Instructions for prednisone acetate tablets

The main component of this product is prednisone acetate. Its chemical name is: 17a, 2 1- dihydroxyprogesterone-1, 4- diene -3, 1 1, 20- trione 2 1- acetate.

Structural formula:

Molecular formula: C23H28O6

Molecular weight: 400.47

Character; Role; letter

This product is a white tablet.

Pharmacology and toxicology

Adrenal corticosteroids have anti-inflammatory, anti-allergic, anti-rheumatic and immunosuppressive effects, and their mechanisms are as follows:

1. Anti-inflammatory effect: This product can reduce and prevent the reaction of tissues to inflammation, thus reducing the manifestations of inflammation. Hormones inhibit the aggregation and phagocytosis of inflammatory cells (including macrophages and leukocytes), the release of lysosomal enzymes and the synthesis and release of inflammatory chemical mediators.

2. Immunosuppression: including preventing or inhibiting cell-mediated immune response and delayed allergic response, reducing the number of T lymphocytes, monocytes and eosinophils, reducing the binding ability of immunoglobulin to cell surface receptors, and inhibiting the synthesis and release of interleukin, thus reducing the transformation of T lymphocytes to lymphocytes and alleviating the expansion of primary immune response. Can reduce the immune complex through the basement membrane, and can reduce the concentration of complement components and immunoglobulin.

pharmacokinetics

This product must show pharmacological activity after reducing 1 1 keto group to 1 1 hydroxyl group in the liver, and its physiological half-life is 60 minutes. The content in liver is the highest, followed by plasma, cerebrospinal fluid, pleural effusion, ascites and kidney. In blood, most of this product is combined with plasma protein, and free and combined metabolites are excreted from urine, some are excreted in the original form, and a small part can be excreted through milk.

indicate

Mainly used for allergic and autoimmune inflammatory diseases. It is suitable for allergic diseases such as connective tissue disease, systemic lupus erythematosus, severe polymyositis, severe bronchial asthma, dermatomyositis and vasculitis, acute leukemia and malignant lymphoma.

dosage

1. Generally, the oral dosage is 5 ~10 mg (12 tablets) once and 0 ~ 60 mg (2 ~12 tablets) once a day.

2. For autoimmune diseases such as systemic lupus erythematosus, gastropathy syndrome, ulcerative colitis and autoimmune hemolytic anemia, 40 ~ 60 mg can be given daily, and gradually reduced after the condition is stable.

3. For allergic diseases such as drug dermatitis, urticaria and bronchial asthma, prednisone can be given 20 ~ 40 mg per day, and the dosage will be reduced after the symptoms are relieved, and the dosage will be reduced by 5mg every 1 ~ 2 days.

4. To prevent organ transplant rejection, generally, oral administration of 100mg per day is started from 1 ~ 2 days before operation, and it is changed to 60mg per day one week after operation, and then gradually reduced.

5. To treat acute leukemia and malignant tumor, take 60 ~ 80 mg orally every day, and reduce it after the symptoms are relieved.

counteraction

High dose of this product is easy to cause diabetes, digestive tract ulcer and Cushing-like syndrome, and has a strong inhibitory effect on hypothalamus-pituitary-adrenal axis. Concurrent infection is the main adverse reaction.

taboo

Patients with hypertension, thrombosis, gastric and duodenal ulcer, psychosis, abnormal electrolyte metabolism, myocardial infarction, visceral surgery, glaucoma, etc. Not suitable for use. It is prohibited for patients with allergic history to this product and adrenocortical drugs, and for fungal and viral infections.

Matters needing attention

1. Patients with tuberculosis, acute bacterial or viral infection must receive appropriate anti-infection treatment.

2. After taking the medicine for a long time, it should be gradually reduced when stopping the medicine.

3. Use with caution in patients with diabetes, osteoporosis, liver cirrhosis, renal insufficiency and hypothyroidism.

Medication for pregnant and lactating women

Using it in pregnant women will increase the incidence of placental insufficiency, neonatal weight loss or stillbirth, and animal experiments have teratogenic effects, so we should weigh the advantages and disadvantages of using it. Breast-feeding mothers should not breast-feed if they receive large doses of drugs, so as to avoid adverse reactions such as infant growth inhibition and adrenal function inhibition caused by drugs discharged through milk.

Children's medication

Children should be very cautious if they use adrenocortical hormone for a long time, because it will inhibit the growth and development of children. If long-term use is needed, short-acting (such as cortisone) or medium-acting preparations (such as prednisone) should be used, and long-acting preparations (such as dexamethasone) should be avoided. Oral alternate-day therapy of intermediate preparation can alleviate the inhibitory effect on growth. It is necessary to closely observe the long-term use of glucocorticoid in children or adolescents, and the risk of osteoporosis, avascular necrosis of femoral head, glaucoma and cataract in children increases. The dosage of hormones used by children depends not only on their age and weight, but also on the severity of the disease and children's response to treatment. For the treatment of children with adrenocortical hypofunction, the dosage of hormone should be determined according to the body surface area, and if it is determined according to the weight, it is easy to overdose, especially for infants and short or obese children.

Medication for elderly patients

Glucocorticoid is easy to cause hypertension, and elderly patients, especially postmenopausal women, are easy to suffer from osteoporosis.

drug interaction

(1) Non-steroidal anti-inflammatory and analgesic drugs can strengthen its ulcer-causing effect.

(2) It can enhance the hepatotoxicity of acetaminophen.

(3) The combination with amphotericin B or carbonic anhydrase inhibitor can aggravate hypokalemia, while the combination with carbonic anhydrase inhibitor for a long time is prone to hypocalcemia and osteoporosis.

(4) Combined with anabolic steroids can increase the incidence of edema and aggravate acne.

(5) Long-term use of anticholinergic drugs (such as atropine) can increase intraocular pressure.

(6) tricyclic antidepressants can aggravate the mental symptoms caused by them.

(7) When combined with hypoglycemic drugs such as insulin, the dosage of hypoglycemic drugs should be adjusted appropriately because it can increase the blood sugar of diabetic patients.

(8) Thyroid hormone can increase its metabolic clearance rate, so the dosage of thyroid hormone or antithyroid drugs should be adjusted appropriately.

(9) Combined with contraceptives or estrogen preparations, it can strengthen its therapeutic effect and adverse reactions.

(10) combined with cardiac glycoside can increase digitalis toxicity and arrhythmia.

(1 1) combined with diuretics can cause severe hypokalemia, and the diuretic effect will be weakened due to water and sodium retention.

(12) combined with ephedrine can enhance its metabolic clearance rate.

(13) combined with immunosuppressants can increase the risk of infection and may induce lymphoma or other lymphoproliferative diseases.

(14) can increase the metabolism and excretion of isoniazid in liver, and reduce the blood concentration and curative effect of isoniazid.

(15) can promote the metabolism of mexiletine in the body and reduce the blood drug concentration.

(16) combined with salicylate can reduce the plasma salicylate concentration.

(17) combined with growth hormone can inhibit the growth-promoting effect of the latter.

excessive

standard

5 mg

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Shading, sealing and storage.

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