Prednisone structure diagram prednisone has anti-inflammatory and anti-allergic effects, can inhibit the proliferation of connective tissue, reduce the permeability of capillary walls and cell membranes, reduce inflammatory exudation, and can inhibit the formation and release of histamine and other toxic substances. It also promotes the conversion of protein breakdown into sugar and reduces the utilization of glucose. As a result, it increases both blood glucose and liver glycogen, and glycosuria can occur, while increasing gastric juice secretion and improving appetite. When severe toxic infections, used in conjunction with a large number of antimicrobial drugs, it can have a good effect on lowering temperature, antitoxicity, anti-inflammatory, anti-shock and promote symptomatic relief. Its sodium retention and potassium excretion effect is smaller than that of cortisone, anti-inflammatory and anti-allergic effect is stronger, with fewer side effects, so it is more commonly used. Indications:

Cholecystitis otitis media urethritis pelvic

proteinuria sepsis gastritis corneal

rash saline glucose anti-inflammatory

indomethacin epilepsy cholera rhinitis

(1) has been a long-term application of the drug in the patient, in the operation and the postoperative period of 3 ~ 4 days often have to discretionary increase in dosage, in order to

Prednisone

protect against cortical Insufficient cortical function. General surgical patients should try not to use, so as not to affect the healing of the wound.

(2) The product and cortisone need to be activated by hepatic metabolism into hydroprednisone or hydrocortisone to be effective, so it is not suitable for people with poor hepatic function.

(3) This product is not suitable for primary adrenocortical insufficiency because of its weak hydrocorticosteroid activity.

(4) It is not suitable for those with hyperadrenocorticism, hypertension, atherosclerosis, heart failure, diabetes mellitus, neuropathy, epilepsy, postoperative patients as well as those with gastric and duodenal ulcers and those with corneal ulcers, intestinal disorders, or chronic malnutrition and hepatic insufficiency; it should be used cautiously or prohibited in pregnant women; it should be used with caution in viral infections.

Glucocorticosteroids have no obvious adverse reactions when applying physiologic dose replacement therapy, adverse reactions mostly occur when applying pharmacologic dose, and are closely related to the course of treatment, dose, type of medication, usage and route of administration. Common adverse reactions are of the following types.

(1) Systemic allergic reactions may occur when large doses are given rapidly intravenously, including swelling of the face, nasal mucous membranes, and eyelids, urticaria, shortness of breath, chest tightness, and wheezing.

(2) Long-term use may cause the following side effects: medical Cushing's syndrome face and posture, weight gain, lower extremity swelling, purple lines, tendency to bleed easily, poor wound healing, acne, menstrual disorders, ischemic necrosis of the humeral or femoral head, osteoporosis or fracture (including vertebral compression fracture, pathologic fracture of the long bones), myalgia, myasthenia gravis, hypokalemia syndrome, gastrointestinal irritation (nausea , vomiting), pancreatitis, peptic ulcer or intestinal perforation, growth suppression in children, glaucoma, cataracts, benign elevated intracranial pressure syndrome, hypoglycemia, and aggravation of diabetes mellitus.

(3) Patients may experience psychiatric symptoms: euphoria, agitation, restlessness, delirium, disorientation, or inhibition. Psychiatric symptoms are particularly likely to occur in people with chronic wasting disease and those who have had previous mental disorders. They can occur in dosages up to 40 mg or more of prednisone per day and within a few days to two weeks of dosing.

(4) Complicated infections are the major adverse reactions to glucocorticoids. Fungal, tuberculosis, staphylococcus, Aspergillus, Pseudomonas aeruginosa and various herpesvirus infections are predominant. Most often occurs in the middle course or long course of therapy, but can also appear in the short term with high doses.

(5) the hypothalamic-pituitary-adrenal axis is suppressed, is an important complication of hormone therapy, and its occurrence is related to the preparation, dosage, course of treatment and other factors. Adrenal suppression should be considered when prednisone is used more than 20 mg daily for more than 3 weeks and when medical Cushing's syndrome occurs.

(6) The post-glucocorticoid discontinuation syndrome can vary as follows. (1) hypothalamic-pituitary-adrenal hypoplasia, which can be manifested as fatigue, weakness, loss of appetite, nausea, vomiting, low blood pressure, after a long course of treatment, the recovery of the function of this axis of

Prednisone

generally takes 9 to 12 months, the function of the recovery of the following sequential: 1, the hypothalamus corticotropin-releasing hormone (CRF) secretion is restored and increased; 2, the ACTH The secretion of ACTH is restored and higher than normal, at this time, the secretion of adrenocorticotropic hormone is still low; 3, the basic secretion of hydrocorticosterone is restored to normal, and the secretion of pituitary ACTH is restored to normal from the original excess; 4, the hypothalamus-pituitary-adrenocortical axis response to stress is restored to normal. ② Symptoms that had been controlled by the original disease reappear after stopping the drug. In order to avoid the occurrence of hypoadrenocorticism and the resurgence of symptoms of the original disease, after a long course of hormone therapy should be slow and gradual reduction of the dose, and from the original several times a day, changed to once a day in the morning to take medication, or every other day in the morning to take medication once. (iii) Glucocorticoid withdrawal syndrome. Sometimes patients after stopping the drug dizziness, fainting tendency, abdominal or back pain, low fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue, weakness, after careful examination if you can exclude the adrenocortical hypoplasia and the rekindling of the original disease, it can be considered as a glucocorticoid dependence syndrome.

Weight gain, hirsutism, acne, elevated blood glucose, blood pressure and intraocular pressure, and sodium retention. It can cause hypokalemia, euphoria, gastrointestinal ulcers and even bleeding and perforation, osteoporosis, and poor wound healing.

The product inhibits antigen-antibody reactions, inhibits leukocyte migration and phagocytosis, and weakens the body's defense against external infections.