequency of development of predicted side effects, including suppression of the hypothalamic-pituitary-adrenal system, depends on the dose, the reception time and the duration of treatment. Side effects can be minimized if using the lowest effective dose for as far as possible, the minimum period of time.

Often

Increased susceptibility to infection, aggravation of existing infection, activation of latent infection and masking symptoms of infection (due to immunosuppressive and anti-inflammatory effect of prednisolone)

Reducing the number of eosinophils and lymphocytes

Masking or exacerbation of an existing disease

Adrenal failure (beginning with the suppression of the hypothalamus and the completed true atrophy of the adrenal cortex) with constant oral use of prednisolone, cancellation syndrome due to adrenal failure (headache, nausea, dizziness, anorexia, weakness, emotional instability, apathy and inadequate reaction to stressful situations), "Steroid diabetes" with low insulin sensitivity, increasing blood sugar in patients already suffering from diabetes diabetes (100%), growth delay in children as a result of a violation of the secretion of growth hormone and reduce sensitivity to it

Increased intraocular pressure (up to 40% of patients treated with a oral preparation), cataracts (in 30% of patients with long-term oral treatment with the drug)

Light abscess (12%)

Candidiasis of the oral cavity, especially in patients with oncological diseases (33%)

Fungal infections of mucous membranes (30%)

Osteoporosis manifested in back pain, restriction of mobility, acute pain, compression vertebrae fractures and reduction of growth, fractures of long bones (25% with long-term treatment with an oral drug), myopathy (10%) when treating high doses

Raising the number of leukocytes and platelets

Cushing Syndrome, including a change in the nature of the fat deposition (moon-like face, the obesity of the body, the "bullish hump") in constant reception of oral doses above the physiological (usually more than 50 mg per day), hypokalemia due to the sodium delay and the removal of potassium, amenorrhea in women of childbearing age, Increasing the level of cholesterol, triglycerides and lipoproteins in the treatment of high doses taken inward, increased appetite and weight gain

Euphoria, depression, psychosis (induced by corticosteroids)

Hypertension (due to sodium delay, which leads to a fluid delay), aggravation of stagnant heart failure (as a result of sodium delay)

Increased risk of developing tuberculosis

Strengthening symptoms and an increase in the risk of developing gastrointestinal perforations, colitis, ileit, diverticulitis

Stretch marks, coherent rash, bruising, dermatitis, ecchimosis, erythera face, atrophy, hirsutism, slow wound healing, increased sweating, teleangectas and skin thinning, disguise or deterioration of skin diseases

Increase the frequency of night urination

Allergic reactions

Diabetes (<1%) при лечении малыми пероральными дозами, повышение уровня холестерина, триглицеридов и липопротеинов при лечении низкими пероральными дозами

Insomnia, mood oscillations, personality changes, mania and hallucinations

Mopathic of respiratory muscles

Gastric or duodenal ulcers with simultaneous admission of acetylsalicylic acid or non-steroidal anti-inflammatory funds (NSAIDs), gastrointestinal bleeding (0.5%), gastrointestinal perforations

Aseptic necrosis of bone tissue

Urinary stones due to increased excretion of calcium and phosphate

Risk of thrombosis due to improving blood clotting

Changes to the thyroid function

Possible increase in coma duration under cerebral malaria, cognitive disorders (for example, bad memory), dementia, epidural lipomatosis

The high risk of destruction of the horny shell of the eye with simultaneous herpetic eye infection (due to the masking of this infection), glaucoma (with long oral treatment)

Rarely

Ketoacidosis and hyperosmolar coma, manifestation of latent hyperparathyroidism, tendency to porphyters, lesis syndrome tumor, violation of sex hormone secretion (menstruation disorders, girsutism, impotence)

Manifestation of latent epilepsy, pseudo-turn of a brain (benign intracranial hypertension with such symptoms as headache, obscure vision and impairment of vision)

Exophthalm (after long-term treatment)

Cardiomyopathy with risk of reduction of cardiac activity, arrhythmias due to hypokalemia, vascular collapse

Pancreatitis (after long-term treatment with high doses)

Epidermal Necrolizes, Stevens-Johnson Syndrome

Trendinopathy Achille Tendon and Padelnik Tendon

Not known

Increased risk of atherosclerosis and thrombosis, vasculitis (may also occur as cancellation syndrome after long therapy)

Ulcers and candidiasis of the esophagus

Muscle atrophy, tendon diseases, tendinite, tendons breaks

Slow healing of wounds, impaired appetite

Note:
With an excessively rapid dose reduction after long-term treatment, such problems may develop such muscle and articular pain, fever, rhinitis, conjunctivitis and weight loss.

Contraindications

Prednisolone Nicomed is contraindicated in the following states / disorders:

Increased sensitivity to prednisone nicomed or to any auxiliary substance in the preparation

Systemic myoses

Vaccination with live viral or bacterial vaccines is contraindicated during immunosuppressor therapy with corticosteroids (not a full-fledged immune response can allow a lively weakened vaccine to cause an infectious disease)

With long therapy:

Pissoral ulcers

Stomach ulcers

Heavy forms of osteoporosis

Severe myopathy (with the exception of masting pregnant women)

Psychiatric anamnesis

Acute viral infections (Herpes, Simple Herpes, Windshield)

Chronic active hepatitis (with HBS AG-positive reaction)

Glaucoma

Polio

Lymphadenit after grafting BCG

Pre- and post permanent period (8 weeks before and 2 weeks after vaccination)

Medicinal interactions

The corticidal effect is weakened when using Cyp3a4 inductors, such as rifampicin, phenytoin, prison, barbiturates, carbamazepine, and aminogllutetimide.
The corticidal effect is enhanced with the use of substances that block CYP3A4: (ketoconazole, ritonavir), erythromycin, trolandromycin.

Gastrointestinal tract and metabolism

Hypoglycemic drugs

Neomed prednisone prevents the effect of hypoglycemic drugs by increasing blood sugar levels. Unwanted effect: increased risk of hyperglycemia.

Cardiovascular

Diuretics, withdrawing potassium (thiazids, furosemide, etc.)

Cardiac glycosides

Glycoside effect due to potassium deficiency.

Inhibitors of angiotensin-converting enzyme (ACE)

Increased risk of changing blood formula.

Antihypertensive

Reduced already reduced blood pressure.

Hormones for systemic use

Oral contraceptives

The level of prednisone in the blood serum can increase due to its reduced metabolism. Unwanted effect: raising the risk of developing side effects of corticosteroids. Excessive use of glucocorticoids can suppress the effect of somatotropin, which stimulate growth.

Antimicrobial means

Rifampicin

Strengthening the metabolism of prednisolone. Unwanted effect: reducing the effectiveness of prednisolone.

Amphotericin B.

The effect of additional potassium loss in the kidneys. Unwanted effect: increased risk of hypokalemia and subsequent heart arrhythmias.

Fluorokinolones

An undesirable effect: an increased risk of rupture tendons.

Ketokonazole.

An undesirable effect: can enhance the effects of prednisolone.

Muscular, articular and bone

Acetylsalicylic acid (ASC)

It is known that acetylsalicylic acid annoys the stomach, and the prednisone can mask this side effect. The mechanism is not known. An increase in acetylsalicylic acid clearance due to the effects of prednisolone was reported. There is an increased risk of gastrointestinal bleeding and ulcers, as well as the risk of reduced the effectiveness of acetylsalicylic acid. Thus, the side effects of salicylate will be manifested in the abolition of prednisolone.

Non-steroidal anti-inflammatory funds (NSAIDs)

NSAIDs irritate the stomach, and prednisone can mask these adverse effects. Unwanted effect: increased risk of gastrointestinal bleeding and formation of ulcers.

Non-opalarizing muscle relaxants

Unwanted effect: long muscle relaxation.

central nervous system

Barbiturates

Barbiturates stimulate hepatic enzymes and enhance the metabolism of prednisolone. Unwanted effect: reducing the effectiveness of prednisolone.

Phenytoin and phosphenitoine

Strengthening the metabolism of prednisolone in the liver. Unwanted effect: reducing the effectiveness of prednisolone.

Quetiapine

Induction of P450-indirect quetiapine metabolism caused by corticosteroids. Unwanted effect: a decrease in the level of quetiapine in serum.

To maintain the control of schizophrenia symptoms, it may be necessary to increase the dose of Quetiapine.

Bupropion

Simultaneous use with systemic glucocorticoids can increase the risk of convulsion.

Immununopressants

Methotrexat

The mechanism is unknown. Strengthening the action of prednisolone.

Cyclosporin

Prednisone can increase the level of cyclosporine of blood plasma.

Impact on laboratory tests and research

Skin reactions to allergic tests can be suppressed. The reduction in the thyrotropic hormone (TTG) increases.

Other agents

The reduced immune response makes it possible to occur infections caused by alive vaccines, and can also lead to a decrease in vaccination efficiency.
There is an increased risk of the development of generalized, potentially threatening life of infections in vaccination with alive vaccines.

The metabolism of glucocorticoids can accelerate and, therefore, their effectiveness can decrease.

Laxative and beta sympathomimetics

Increase the loss of potassium.

Chlorookhin, Hydroxychlorookhin, Meflohin

Increased risk of myopathies, cardiomyopathy

Derivatives Kumarina

Reducing their effectiveness due to the action of prednisolone.

Teophyllin

An undesirable effect: an increase in clearance during prednisone treatment.

Cyclophosphamide

One-time doses of prednisolone can slow down the activation of cyclophosphamide, but the level of activation increases after a long application.

Thalidomide

May increase the effect of prednisone.

Prasikvanttel

A possible decrease in the concentration of the prazicvantel in the blood due to the reception of corticosteroids.

Unwanted effect: It is possible to increase intraocular pressure while at the same time reception with prednisone.

Inhibition of the metabolism of corticosteroids by Lacrice. Unwanted effect: increased risk of side effects of corticosteroids.

special instructions

Patients with certain physical problems such as feverish conditions, injury or surgical interventions, during treatment may require temporary adjustment of the daily corticidal dose

The risk of tendon diseases, tendinite or tenders will increase while using fluoroquinolones and corticosteroids

Long-term use of the drug must be accompanied by an examination of an ophthalmologist every three months.

Long-term use may be due to the rapid progression of the sarcoma of the capos

With the exception of substitution therapy, corticosteroids have non-medical, but palliative effect due to their anti-inflammatory and immunosuppressor properties. Long-term reception, depending on the dose and duration of treatment, is associated with an increase in the incidence of undesirable effects. Patients who receive long-term therapy with corticosteroids of systemic effects should be under observation in order to detect suppression of the hypothalamic-pituitary-adrenal system (GGN) (adrenal failure), Cushing syndrome, hyperglycemia and glucose

After long-term therapy with corticosteroids, the treatment should be canceled smoothly to prevent "Cancellation syndrome". Adrenocortic failure can be maintained for months after the cessation of corticosteroid treatment, and during the periods of stress (surgical operation, illness), replacement therapy may be required. The risk of adrenal insufficiency can be reduced by the appointment of the drug every other day instead of daily doses.

Due to the anti-inflammatory and immunosuppressor effects of corticosteroids, their use in doses are higher than necessary for substitution therapy, increases susceptibility to infection, leads to aggravation of the existing infection and activation of latent infections. Anti-inflammatory action can cause masking symptoms until the infectious disease proceeds to the running step. If new infections arise during treatment, then the fact should be taken into account that it will be impossible to localize such an infection.

In patients with latent tuberculosis (TB), corticosteroid therapy may increase the risk of TB development. It is necessary to carefully observe such patients for reactivation of TB and, if long-term treatment with corticosteroids is required, anti-tuberculosis chemotherapy can be shown. The use of corticosteroids in patients with the active form of tuberculosis should be limited to cases such as aggravation or dissemination of TB, if their use for the treatment of the disease is planned together with suitable anti-tuberculosis therapy

Systemic therapy with corticosteroids can increase the risk of heavy or lethal infections in persons exposed to viral diseases such as chickenpox or cortex (patients should be prevented about the need to avoid such risks and immediate appeal to the doctor in the event of its presence). Corticosteroids can contribute to the development of bacterial and fungal infections (Candida infections). Corticoids can activate latent amoebic infections, so it is very important to exclude them before starting corticoid therapy

Prednisolone enhances glukegenesis. Approximately 20% of patients receiving high doses of steroids develop a benign "steroid diabetes" with low sensitivity to insulin and a low renal threshold for glucose. The state is reversible when canceling therapy. With confirmed diabetes treatment with corticosteroids usually leads to a balance of the balance, which can be compensated by adjusting the insulin dose

Long-term treatment prednisone affects calcium and phosphate metabolism and increases the risk of osteoporosis. Prednisolone helps to reduce the level of calcium and phosphate, which affects the level of vitamin D, thereby causing a dose-dependent reduction in serum osteokalcin level (bone matrix protein, which correlates with the formation of the bone)

Prednisolone therapy for several weeks causes children a risk of growth in growth delay associated with a reduction in the secretion of growth hormone and reduced peripheral sensitivity to this hormone

Corticosteroids can cause mental violations, including euphoria, insomnia, mood fluctuations, personality changes, depression and psychotic tendencies

The long-term purpose of the systemic corticosteroids may cause the rear subcapsular cataract and glaucoma (due to increased intraocular pressure), as well as an increase in the risk of infection with infections. Ophthalmological inspection and treatment in the case of glaucoma, ulcers and corneal injuries are also shown. Patients with herpetic infection have an increased risk of damage to the cornea, since prednisone can mask infections.

Corticosteroids should be prescribed with caution at the following states:

Gastrointestinal diseases, such as nonspecific ulcerative colitis and diverticulitis due to the probability of breaking the colon, abscesses of colon or other pyrogen infections, obstruction of the colon, severe fistula and sinus paths, fresh intestinal anastomoses and latent peptic ulcers. Anti-inflammatory properties of glucocorticoids can mask signs of gastrointestinal perforations and thus lead to a delay in diagnosis A, consequently, to potentially fatal outcomes

High blood pressure or congestive diseases of the cardiovascular system (due to the mineralocorticoid effect of prednisolone, which can lead to retention of liquid and salt)

Osteoporosis (because corticosteroids can enhance the symptoms of osteoporosis)

Famous and alleged infections

Famous lymphatic tumors, because there are reports on the development of acute lysis syndrome after the purpose of glucocorticoids

Cardiac or renal failure: concomitant effective therapy of the main disease and continued constant monitoring

Liver disease

Hypothyroidism

Miasthenia, which can lead to the strengthening of myopathy

Cerebral malaria (can be extended coma, may increase cases of morbidity of pneumonia and gastrointestinal bleeding)

Latent epilepsy

Hyperparathyroidism (since prednisone can contribute to the manifestation of the disease)

Treatment of patients with acetylsalicylic acid or non-steroidal anti-inflammatory means (due to increased risk of ulcers)

Diuretics, withdrawing potassium.

In patients who are prescribed corticoids, the diet should contain potassium, proteins and vitamins, but at the same time with low fat, carbohydrates and salts.

Elderly patients, especially during long-term therapy, should be monitored by side effects, such as osteoporosis and tendon disease. If possible, children in the period of growth are recommended circadian or periodic treatment.

Patients with rare hereditary problems of galactose intolerance, lapp-lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Pregnancy and lactation

Prednisolone penetrates the placenta. Animal research has shown an increase in side effects depending on the dose value (wolf fall, the effect on the growth and development of the brain). However, in general, these studies suggest that low risk for the fetus, when using prednisolone during pregnancy. But therapy is prednisone during pregnancy should be carried out only after a thorough estimate of benefit and risk for the fetus. If glucocorticoids are used in late pregnancy, theoretically there is a risk of suppressing the function of the adrenal fetus, which may require a gradual decrease in the dose of substitution therapy in newborns.
The amount of prednisone excreted into breast milk is estimated as 0.1% of the dose obtained by the mother. The dose obtained by a child can be minimized when breastfeeding for 3 to 4 hours after receiving the dose of prednisolone's mother. Children of mothers accepting daily doses of 40 mg or more must be monitored for signs of suppressing adrenal function.