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110 - Prednisone

Published online by Cambridge University Press:  06 October 2020

Stephen D. Silberstein
Affiliation:
Thomas Jefferson University, Philadelphia
Michael J. Marmura
Affiliation:
Thomas Jefferson University, Philadelphia
Hsiangkuo Yuan
Affiliation:
Thomas Jefferson University, Philadelphia
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

THERAPEUTICS

Brands

• Sterapred, Cordrol, Orasone, Prednicot, Panasol, Meticorten, Deltasone, Sterane, Flo-Pred

Generic?

• Yes

Class

• Corticosteroid

Commonly Prescribed for

(FDA approved in bold)

Acute exacerbation of multiple sclerosis (MS)

Optic neuritis

Inflammatory myopathies: dermatomyositis (DM) and polymyositis (PM)

Temporal arteritis (TA)

Cerebral edema associated with brain tumor or head injury

Asthma

Chronic obstructive pulmonary disease

Rheumatological disorders: gouty arthritis, rheumatoid arthritis, bursitis (many others)

Systemic lupus erythematosus

Neoplastic disorders: lymphoma and acute leukemia

Hematological disorders: hemolytic anemia, idiopathic thrombocytopenia purpura (many others)

Allergic conditions, such as atopic dermatitis, drug hypersensitivity reactions

Acute episodes in Crohn's disease and ulcerative colitis

Nephrotic syndrome

Tuberculous meningitis

• Chronic inflammatory demyelinating polyneuropathy (CIDP)

• Myasthenia gravis (MG)

• Duchenne's muscular dystrophy (DMD)

• Migraine headache

• Cluster headache

• Idiopathic intracranial hypertension

• Acute demyelinating encephalomyelitis (ADEM)

• Graves’ ophthalmopathy

• Ophthalmoplegic migraine

How the Drug Works

• Glucocorticoids have anti-inflammatory effects, modify immune responses to stimuli, and have numerous metabolic effects. Prednisone is a synthetic steroid with glucocorticoid and mineralcorticoid activity

How Long Until It Works

• MS, migraine, cluster: days

• MG, DM, PM, CIDP: weeks to months

• TA: days

If It Works

• MS: use for acute exacerbation that causes significant disability. In relapsing-remitting form, long-term disease-modifying treatments improve prognosis

• Migraine: usually used for intractable headache or status migrainosus for short periods of time. After resolution, revert to safer preventive and abortive therapy

• Cluster: start preventive therapy and prednisone at the beginning of a cycle

• MG: weakness and fatigability improve. Decrease dose cautiously if clinical remission occurs

• DM/PM: improves strength and mobility. Start a corticosteroid-sparing agent if needed and taper dose cautiously with clinical remission

• CIDP: improves strength and sensory symptoms and prevents disability. Decrease dose cautiously if clinical remission occurs

• TA: monitor clinical response and sedimentation rate

Type
Chapter
Information
Essential Neuropharmacology
The Prescriber's Guide
, pp. 404 - 409
Publisher: Cambridge University Press
Print publication year: 2015

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  • Prednisone
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.111
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  • Prednisone
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.111
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Prednisone
  • Stephen D. Silberstein, Thomas Jefferson University, Philadelphia, Michael J. Marmura, Thomas Jefferson University, Philadelphia, Hsiangkuo Yuan, Thomas Jefferson University, Philadelphia
  • Edited in consultation with Stephen M. Stahl, University of California, San Diego
  • Book: Essential Neuropharmacology
  • Online publication: 06 October 2020
  • Chapter DOI: https://doi.org/10.1017/9781316161753.111
Available formats
×