Prednisolone

Chemical name

(11бета)-11,17,21-Тригидрок сипрегна-1,4-диен-3,20-ди��н

Gross

C21-H28-O5

Characteristics

White or weak yellowish white crystalline powder. Virtually nerastvorim in water, soluble in alcohol.

Of drugs

Drugs, the anti-inflammatory, protiwallergicescoe, immunodepressivne. Increases products lipokortinov inhibiting fosfolipazu A_2 and reduces synthesis of metabolism arahidonova acid-cyclical endoperekisey, NG, tromboksana. The plasma 90% is sequestered (with transkortinom and albuminom), a decrease in protein synthesis or loss of a toxic effect on normal therapeutic doses. Биотрансформируется oxidation mainly in the liver and kidney, small intestine, bronchitis. Oxidized forms glukuroniziruyutza or sulfatiruyutza. T_1/2 2-4 h for bioeffekta - 18-36 hours 4-3 lizosom membranes, synthesis ingibiruet gialuronidasy reduces products limfokinov and inhibits migration макрофагов.Противоал��ергический effects due to a drop in the number of bazofilov, direct application secreta and synthesis mediators immediate allergies. It limfopeniu and involution limfoidna tissue than from immunosuppression. And protivosokovmi properties, the more rest and restores the sensitivity of receptors to kateholaminam. Decreases of protein in the plasma increases catabolised protein in the muscle, it increases synthesis in the liver. Is higher education fatty acids and triglycerides, fat redistribution. Increases resorption of carbohydrate digestion, activity and glukozo-6-fosfataza fosfoenolpiruwatkinaza, leading to the mobilization of glucose into the bloodstream and on the Strengthening of glukoneogeneza. Delays sodium and water and contributes to the development of potassium through минералокортикоидног о actions. Reduces intake of calcium in the gut, enhances its leaching from the bones and kidneys excretion.

Indications

System of connective tissue, systemic васкулиты, bronchial asthma, asthma status, allergies, illness Аддисона, адреногенитальный syndrome, аутоиммунный hepatitis, гломерулонефрит, immune haemolytic anaemia, thrombocytopenia, гематобластоз, гематосаркома, vesicular disease, eczema, skin, эксфолиативный dermatitis, psoriasis, почесуха, себорейный dermatitis, эритродермия, allergic conjunctivitis and блефарит inflammation of cornea, and склерит эписклерит, sympathetic офтальмия, chronic arthritis, эпикондилит, tendowaginit, bursitis, plechelopaterny periartrit, kelloida, ishialgia, Dupuitrena contracture.

Contraindications

Ulcers disease in the phase of deterioration, decompensirovanny diabetes, severe arterial hypertension, osteoporosis, a disease Itsenko - Kushinga, the active form of tuberculosis, glaucoma, mikozy system, the acute viral infection symptoms productive with mental illnesses. Viral and bacterial diseases of the eye, the primary glaucoma, corneal disease with epithelial damage. Bacterial, fungal, viral skin infections, tuberculosis, syphilis, tumors of the skin, pregnancy.

Side-Effects

Erosivno-azwenne defeat mucous membrane cancer, diabetes, osteoporosis, arterial hypertension, psychosis, Itsenko syndrome - Kushinga, tachycardia, weakness, gipokaliemia whose fluid napochechnikovaya deficiency, the reduction of reparations tissues, immuno-suppression, reduced muscle mass, the syndrome, aggravation of the (post).

Patient interaction

Do protivosvertawati anti effect increases the likelihood of bleeding in the face salicilatov violations elektrolitnogo exchange dioretikov backdrop, the risk of cardiac toxicity glycosides. Decreases gipoglikemiceski effect protivodiabeticakih preparations antibacterial - rifampitina.

Precautions

During the days designated on the basis zirkadnyi rhythm endogenous secreta Corticosteroids (6-8 in the morning hours). The treatment requires eye observation, monitoring AD vodno-elektrolitnogo balance, the level of sugar in the plasma, regular analyses of the cells of peripheral blood. To reduce the side effects justified the appointment of anabolic steroids, as well as the increase of potassium. When Addison disease should avoid the simultaneous application of barbiturates. When nonspecific infections and tuberculosis used with caution (in the face of chemotherapy). At the end of the course are encouraged to consider the need to introduce ACTG.

Dosing and Administration

In substitution therapy initial dose of 20 to 30 mg / day (if necessary, 15-100 mg / day), which supports the 15-mg. Reduce dose gradually. For children initial dose of 1-2 mg / kg body weight per day for four receptions supporting-0.3-0.6 mg / kg / sut. In large joints being 25-50 mg, in the joints average, 10-25 mg, in the small-5-10 mg. For infiltration tissue from 5 to 50 mg. Eye suspension buried by 1-2 drops three times a day, no more than 14 days. Ointment applied on the affected areas of skin 1-3 times a day for 2 weeks (maximum).

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