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Prednisolone serves as an anti-inflammatory, anti-allergic, anti-toxic, and anti-shock medication. It stands as a synthetic counterpart to cortisone and hydrocortisone, the natural hormones originating from the adrenal cortex. Administered orally, Prednisolone has demonstrated potency that is four to five times greater than hydrocortisone and approximately three times more robust than cortisone.

Indications

• Inflammation of the cornea in individuals with intact mucosa; swollen eyelids (blepharitis).

• Chronic allergic conjunctivitis (inflammation of the ocular mucous membrane).

• Sympathetic ophthalmia (inflammation of the uveal tract that manifests in one eye after trauma or surgery to the other eye).

• Post-cataract surgery.

• Multiple sclerosis.

• Bronchial asthma.

• Hepatitis.

• Chronic and acute allergies (atopic dermatitis, urticaria, food and drug allergies, Quincke's edema, toxicoderma, and hay fever).

• Rheumatic fever.

• Rheumatic carditis.

• Chronic and acute joint disorders (polyarthritis, osteoarthritis, bursitis, synovitis, rheumatoid arthritis, psoriasis and psoriatic arthritis, humeroscapular periarthritis, and adult-onset Still’s disease).

• Inflammatory bowel diseases (localized enteritis and nonspecific ulcerative colitis).

• Infectious mononucleosis (characterized by swollen lymph glands, liver enlargement, and fever).

• Connective tissue disorders (dermatomyositis, scleroderma, systemic lupus erythematosus, and polyarteritis nodosa).

• Autoimmune diseases.

• Acute pancreatitis (sudden inflammation of the pancreas).

• Hemolytic anemia.

• Glomerulonephritis (kidney disease).

Additional Indications

• Surgical shock.

• Prevention of organ transplant rejection.

Administration Routes and Dosages

Dosage determination should be tailored to each patient's specific needs. When establishing the appropriate Prednisolone dosage, accounting for the circadian rhythm of glucocorticoid secretion is crucial. Oral ingestion of tablets with a small quantity of water is recommended. Typically, the highest dose is advised in the morning, followed by a moderate dose in the afternoon, and the lowest dose in the evening. Commencing with an initial dose of 20-30 mg (equivalent to 4-6 pills) per day, a gradual reduction can lead to a maintenance dose of 5-10 mg (1-2 pills).

For specific conditions like rheumatic disorders and nephrosis, the daily Prednisone dose ranges from 15 to 100 mg. Termination of treatment necessitates a gradual tapering of the daily dose. Pediatric patients are typically initiated at an initial Prednisone dose of 1-2 mg/kg/day, divided into four to six doses, with a maintenance dose of 300-600 μg/kg/day. Throughout the course of Prednisolone treatment, regular urine tests should be conducted to monitor blood pressure and blood sugar levels.

Contraindications

• Hypersensitivity to the drug or its constituents .

• During the post-vaccination period .

• Presence of diabetes .

• Acute bacterial endocarditis .

• Pregnancy .

• Stomach and duodenal ulcers .

• Gastritis, particularly acute peptic ulcer .

• Persistent high blood pressure .

• Active tuberculosis .

• Syphilis .

• Nephritis (kidney inflammation) .

• Acute psychosis .

• Poliomyelitis .

• Recent myocardial infarction .

• Chronic heart failure.

Undesirable Effects

The incidence of adverse reactions is contingent on the treatment's duration and the dosage of the drug. Prednisolone usage can lead to the following common adverse reactions:

• Mental disturbances .

• Elevated blood sugar levels.

• Menstrual irregularities .

• Weight gain and obesity .

• Reduced resistance to infections .

• Excessive hair growth in women (hirsutism) .

• Seizures .

• Dizziness (vertigo) .

• Weakening of bones (osteoporosis) .

• Impaired growth rate .

• Depressive symptoms .

• Insomnia .

• Hallucinations .

• Muscle atrophy.

Prednisolone leads to a marginal elevation in potassium excretion without inducing sodium and fluid retention. The peak plasma concentration of Prednisolone is observed 1.5 hours post-administration. The drug is effectively absorbed through the gastrointestinal tract and undergoes hepatic biotransformation, predominantly via oxidation. Prednisolone and its metabolites are excreted through feces or urine. The medication influences protein, carbohydrate, lipid, and electrolyte balance, as well as water equilibrium.