Oral corticosteroid potency chart

Oral corticosteroids may be life-saving for symptoms of acute asthma, and short courses are often useful to relieve even less serious acute exacerbations when the patient has become inadequately responsive to bronchodilators. Adverse effects are rarely if ever associated with short courses of steroids used for this purpose. Long-term use of oral corticosteroids, however, are associated with a variety of well-established toxic effects. The safe and effective use of oral corticosteroids in substantial doses given every other morning for various steroid-responsive diseases has been described in numerous studies since 1963. Among children with chronic asthma, suppression of the hypothalamic-pituitary-adrenal axis by alternate day prednisone in mean doses of 30 mg was found not to exceed that which occurred with inhaled beclomethasone dipropionate at doses averaging 550 micrograms/day. Growth was also similar in the 2 groups of patients. A few patients receiving alternate-day prednisone gained excessive weight, but this was not a clinical problem for most. Alternate-day prednisone is easier to administer, is associated with better compliance, and costs less than the inhaled steroid. Inhaled beclomethasone dipropionate is more bother, causes cough and throat irritation in some patients, and cannot be administered to very young children. Alternate-day prednisone, given as a single dose every other morning, and the new generation of inhaled steroids such as inhaled beclomethasone dipropionate are alternative means of providing safe and effective treatment with long-term corticosteroid therapy.

Most clinicians in private practice are regularly faced with challenging dermatologic cases, and a common question arises: How much prednisone is too much? No one can definitively answer this question, as different dogs respond in different ways. Some patients are unaffected by long-term prednisone administration, while others immediately demonstrate polyphagia, polydipsia and polyuria, or incontinence. Still others show signs of iatrogenic Cushing's disease—muscle wasting, a pot-bellied appearance, and muscle weakness—early on in therapy. The best approach is to try the safest treatment first, monitor the patient's response carefully, and adjust the therapeutic protocol if side effects become problematic or the condition does not respond.

The most commonly reported side effects were: oral thrush , nausea , headache , and pain in the pharynx or larynx . More rarely reported side effects (occurring in <1% of patients during the clinical trial) include: tachycardia , palpitations , dry mouth , allergic reaction ( bronchospasm , dermatitis , hives ), pharyngitis , muscle spasms , tremor , dizziness , insomnia , nervousness , and hypertension . Patients experiencing an allergic reaction or increase in difficulty breathing while using this medication should immediately discontinue its use and contact their physician. [4]

The first isolation and structure identifications of prednisone and prednisolone were done in 1950 by Arthur Nobile . [23] [24] [25] The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation , by Arthur Nobile and coworkers. [26] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone . [27]

Oral corticosteroid potency chart

oral corticosteroid potency chart

The first isolation and structure identifications of prednisone and prednisolone were done in 1950 by Arthur Nobile . [23] [24] [25] The first commercially feasible synthesis of prednisone was carried out in 1955 in the laboratories of Schering Corporation, which later became Schering-Plough Corporation , by Arthur Nobile and coworkers. [26] They discovered that cortisone could be microbiologically oxidized to prednisone by the bacterium Corynebacterium simplex. The same process was used to prepare prednisolone from hydrocortisone . [27]

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