Drug alias prednisone
The chemical name of the molecular formula is 17α, 2 1- dihydroxyprogesterone-1, 4- diene -3,1,20- trione 2 1- acetate. Molecular formula: C23H28O6. Molecular weight: 400.47
Formulation specification tablets: 5mg. 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 is active only when the liver is transformed into prednisolone, and the physiological T 1/2 is 60min.
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.
Indications: allergic and inflammatory diseases. Allergy and autoimmune inflammatory diseases. It is suitable for allergic diseases such as connective tissue disease, systemic lupus erythematosus, severe bronchial asthma, dermatomyositis, vasculitis, acute leukemia, malignant lymphoma and other adrenocortical drugs.
Adverse reactions A large dose of this product is easy to cause diabetes, digestive tract ulcer and Cushing's syndrome, and has a strong inhibitory effect on hypothalamus-pituitary-adrenal axis. Concurrent infection is the main adverse reaction.
Interaction (1) Non-steroidal anti-inflammatory and analgesic drugs can strengthen its ulcer-causing effect.
⑵ It can enhance the hepatotoxicity of acetaminophen.
⑶ 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.
⑷ Combined with anabolic steroids can increase the incidence of edema and aggravate acne.
5] Long-term use with anticholinergic drugs (such as atropine) can increase intraocular pressure.
[6] tricyclic antidepressants can aggravate the mental symptoms caused by them.
Once it is 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.
Being a thyroid hormone can increase its metabolic clearance rate, so the dose of thyroid hormone or antithyroid drugs should be adjusted appropriately.
⑼ Combined with contraceptives or estrogen preparations, the therapeutic effect and adverse reactions can be enhanced.
⑽ Combination with cardiac glycoside can increase digitalis toxicity and arrhythmia.
⑾ Combined with potassium diuretics, it can cause severe hypokalemia, and the sodium excretion and diuresis will be weakened due to water and sodium retention.
⑿ Combined with ephedrine, its metabolic clearance rate can be enhanced.
[13] Combined with immunosuppressants can increase the risk of infection and may induce lymphoma or other lymphoproliferative diseases.
14. It can increase the metabolism and excretion of isoniazid in the liver, and reduce the blood concentration and curative effect of isoniazid.
⒂ can promote the metabolism of mexiletine in the body and reduce the blood concentration.
⒃ Combined with salicylate, the concentration of salicylate in plasma can be reduced.
⒄ Combined with growth hormone, it can inhibit the growth-promoting effect of the latter.
Usage and dosage: the adult dose is 15mg ~ 40mg/ day, and it can be increased to 60mg/ day if necessary, and taken in batches, and gradually reduced after the condition is stable. The maintenance amount is 5mg ~ 10mg/ day.
1. For autoimmune diseases such as systemic lupus erythematosus, nephrotic syndrome, ulcerative colitis, autoimmune hemolytic anemia, etc., 40-60mg can be given daily, and gradually reduced after the condition is stable.
2. For allergic diseases such as drug dermatitis, measles and bronchial asthma, prednisone can be given 20-40mg 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.
3. To prevent organ transplant rejection, oral administration of 100mg/ day is generally started on 1-2 days before operation, changed to 60mg/day one week after operation, and then gradually reduced.
4. For the treatment of acute leukemia and malignant tumor, 60-80mg is taken orally every day, and the amount is reduced after the symptoms are relieved.
Precautions: Class C pregnancy. This product does not need liver transformation, and can be used for patients with hepatic insufficiency. Generally, it is not used as an alternative treatment for adrenocortical hypofunction. This product injection (alcohol type) contains 50% ethanol, which must be fully diluted to 0.2mg/ml before intravenous drip. If there is central nervous system inhibition or hepatic insufficiency, use it with caution, and hydrocortisone sodium succinate should be used when a large dose is needed.
1. Use with caution in patients with pulmonary tuberculosis, acute bacterial or viral infection. Appropriate anti-infective treatment must be given when necessary.
2. After taking the medicine for a long time, it should be gradually reduced and then stopped.
3. Use with caution in patients with diabetes, osteoporosis, liver cirrhosis, renal insufficiency and hypothyroidism.
4. For patients infected by bacteria, fungi and viruses, we should use enough sensitive antibiotics with caution.
[Medication for pregnant women and lactating women] Pregnant women can increase the incidence of placental insufficiency, neonatal weight loss or stillbirth. Animal experiments have teratogenic effects, so we should weigh the advantages and disadvantages of using them. 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 this hormone will inhibit children's growth and development. If they must use it for a long time, they should use short-acting (such as cortisone) or medium-acting preparations (such as prednisone) and avoid using long-acting preparations (such as dexamethasone). 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, which is easy to cause excessive, 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 prone to osteoporosis.
Contraindications are prohibited for patients with allergic history of this product and adrenocortical drugs. Patients with hypertension, thrombosis, gastric and duodenal ulcer, psychosis, abnormal electrolyte metabolism, myocardial infarction, visceral surgery, glaucoma, etc. Usually not suitable for use. Under special circumstances, weigh the advantages and disadvantages, and pay attention to the possibility of deterioration.