Prednisone oral steroid side effects

4/27/2015  
What are the current recommendations and dosing amount/duration for treating with oral Prednisone in active/chronic childhood and adult asthmatics with exacerbations most likely due to molds (Florida late winter & early spring) . non-productive paroxysmal cough and wheeze not responding to inhaler (Advair type combo and/or inhaled steroid) and anti-histamines and recently treated and/or failure to resolve with Antbx?

Second question,
In a patient as described above (no relief with inhaled treatments and anti-histamines/Leukotriene inhibitor) what levels can be used for IgE? Total to initiate Oral Steroids, I've seen a local Pulmonologist recommend adding Oral Steroids when the Ige total is above 500. Is there a reference for this? It has worked on our patients we have referred to them and they initiated that treatment type recommendation and protocol. Also they used Ige total greater than 200 for ABPA patients to start treatment.

As a glucocorticoid , the lipophilic structure of prednisolone allows for easy passage through the cell membrane where it then binds to its respective glucocorticoid receptor (GCR) located in the cytoplasm. Upon binding, formation of the GC/GCR complex causes dissociation of chaperone proteins from the glucocorticoid receptor enabling the GC/GCR complex to translocate inside the nucleus. This process occurs within 20 minutes of binding. Once inside the nucleus, the homodimer GC/GCR complex binds to specific DNA binding-sites known as glucocorticoid response elements (GREs) resulting in gene expression or inhibition. Complex binding to positive GREs leads to synthesis of anti-inflammatory proteins while binding to negative GREs block the transcription of inflammatory genes. [28]

For the pet owner, a serious discussion with your dog's vet is critical in understanding proper use of prednisone and its possible side effects. The list is long and one has to weigh the possible results against the possible side effects. In the past, it was the pet owner's insistence on immediate relief of symptoms that made prednisone the drug of choice for anti-inflammatory action. Today's pet owners are better educated and wiser about long term issues that can be detrimental. Other drugs and treatment options make it possible to alleviate symptoms in the mildly allergic dog without resorting to steroid treatment and should be tried for a period of weeks, even months, before giving up. These options would include a better understanding of day to day attention to environmental factors, improved diet that will build up immunity and often the simple matter of keeping the dog inside in an air conditioned environment during seasonal allergic reactions. When steroid treatment is absolutely needed, the sooner the drug regimen can be completed the better. While steroids may alleviate symptoms, they are not a cure.

The first isolation and structure identifications of prednisone and prednisolone were done in 1950 by Arthur Nobile . [22] [23] [24] The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation , by Arthur Nobile and coworkers. [25] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone . [26]

Prednisone oral steroid side effects

prednisone oral steroid side effects

The first isolation and structure identifications of prednisone and prednisolone were done in 1950 by Arthur Nobile . [22] [23] [24] The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation , by Arthur Nobile and coworkers. [25] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone . [26]

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