Trade name:
Prednisone

International name:
Prednisone (Prednisone)

Group affiliation:
Glucocorticosteroid

Description of the active substance (INN):
Prednisone

Dosage form:
pills

Pharmacological actions:
CSG; anti-inflammatory, protiwallergicescoe, protivosokowoe and immunodepressive action. Reduces the amount of protein in the plasma, mainly globulin (with an increase of the coefficient albumin / globulin); reinforces the catabolic processes in the muscle tissue. Increases the synthesis of fatty acids and TG, redistributes fat accumulation of fat in the shoulder, face, stomach, and hypercholesterolemia. Increases the absorption of carbohydrates from the digestive TRACT increases the activity of glucose-6-phosphatase, increasing the release of glucose from the liver into the blood, increases the activity of фосфоэнолпируваткарбоксилазы and synthesis of the aminotransferaz, which leads to activation of gluconeogenesis. The water-electrolytic exchange - delayed Na + and water in the body, stimulates the excretion of K +, reduces the absorption of Ca2 + from the digestive TRACT, an antagonist of vitamin D ("washing away" of Ca2 + from the bones), increases the excretion of Ca2 + kidneys. The anti-inflammatory effect is due to inhibition of release of mediators of inflammation eosinophils; induction lipokortina education and decrease in the number of fat cells, generating hyaluronic acid (with a decrease in the permeability of the capillaries, the stabilization of cell membranes and membrane organell). Protiwallergiceski effect is caused by decrease in the number of circulating basophils, which leads to the reduction of mediators of immediate allergy; reduces the impact of mediators allergies to effector cells. Immunodepressivny effect is due to inhibition of the release of cytokines (interleykina1, interleykina2,? Interferon) from the cells and macrophages. Suppresses the activity of vitamin D, which leads to a decrease in absorption of Ca2 + and increase its excretion; suppresses the synthesis and secretion of ACTH and a second time - the synthesis of endogenous CORTICOSTEROID.

Indications:
System diseases of connective tissue (SLE, scleroderma, periarteritis nodosa, dermatomyositis, rheumatoid arthritis). Acute and chronic inflammatory diseases of the joints: gout, psoriatic arthritis, osteoarthrosis (including post-traumatic), polyarthritis, scapulohumeral periarthritis, ankylosing spondylitis (Bechterew's disease), juvenile rheumatoid arthritis, syndrome Still in adults, bursitis, the non-tenosynovitis, synovitis and epicondylitis. Acute rheumatism, rheumatic carditis and chorea minor. Bronchial asthma, asthma status. Acute and chronic allergic diseases: allergic reactions to DRUGS and food products, serum sickness, urticaria, allergic rhinitis, angioneuroticeski swelling, drug exanthema, hay fever. Diseases of the skin: pemphigus, psoriasis, eczema, atopic dermatitis, diffuse, atopic dermatitis, contact dermatitis (with the defeat of the large surface of the skin), drug reaction, seborrheic dermatitis exfoliativei dermatitis, toxic epidermal necrolysis (Laiella syndrome), bullous dermatitis herpetiformis, malignant exudative erythema (Stevens-Johnson syndrome). Edema of the brain (including in the face of brain tumor or associated with surgery, radiation therapy, or head injury) after pre-parenteral administration. Allergic eye diseases: allergic corneal ulcers, allergic forms of conjunctivitis. Inflammatory diseases of the eye: the sympathetic ophthalmic, heavy lingering front and rear uveitis, optic neuritis. Primary or secondary adrenal insufficiency (including condition after removal of the adrenal glands). Congenital adrenal hyperplasia. Kidney disease autoimmune genesis (incl. acute glomerulonephritis); argued syndrome. Subacute thyroiditis. Diseases of the organs of hematopoiesis: agranulocytosis, panmielopatiya, autoimmune hemolytic anemia, acute lymphoid and myeloid leukemia, hodgkin's disease, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia injectable (anemia), congenital (erythroid) hypoplastic anemia. Interstitial lung disease: acute alveolitis, fibrosis of the lungs, sarcoidosis II-III century. Tuberculous meningitis, tuberculosis of the lungs, aspirate pneumonia (in conjunction with specific chemotherapy). Berylliosis, Leffler syndrome (not resistant to other therapy). Lung cancer (in combination with zitostatikami). Multiple sclerosis. DIGESTIVE diseases: ulcerative colitis, Crohn's disease, local enteritis. Hepatitis, gipoglikemicakie condition. Prevention of rejection reactions transplant. Gipercalziemia on the background of oncological diseases, nausea and vomiting associated with the conduct of cytostatic therapy. A disease mielomnaya.

Contraindications:
For short-term use for the "life" of the testimony of the only contraindication is giperchuvstvitelnost.S caution. Parasitic and infectious diseases of viral, fungal or bacterial nature (currently or recently transferred, including the recent contact with sick): a simple herpes, herpes zoster (viremicheskaya phase), chickenpox, measles; amebiaz, strongyloidiasis (fixed or suspect); systemic mycosis, active and latent tb. Application in case of severe infectious diseases shall be admissible only on the background of specific therapy. Following immunization (period of 8 weeks before and two weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (incl. AIDS or HIV infection). Diseases of the GASTROINTESTINAL tract: stomach ulcer and 12 duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, recently created anastomosis of the bowel, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis. Diseases of the CCC, including recent myocardial infarction (in patients with acute and subacute myocardial infarction may spread of necrosis, slowing the formation of scar tissue and due to this - the rupture of the heart muscle), decompensated CHF, hypertension, hyperlipidemia). Endocrine diseases: diabetes mellitus (including infringement of tolerance to carbohydrates), thyrotoxicosis, hypothyroidism, a disease Itsenko-Kushinga. Severe chronic renal and / or hepatic impairment, nefrourolitiaz. Gipoalbuminemia, and conditions that predispose to its emergence. Systemic osteoporosis, and myasthenia gravis, acute psychosis, obesity (III-IV article.), Polio (except for the form bulbar encephalitis), an open-and closed-angle glaucoma, pregnancy, lactation period.

Side effects:
The frequency of the development and severity of side effects depends on the duration of use, amount used, the dose and the possibility of compliance with the circadian rhythm of destination. Endocrine system: reduced tolerance to glukoze, "steroid diabetes or a manifestation of latent diabetes mellitus, the oppression of the adrenal glands, the syndrome Itsenko-Kushinga (moon face, obesity pituitary type, hirsutism, increased AD, dysmenorrhea, amenorrhea, myasthenia gravis , austria), delayed sexual development in children. From the digestive system: nausea, vomiting, pancreatitis, "steroid" gastric ulcer and 12 duodenal ulcer, erosive esophagitis, bleeding and perforation of the GASTROINTESTINAL tract, increased or decreased appetite, flatulence, hiccups . In rare cases, increased activity of hepatic transaminases and alkaline phosphatase. By the CCC: arrhythmia, bradycardia (up to the stopping of the heart), development (in predisposed patients) or increased symptoms of heart failure, ECG changes, characteristic for hypokalemia, increased AD, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction: spread of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor the cerebellum, headache, convulsions. From the sensory organs: posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve , propensity to development of secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, exophthalmos. From the metabolic: increased excretion of Ca2 +, gipocalziemia, increased body mass, negative nitrogen balance (increased disintegration of proteins), increased sweating. Due to the ISS activity - fluid retention and Na + (peripheral edema), hypernatriemia, gipokaliemicski syndrome (gipokaliemia, arrhythmia, myalgia or spasm of the muscles, unusual weakness and fatigue). From the musculoskeletal system: slowing growth and the processes of fossilization in children (premature closure of the epiphysial zone growth), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head humerus and femur), the gap tendons of muscles, "steroid" myopathy, reduced muscle mass (atrophy). By the skin and mucous membranes: slow healing of wounds, petechiaea €, ekhimozy, thinning of the skin, hyper-or hypopigmentation, steroid acne, scars, propensity to development of pyoderma and candidiasis. Allergic reactions: generalized (skin rashes, itching, anaphylactic shock ), local allergic reaction. Other: development or exacerbation of infection (the appearance of this side effect contribute to the jointly used immunosuppressants and vaccination), leukocyturia, the syndrome of "lifting".

Way of administration and dosage:
Substitution therapy is 20-30 mg / day; supporting dose - 5-10 mg / day; if necessary, the initial dose of 15 mg to 100 mg / day, supporting - 5-15 mg / day. Children 1-2 mg / kg / day in 4-6 receptions supporting - 300-600 mg / kg / day, in the morning - the big doses, the day - average, in the evening - small.

Special instructions:
Before treatment to a study of CCC, x-ray examination of the lungs, the study of the stomach and duodenum; retention system, the organs of vision.