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Name: Prednisone

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Pregnancy Category C

Drug classes

• Corticosteroid (intermediate acting)
• Glucocorticoid
• Hormonal agent

Therapeutic actions

Enters target cells and binds to intracellular corticosteroid receptors, thereby initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.

Indications

• Replacement therapy in adrenal cortical insufficiency
• Hypercalcemia associated with cancer
• Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders
• Hematologic disorders: thrombocytopenia purpura, erythroblastopenia
• Ulcerative colitis, acute exacerbations of multiple sclerosis and palliation in some leukemias and lymphomas
• Trichinosis with neurologic or myocardial involvement

Contraindications/cautions

Contraindicated in the presence of infections, especially tuberculosis, fungal infectons, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; lactation.

Use caution in the presence of kidney or liver disease, hypothyroidism, ulcerative colitis with impending perforation, diverticulitis, active or latent peptic ulcer, inflammatory bowel disease, CHF, hypertension, thromboembolic disorders, osteoporosis, convulsive disorders, diabetes
mellitus; hepatic disease; pregnancy (monitor infants born to mothers who have received substantial corticosteroid doses during pregnancy for adrenal insufficiency).

Adverse effects

• CNS: Vertigo, headache, paresthesias, insomnia, convulsions, psychosis, cataracts, increased intraocular pressure, glaucoma (long-term therapy)
• GI: Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea, vomiting, increased appetite, weight gain (long-term therapy)
• CV: Hypotension, shock, hypertension and CHF secondary to fluid retention, thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias
• MS: Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, spontaneous fractures (long-term therapy)
• Hypersensitivity: Hypersensitivity or anaphylactoid reactions
• Endocrine: Amenorrhea, irregular menses, growth retardation, decreased carbohydrate tolerance, diabetes mellitus, cushingoid state (long-term effect), increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels, HPA suppression with systemic therapy longer than 5 d
• Electrolyte imbalance: Na+ and fluid retention, hypokalemia, hypocalcemia
• Other: Immunosuppression, aggravation, or masking of infections; impaired wound healing; thin, fragile skin; petechiae, ecchymoses, purpura, striae; subcutaneous fat atrophy

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