Side effects with short-term use include nausea, inability to concentrate, insomnia, or feeling tired.[5] More severe side effects include psychiatric problems, which may occur in about 5% of people.[9] Common side effects with long term use include bone loss, weakness, yeast infections, and easy bruising.[6] While short-term use in the later part of pregnancy is safe, long-term use or use in early pregnancy is occasionally associated with harm to the baby.[1] It is a glucocorticoid made from hydrocortisone (cortisol).[10]
Prednisolone acetate ophthalmic suspension (eye drops) is an adrenocortical steroid product, prepared as a sterile ophthalmic suspension and used to reduce swelling, redness, itching, and allergic reactions affecting the eye.[30][8][31] It has been explored as a treatment option for bacterial keratitis.[32]
Dermatological effects including reddening of face, bruising/skin discoloration, impaired wound healing, thinning of skin, skin rash, fluid build up and abnormal hair growth
Hyperglycemia; patients with diabetes may need increased insulin or diabetic therapies
Menstrual abnormalities
Lower response to hormones, especially during stressful instances such as surgery or illness
Change in electrolytes: rise in blood pressure, increased sodium and low potassium, leading to alkalosis
GI system effects: swelling of stomach lining, reversible increase in liver enzymes, and risk of stomach ulcers
Muscular and skeletal abnormalities, such as muscle weakness/muscle loss, osteoporosis (see steroid-induced osteoporosis), long bone fractures, tendon rupture, and back fractures
Neurological effects, including involuntary movements (convulsions), headaches, and vertigo
Psychosocial behavioral and emotional disturbances[38] with aggression being one of the most common cognitive symptoms or symptoms overall, especially with oral use.[39]
Nasal septum perforation and bowel perforation (in some pathologic conditions).[40][41]
Withdrawal from prednisolone after long-term or high-dose use can lead to adrenal insufficiency.[38]
Pregnancy and breastfeeding
Although there are no major human studies of prednisolone use in pregnant women, studies in several animals show that it may cause birth defects including increased likelihood of cleft palate.
Prednisolone is found in breast milk of mothers taking prednisolone.[38]
Local adverse effects in the eye
When used topically on the eye, the following are potential side-effects:
Cataracts: Extended usage of corticosteroids may cause clouding at the back of the lens, also known as posterior subcapsular cataract. This type of cataract reduces the path of light from reaching the eye, which interferes with a person's reading vision. Consumption of prednisolone eye drops post surgery may also retard the healing process.[26]
Corneal thinning: When corticosteroids are used in the long term, corneal and scleral thinning is also one of its consequences. When not ceased, thinning may ultimately lead to perforation of the cornea.[26]
Glaucoma: Elongated use of corticosteroids has a chance of causing a raised intraocular pressure (IOP), injuring the optic nerve and weakening of visual awareness. Corticosteroids should be used cautiously in patients with concomitant conditions of glaucoma. Doctors track patients' IOP if they are using corticosteroid eye drops for more than 103 days.[26]
Pharmacology
Pharmacodynamics
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.[42] 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 blocks the transcription of inflammatory genes.[43] They inhibit the release of signals that promote inflammation such as nuclear factor-Kappa B (NF-κB), Activator protein 1 (AP-1), nuclear factor of activated T-cells (NFAT), and stimulate anti-inflammatory signals such as the interleukin-10 gene.[44][45] All of them will collectively cause a sequence of events, including the inhibition of prostaglandin synthesis and additional inflammatory mediators. Glucocorticoids also inhibit neutrophilcell death and demargination. As well as phospholipase A2, which in turn lessens arachidonic acid derivative genesis.[46]
Pharmacokinetics
Prednisolone has a relatively short half-life, ranging 2–4 hours. It also has a large therapeutic window, considering the dosage required to produce a therapeutic effect is a few times higher than what the body naturally produces.[45]
Both prednisolone phosphate and prednisolone acetate go through esterhydrolysis in the body to form prednisolone. It subsequently undergoes the usual metabolism of prednisolone. Concomitant use of prednisolone and strong CYP3A4 inhibitors such as ketoconazole is shown to cause a rise in plasma prednisolone concentrations by about 50% owing to a diminished clearance.[44]
Prednisolone predominantly undergoes kidney elimination and is excreted in the urine as sulphate and metabolites of glucuronide conjugate.[45]
Prednisone
Prednisone is a prodrug that is activated in the liver. When it enters the body, prednisone is triggered by the liver and body chemicals to turn into its active form, prednisolone.[47]
Chemistry
Prednisolone is a syntheticpregnanecorticosteroid closely related to its cognate prednisone, having identical structure save for two fewer hydrogens near C11. It is also known as δ1-cortisol, δ1-hydrocortisone, 1,2-dehydrocortisol, or 1,2-dehydrohydrocortisone, as well as 11β,17α,21-trihydroxypregna-1,4-diene-3,20-dione.[48][49]
This section is empty. You can help by adding to it. (October 2023)
Minor contraindications and drug reactions
Co-administration of prednisolone eye drops with ophthalmic nonsteroidal anti-inflammatory agents (NSAIDs) may perhaps exacerbate its effects, causing unwanted side effects such as toxicity. The wound healing process may also be hindered.[51]
When used in low doses, corticosteroids serve as an anti-inflammatory agent. At higher doses, they are considered as immunosuppressives.[45] Corticosteroids inhibit the inflammatory response to a variety of inciting agents and, it is presumed, delay or slow healing.[52] They inhibit the edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation with inflammation.[53]
Special populations
Child use
Prolonged use of prednisolone eye drops in children may lead to a raised intraocular pressure. While this phenomenon is dose dependent, it is shown to have a greater effect especially in children under 6 years of age.[26]
Pregnancy and breastfeeding
Researches on animal reproduction have indicated that there is a trace of teratogenicity when doses are reduced by 10 times of the human recommended dose.[54] There is no sufficient information on human pregnancy at this moment. Use is only recommended when the potential benefits outweigh the potential risks of the pregnant mother and the fetus.[54]
Prednisolone when delivered systemically can be found in the mother's breast milk, however, there is no data provided for the extent of prednisolone found in the system after administering eye drops.[26][54] However, the presence of corticosteroids is recorded when they are administered systemically, and it could possibly affect the fetus' growth.[54] Therefore, use of prednisolone during breastfeeding is not advocated.[54]
Society and culture
Dosage forms
Prednisolone is supplied as oral liquid, oral suspension, oral syrup, oral tablet, and oral disintegrating tablet. It may be a generic medication or supplied as brands Flo-Pred (prednisolone acetate oral suspension),[37] Millipred (oral tablets),[22] Orapred (prednisolone sodium phosphate oral dissolving tablets),[7] Pediapred (prednisolone sodium phosphate oral solution),[38] Veripred 20, Prelone, Hydeltra-T.B.A., Hydeltrasol, Key-Pred, Cotolone, Predicort, Medicort, Predcor, Bubbli-Pred, Omnipred (prednisolone acetate ophthalmic suspension),[8] Pred Mild,[31] Pred Forte,[30] and others.[55]
Athletics
As a glucocorticosteroid, unauthorized or ad hoc use of prednisolone during competition via oral, intravenous, intramuscular or rectal routes is banned under World Anti-Doping Agency (WADA) anti-doping rules.[56]
Veterinary uses
Prednisolone is used in the treatment of inflammatory and allergic conditions in cats, dogs, horses, small mammals such as ferrets, birds, and reptiles.[57][58] Its usage in treating inflammation, immune-mediated disease, Addison's disease, and neoplasia is often 'off label' or 'extra label'. Many drugs are commonly prescribed for off label use in veterinary medicine."[59] Studies in ruminating species, such as alpacas, have shown that oral administration of the drug is associated with a reduced bioavailability compared to intravenous administration; however, levels that are therapeutic in other species can be achieved with oral administration in alpacas.[60]
It is used in a broad spectrum of diseases, for example, inflammation of scleral tissues, cornea, conjunctiva in dogs.[57] In horses, prednisolone acetate suspensions are priorly used to treat inflammation in the middle layer of the eye, also known as anterior uveitis and equine recurrent uveitis (ERU), which is the leading cause of visual impairment in horses.[58] Prednisolone acetate eye drops are not to be used in other animals such as birds.[57]
Prednisolone acetate eye drops are also prescribed to the dogs and cats to lessen swelling, redness, burning and pain sensations after surgeries of the eye.[57]
Cats with conjunctivitis usually are required to avoid using ophthalmic preparations of corticosteroids and its derivatives. The most typical infections are caused by herpes virus.[58]
^Bergrem H, Grøttum P, Rugstad HE (1983). "Pharmacokinetics and protein binding of prednisolone after oral and intravenous administration". European Journal of Clinical Pharmacology. 24 (3): 415–9. doi:10.1007/BF00610064. PMID6861855. S2CID33189235.
^World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
^Lambrou GI, Vlahopoulos S, Papathanasiou C, Papanikolaou M, Karpusas M, Zoumakis E, Tzortzatou-Stathopoulou F (December 2009). "Prednisolone exerts late mitogenic and biphasic effects on resistant acute lymphoblastic leukemia cells: Relation to early gene expression". Leukemia Research. 33 (12): 1684–95. doi:10.1016/j.leukres.2009.04.018. PMID19450877.
^Arslan N, Tepe D, Taştan E, Demirci M, Caydere M, Ustun H, Oguz H (November 2012). "Evaluation of the effectiveness of topical ciprofloxacin and prednisolone in the prevention of myringosclerosis". European Archives of Oto-Rhino-Laryngology. 269 (11): 2335–2341. doi:10.1007/s00405-011-1889-z. PMID22197890. S2CID23472925.
^Wilhelmus KR, Gee L, Hauck WW, Kurinij N, Dawson CR, Jones DB, et al. (April 2020). "Herpetic Eye Disease Study: A Controlled Trial of Topical Corticosteroids for Herpes Simplex Stromal Keratitis". Ophthalmology. 127 (4S): S5–S18. doi:10.1016/j.ophtha.2020.01.037. PMID32200827. S2CID214616647.
^Gayam K, Ramulu PY, Rengaraj V, Srinivasan K (29 February 2020). "Safety and Efficacy of 0.1% Nepafenac versus 1% Prednisolone Acetate Eye Drops after Laser Peripheral Iridotomy: A Prospective, Randomized Trial". Ophthalmology. Glaucoma. 3 (3): 174–180. doi:10.1016/j.ogla.2020.02.006. PMID32672612. S2CID90234022.
^Cervin A, Andersson M (September 1998). "Intranasal steroids and septum perforation--an overlooked complication? A description of the course of events and a discussion of the causes". Rhinology. 36 (3): 128–32. PMID9830677.
US patent 2837464, Arthur Nobile, "Process for production of dienes by corynebacteria", published 1958-06-03, issued 1958-06-03, assigned to Schering Corp
Sebuah couillard di Château de Calmont d'Olt, Prancis. Couillard (pengucapan bahasa Prancis: [ku.jaʁ]) adalah mesin kepung Abad Pertengahan, berbentuk mirip manjanik namun lebih kecil. Berbeda dengan manjanik yang memiliki dua kaki penunjang yang mengapit kedua sisi lengan pengumbannya, couillard hanya memiliki satu kaki penunjang, tetapi ujung lengan pengumbannya (pada beban pemberat) terbelah menjadi dua (seperti bentuk Y) sehingga memiliki dua beban pemberat dan titik tumpunya terletak…
Japanese Shrine during Indonesia's occupation Ching Nan JinjaChinnan Shrine鎮南神社Japanese officers pose with Indonesians in Ching Nan Jinja, MalangReligionAffiliationShintoDeityAmaterasuTypeShinto shrineLocationLocationMalang, East Java, IndonesiaShown within JavaShow map of JavaChing Nan Shrine (Indonesia)Show map of IndonesiaChing Nan Shrine (Asia)Show map of AsiaGeographic coordinates7°57′34.074″S 112°37′12.8316″E / 7.95946500°S 112.620231000°E / -7.9…
العلاقات العراقية السورية العراق سوريا السفارات السفارة العراقية في دمشق السفير : سعد محمد رضا العنوان : دمشق (أبو رمانة-شارع المهدي بن بركة) السفارة السورية في بغداد السفير : صطام الدندح العنوان : بغداد ( المنصور شارع الاميرا…
Військово-музичне управління Збройних сил України Тип військове формуванняЗасновано 1992Країна Україна Емблема управління Військово-музичне управління Збройних сил України — структурний підрозділ Генерального штабу Збройних сил України призначений для плануван…
Summary of algorithms for nonlinear dimensionality reduction Top-left: a 3D dataset of 1000 points in a spiraling band (a.k.a. the Swiss roll) with a rectangular hole in the middle. Top-right: the original 2D manifold used to generate the 3D dataset. Bottom left and right: 2D recoveries of the manifold respectively using the LLE and Hessian LLE algorithms as implemented by the Modular Data Processing toolkit. Nonlinear dimensionality reduction, also known as manifold learning, is any of various …
Dalam artikel ini, nama keluarganya adalah Zhang. Zhang YimanInformasi pribadiKebangsaanTiongkokLahir15 Januari 1997 (umur 27)Hunan, TiongkokTempat tinggalBeijing, TiongkokPeganganKananTunggal putriPeringkat tertinggi16 (27 Desember 2022)Peringkat saat ini16 (27 Desember 2022) Rekam medali Putri bulu tangkis Mewakili Tiongkok World Championships 2021 Huelva Women's singles Piala Uber 2022 Bangkok Women's team Profil di BWF Zhang Yiman (Hanzi: 张艺曼; Pinyin: Zhān…
دخانمعلومات عامةصنف فرعي من ضبوبlithometeor (en) جسيمات معلقة الاستعمال تدخين جانب من جوانب جهاز الرؤيةاستنشاق الأسباب احتراق سبب مباشر لهذا الحدث brick stove (en) قاطرة بخاريةحريق تسبب في استنشاق الدخان السبب المباشر لـ موت لديه عامل المساهمة احتراق لديه جزء أو أجزاء جسيمات معلقةغاز ت…
Sexual crimes committed during the occupation of Japan Rape Types Acquaintance rape Campus rape Child sexual abuse Corrective rape LGBT victims Cybersex trafficking Drug-facilitated rape Date rape Gang rape Genocidal rape Gray rape Live streaming rape Marital rape Prison rape Rape chant Serial rape Sexual abuse Sexual assault Statutory rape Unacknowledged rape Rape by deception Effects and motivations Effects and aftermath Factors involved Pregnancy from rape Rape crisis movement Rape trauma syn…
1974 single by James Brown This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed.Find sources: Funky President People It's Bad – news · newspapers · books · scholar · JSTOR (March 2020) (Learn how and when to remove this message) Funky President (People It's Bad)Single by James Brownfrom the album Reality B-sideColdbloodedRel…
United States historic placeDearborn County CourthouseU.S. National Register of Historic PlacesU.S. Historic districtContributing property Dearborn County Courthouse, July 2019Show map of IndianaShow map of the United StatesInteractive map showing the location for Dearborn County CourthouseLocationHigh and Mary Sts., Lawrenceburg, IndianaCoordinates39°5′28″N 84°50′59″W / 39.09111°N 84.84972°W / 39.09111; -84.84972Area1 acre (0.40 ha)Built1870 (1870)-…
Newspaper in Panamá La Estrella de PanamáTypeDaily newspaperFounded1849; 175 years ago (1849)LanguageSpanishCountryPanamaWebsitelaestrella.com.paMedia of PanamaList of newspapers La Estrella de Panamá is the oldest daily newspaper in Panamá.[1] The newspaper originally began in 1849 as a Spanish-language translation insert of an English daily, The Panama Star, which had been formed in 1849.[2] It has a circulation of approximately 8,000 print copies.[3…
Прецизио́нные спла́вы (от фр. précision — точность) — группа сплавов с заданными физико-механическими свойствами. В эту группу, как правило, входят высоколегированные сплавы с точным химическим составом[1]. Содержание 1 Маркировка 2 Классификация 2.1 Магнитно-мягкие…
Lihat Bahasa Occitania di: ISO • Ethnologue • Wikipedia bahasa Inggris Bahasa Occitania Occitan lenga d'òc Dituturkan diPrancis, Spanyol, ItaliaPenutur1.939.000 Rincian data penutur Jumlah penutur beserta (jika ada) metode pengambilan, jenis, tanggal, dan tempat.[1][2][3] 542.000 (estimate, dipertentangkan, 2020)110.000 (estimate, dipertentangkan, 2012)526.000 (estimate, dipertentangkan, 2002)30.000 (estimate, hypothetically, 2030) Rumpun…
Mappa di Milano del XVIII secolo con indicati i principali luoghi pii e chiese dell'epoca San Nazaro in Pietrasanta San Giovanni alle Case Rotte Vecchia chiesa di San Bartolomeo Santa Maria in Aracoeli Santa Maria in Brera San Pietro in Cornaredo San Donnino alla Mazza Chiesa di Santa Caterina alla Chiusa Dipinto di Santo Stefano in Borgogna San Giovanni in Laterano Monastero e chiesa della Maddalena Basilica di San Giovanni in Conca La scomparsa chiesa di Santa Maria Beltrade San Michele sul Do…
Canadian actress (1955–2015) Alberta WatsonAlberta Watson on 24BornFaith Susan Alberta Watson(1955-03-06)March 6, 1955Toronto, Ontario, CanadaDiedMarch 21, 2015(2015-03-21) (aged 60)Toronto, Ontario, CanadaOccupationActressYears active1975–2012SpouseKen Sedgwick Faith Susan Alberta Watson (March 6, 1955 – March 21, 2015), better known as Alberta Watson, was a Canadian film and television actress.[1] Early life Watson was born in Toronto, Ontario, in 1955.[2] She g…
Campaign during the Syrian Civil War For other uses, see Latakia offensive (disambiguation). 2013 Latakia offensivePart of the Syrian Civil WarThe situation in the Latakia Governorate in August 2013 Syrian Army control Opposition controlDate4–19 August 2013(2 weeks and 1 day)LocationLatakia Governorate, SyriaResult Syrian Army victory Rebel forces initially captured 13 villages[4] Army counter-attack recaptures all of the villages[5] Rebels kil…
العلاقات اليمنية السريلانكية اليمن سريلانكا اليمن سريلانكا تعديل مصدري - تعديل العلاقات اليمنية السريلانكية هي العلاقات الثنائية التي تجمع بين اليمن وسريلانكا.[1][2][3][4][5] مقارنة بين البلدين هذه مقارنة عامة ومرجعية للدولتين: وجه المقارن…