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Prednisone
Systematic (IUPAC) name
17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl- 7,8,9,10,12,13,14,15,16,17-decahydro-6H- cyclopenta[a]phenanthrene-3,11-dione
Identifiers
CAS number	53-03-2
ATC code	A07EA03 H02AB07
PubChem	5865
DrugBank	APRD00340
ChemSpider	5656
Chemical data
Formula	C21H26O5
Mol. mass	358.428 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	70%
Metabolism	prednisolone (liver)
Half life	1 hour
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	C
Legal status	Prescription only
Routes	Oral, Nasal, Rectal, Injection, IV

Prednisone is a synthetic corticosteroid drug that is usually taken orally but can be delivered by intramuscular injection and can be used for a great number of different conditions. It has a mainly glucocorticoid effect. Prednisone is a prodrug that is converted by the liver into prednisolone, which is the active drug and also a steroid.

Contents 1 Uses 2 History 3 Dependency 4 Side-effects 4.1 Major 4.2 Minor 5 References 6 External links

Uses

Prednisone is particularly effective as an immunosuppressant, and affects virtually all of the immune system. It can, therefore, be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe allergies, severe poison ivy dermatitis, systemic lupus erythematosus, ulcerative colitis, rheumatoid arthritis, Bell's Palsy, Crohn's disease, pemphigus and sarcoidosis), uveitis, various kidney diseases including nephrotic syndrome, mononucleosis [Epstein Barr virus], and to prevent and treat rejection in organ transplantation. This medicine may also reduce the sex drive. Prednisone has also been used in the treatment of migraine headaches and cluster headaches and for severe Aphthous ulcer ("Cankersore") outbreaks.

Prednisone is used as an antitumor drug. Prednisone is very important in the treatment of acute lymphoblastic leukemia, Non-Hodgkin's lymphomas, multiple myeloma, and other tumors in combination with other anticancer drugs

Furthermore, the pharmaceutical industry uses prednisone tablets for the calibration of dissolution testing equipment according to the United States Pharmacopeia (USP).

Intravenous application may be employed for cerebral inflammation, as in the periodic attacks caused by multiple sclerosis.

Prednisone is also used for the treatment of the Jarisch-Herxheimer Reaction which is common during the treatment of syphilis, and to delay the onset of symptoms of Duchenne's Muscular Dystrophy. The mechanism for the delay of symptoms is unknown.

History

Prednisone was invented in the early 1950s when Arthur Nobile at Schering, strep throat demonstrated that the side-effects of cortisone, such as water retention, high blood pressure and muscle weakness, could be removed by oxidisation of the drug through exposure to microbes. The drug was introduced by Schering in the mid-1960s.

Dependency

Adrenal suppression occurs if prednisone is taken for longer than 7 days, a condition wherein the body is unable to synthesize natural corticosteroids and becomes dependent on the prednisone taken by the patient. For this reason, prednisone should not be stopped abruptly if taken for longer than seven days; rather the dosage must be reduced slowly. This reduction may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis, which may be life-threatening. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects.^[1]

Side-effects

Short-term side-effects, as with all glucocorticoids, include high blood glucose levels, especially in patients that already have diabetes mellitus or are on other medications that increase blood glucose (such as tacrolimus), and mineralocorticoid effects such as fluid retention (although it is worth noting, however, that the mineralocorticoid effects of prednisone are very minor; this is why it is not used in the management of adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly). Additional short-term side-effects include insomnia, euphoria, and, rarely, mania. Long-term side-effects include Cushing's syndrome, weight gain, osteoporosis, glaucoma, type II diabetes mellitus, and depression upon withdrawal.

Major

• increased blood sugar for diabetics
• weight gain
• facial swelling
• depression, mania, or other psychiatric symptoms
• unusual fatigue or weakness
• mental confusion / indecisiveness
• blurred vision
• abdominal pain
• peptic ulcer
• infections
• painful hips or shoulders
• osteoporosis
• insomnia
• severe joint pain
• cataracts
• osteonecrosis
• anxiety
• black stool
• stomach pain or bloating
• severe swelling
• mouth sores or dry mouth

Minor

• stretch marks
• nervousness
• acne
• rash
• increased appetite
• hyperactivity
• frequent urination
• diarrhea
• removes intestinal flora

References

External links

• Kelly, Janis (July 2000). "Prednisone-related growth impairment persists in children with CF". Respiratory Reviews 5 (7). 

v • d • e Corticosteroids - glucocorticoid/receptor and mineralocorticoid/receptor (A07EA, C05AA, D07, D10AA, H02, R01AD, R03BA, S01BA, S02B, and S03B) (Endogenous in CAPS) Mineralocorticoids ALDOSTERONE, Deoxycorticosterone, Fludrocortisone Glucocorticoids CORTISONE, HYDROCORTISONE/CORTISOL, DESOXYCORTONE, Beclometasone, Betamethasone, Budesonide, Ciclesonide, Cloprednol, Cortivazol, Deflazacort, Dexamethasone, Fluticasone, Flunisolide, Hydrocortisone aceponate, Hydrocortisone buteprate, Hydrocortisone butyrate, Meprednisone, Methylprednisolone, Methylprednisolone aceponate, Mometasone furoate, Paramethasone, Prednicarbate, Prednisolone, Prednisone, Prednylidene, Rimexolone, Triamcinolone Other/ungrouped corticosteroids Alclometasone, Amcinonide, Clobetasol, Clobetasone, Clocortolone, Desonide, Desoximetasone, Diflorasone, Diflucortolone, Difluprednate, Fluclorolone, Fludroxycortide, Flumetasone, Fluocinolone acetonide, Fluocinonide, Fluocortin, Fluocortolone, Fluorometholone, Fluperolone, Fluprednidene, Formocortal, Halcinonide, Halometasone, Loteprednol, Medrysone, Tixocortol, Ulobetasol Aldosterone antagonists Spironolactone, Eplerenone, Potassium canrenoate, Canrenone

v • d • e Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07) Intestinal anti-infectives Antibiotics (Neomycin, Nystatin, Natamycin, Streptomycin, Polymyxin B, Paromomycin, Amphotericin B, Kanamycin, Vancomycin, Colistin, Rifaximin) Sulfonamides (Phthalylsulfathiazole, Sulfaguanidine, Succinylsulfathiazole) other (Miconazole, Broxyquinoline, Acetarsol, Nifuroxazide, Nifurzide) Intestinal adsorbents Charcoal - Bismuth - Pectin - Kaolin - Crospovidone - Attapulgite - Diosmectite Antipropulsives (opioids) Diphenoxylate - Opium - Loperamide - Difenoxin - Paregoric - Laudanum - Codeine - Morphine Intestinal anti-inflammatory agents corticosteroids acting locally (Prednisolone, Hydrocortisone, Prednisone, Betamethasone, Tixocortol, Budesonide, Beclometasone) antiallergic agents, excluding corticosteroids (Cromoglicic acid) aminosalicylic acid and similar agents (Sulfasalazine, Mesalazine, Olsalazine, Balsalazide) Antidiarrheal micro-organisms Saccharomyces boulardii Other antidiarrheals Albumin tannate - Ceratonia - Racecadotril

v • d • e Corticosteroids for systemic use (H02) Mineralocorticoids Aldosterone - Fludrocortisone - Desoxycortone Glucocorticoids Betamethasone - Dexamethasone - Fluocortolone - Methylprednisolone - Paramethasone - Prednisolone - Prednisone - Triamcinolone - Hydrocortisone - Cortisone - Prednylidene - Rimexolone - Deflazacort - Cloprednol - Meprednisone - Cortivazol Anticorticosteroids Trilostane

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