Prednisolone

Question 1

Drug Class

Answer 1

Corticosteroids

Question 2

Active

Answer 2

Prednisolone

Question 3

Indications

Answer 3

Immunosuppression in autoimmune disease and transplantation.

Anti-inflammatory (IBD, asthma, allergy and skin conditions).

Chemotherapy-induced nausea and vomiting.

Replacement therapy in adrenal insufficiency

Question 4

Dose Range

Answer 4

Adult: 5 – 60 mg daily in divided doses

Children: Asthma, 1 mg/kg once daily

Question 5

SE’s

Answer 5

Glucocorticoid

• GI effects (dyspepsia, peptic ulceration, gastric bleeding)
• Metabolic effects (hyperglycaemia, diabetes)
• Increased appetite, weight gain
• Insomnia
• Psychological disturbances (psychosis, euphoria, depression)
• Immunosuppression and increase risk of infection
• Myopathy, muscle weakness
• Osteoporosis (long-term)

Mineralocorticoid
Salt retention Oedema Hypertension

Question 6

Counselling

Answer 6

Labels: B, 9

• Take the tablets or oral liquid with food to help reduce stomach upset.
• Tell your doctor immediately if you have any signs of infection.
• This medication may affect your mood, eg you may feel more happy or sad than usual. It may also cause problems with sleeping; talk to your doctor if you have any concerns.
• Do not stop taking this medicine suddenly unless your doctor tells you to. The dose may need to be reduced gradually when stopping treatment.
• Tell all doctors, surgeons and dentists treating you that you are taking corticosteroids (or have taken them in the past) because if you become ill or are going to have surgery your dose of medicine may need to be increased.
• Consider wearing a Medic Alert® bracelet and carrying a card with the details of your treatment.

Question 7

Monitoring

Answer 7

• measure blood glucose, electrolytes, weight and BP at baseline, then each week for the first month of treatment.
• watch for signs/symptoms of infection, however, these may be masked.
• measure BMD at baseline if likely to require chronic treatment (>3 months) or repeat courses; evaluate and manage other risk factors for osteoporosis and consider need for drug treatment to prevent bone loss.
• monitor for cataracts and glaucoma in patients on long-term corticosteroids.