Prednisone: Difference between revisions
No edit summary
Line 1: Line 1:
==General==
==General==
*Type: Corticosteroids, systemic
*Type:  
*Dosage Forms:1, 2, 5, 10, 20, 50, 5/5ml  
*Dosage Forms:1, 2, 5, 10, 20, 50, 5/5ml  
*Common Trade Names: Sterapred, Sterapred DS, Rayos
*Common Trade Names: Sterapred, Sterapred DS, Rayos


==Adult Dosing==
==Adult Dosing==
For all doses of prednisone, it is best given with food. Also, ideally best when given in AM to coincide with natural cortisol release. No need to taper if short course less than 1 week, otherwise consider taper.


*Corticosteroid-responsive conditions
*Corticosteroid-responsive conditions
5-60mg PO qd
5-60mg PO qd
Dose varies based on condition
Dose varies based on condition, best when given with food. Best when given in AM to coincide with natural cortisol release. No need to taper if short course less than 1 week, otherwise consider taper.


*Asthma, acute
*Asthma, acute
40-80 mg/day PO divided qd-bid (most practitioners give 60mg po x 1 to 80-100kg adult)
40-80 mg/day PO divided qd-bid (most practitioners give 60mg po x 1 to 80-100kg adult)
If patient can tolerate PO, no need to give steroids IV, but if asthma is severe, and bipap / intubation likely, best to keep patient NPO and give methylprednisolone IV
If patient can tolerate PO, no need to give steroids IV, but if asthma is severe, and bipap/intubation likely, best to keep patient NPO and give methylprednisolone


 
*
*Adrenal Insufficiency
4-5mg/ m^2 PO qd
Taper dose gradually to d/c when appropriate
 
 
*Multiple Sclerosis, acute exacerbation
200mg PO qd x1 week, then 80mg po qod x1 mo
Give with food, also prescribe PPI for gastric protection. Taper dose gradually to d/c
 
 
*Alcoholic Hepatitis, acute
40mg PO qd
 
 
*PCP, Adjunct tx
40mg PO bid x5 days, then 40mg PO qd x5 days, then 20mg PO qd x11 days
Start w/in 72hrs of antimicrobial tx
Always consider discussion with HIV consultants prior to given steroids, as they will be managing patient in hospital


==Pediatric Dosing==
==Pediatric Dosing==
For all doses of prednisone, it is best tolerated with food. Ideally best when given in AM to coincide with natural cortisol release. No need to taper if short course less than 1 week, otherwise consider taper.
*Corticosteroid-responsive conditions
0.05-2mg/kg/day PO divided qd-qid
Dose varies based on condition
*Asthma, acute
1-2 mg/day PO divided qd-bid Max 60mg/day
If patient can tolerate PO, no need to give steroids IV, but if asthma is severe, and Bipap / intubation likely, best to keep patient NPO and give methylprednisolone IV
*Adrenal Insufficiency
4-5mg/ m^2 PO qd Taper dose gradually to d/c when appropriate
*Nephrotic Syndrome
2mg / kg PO qd
Max 80 mg / day. Use for 1st 3 episodes
*PCP, adjunct tx
(children <40kg)
1mg/kg PO bid x5days, then 0.5mg/kg PO bid x5days, then 0.5mg PO qd x 11 days. Start w/in 72 hrs of antimicrobial tx
(Children >40kg)
40mg PO bid x5 days, then 20mg PO bid x5 days, then 20mg PO qd x 11 days. Start w/in 72 hrs of antimicrobial tx
(Adolescents)
40mg PO bid x5 days, then 40mg PO qd x5 days, then 20mg PO qd x 11 days. Start w/in 72 hrs of antimicrobial tx


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Category D
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]:
*Lactation: Probably safe "Limited information in animals and/or humans demonstrates no risk/minimal risk of adverse effects to infant/breast milk production; caution advised" -Epocrates
*Lactation:
*Renal Dosing
*Renal Dosing
**Adult - No adjustment
**Adult
**Pediatric - No adjustment
**Pediatric
*Hepatic Dosing
*Hepatic Dosing
**Adult - Not defined
**Adult
**Pediatric - Not defined
**Pediatric


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*Systemic fungal infx
*Recent varicella or measles infx
*Caution in TB, immunosuppressed, HTN, CHF, DM, PUD, seizure disorder, psychiatric disorder, osteoporosis,


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Adrenal insufficiency
*Cushing syndrome
*Immunosuppression
*Infection
*HTN
*CHF
*DM
*GI perf / ulcer
*Osteopenia / osteoporosis
*tendon rupture
*pseudotumor cerebri
*Increased ICP
*Seizures
*Glaucoma


===Common===
===Common===
*Sodium and fluid retention
*diaphoresis
*HA
*Vertigo
*Insomnia
*Nervousness, mood swings
*Muscle weakness
*BP elevation
*glucose intolerance
*Menstrual irregularities


==Pharmacology==
==Pharmacology==
*Half-life: 18-36h (biological)
*Half-life:  
*Metabolism: Liver CYP450; 3A4 substrate. Prodrug is converted to prenisolone
*Metabolism:  
*Excretion: Urine
*Excretion:  
*Mechanism of Action: Exact mechanism unknown, inhibits inflammatory cytokines, produces multiple glucocorticoid and mineralcorticoid effects
*Mechanism of Action:


==See Also==
==See Also==


==Sources==
==Sources==
Epocrates


<references/>
<references/>
[[Category:Drugs]]
[[Category:Drugs]]

Revision as of 15:42, 4 April 2015

General

  • Type:
  • Dosage Forms:1, 2, 5, 10, 20, 50, 5/5ml
  • Common Trade Names: Sterapred, Sterapred DS, Rayos

Adult Dosing

  • Corticosteroid-responsive conditions

5-60mg PO qd Dose varies based on condition, best when given with food. Best when given in AM to coincide with natural cortisol release. No need to taper if short course less than 1 week, otherwise consider taper.

  • Asthma, acute

40-80 mg/day PO divided qd-bid (most practitioners give 60mg po x 1 to 80-100kg adult) If patient can tolerate PO, no need to give steroids IV, but if asthma is severe, and bipap/intubation likely, best to keep patient NPO and give methylprednisolone

Pediatric Dosing

Special Populations

  • Pregnancy Rating:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

See Also

Sources

Retrieved from "https://www.wikem.org/w/index.php?title=Prednisone&oldid=35394"