Prednisone

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Prednisone chemical structure
Prednisone
Systematic (IUPAC) name
17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl- 7,8,9,10,12,13,14,15,16,17-decahydro-6H- cyclopenta[a]phenanthrene-3,11-dione
Identifiers
CAS number 53-03-2
ATC code A07EA03 H02AB07
PubChem 5865
DrugBank APRD00340
Chemical data
Formula C21H26O5
Mol. weight 358.428 g/mol
Pharmacokinetic data
Bioavailability 70%
Metabolism prednisolone (liver)
Half life 1 hour
Excretion Renal
Therapeutic considerations
Pregnancy cat.

A

Legal status

Prescription only

Routes Oral, Nasal, Rectal, Injection, IV

Prednisone is a synthetic corticosteroid drug which is usually taken orally but can be delivered IM (intramuscular i.e an injection) and can be used for a large number of different conditions. It has a mainly glucocorticoid effect. Prednisone is a prodrug that is converted by the liver into prednisolone, which is the active drug and a steroid.

Contents

[edit] Uses

Prednisone is particularly effective as an immunosuppressant and affects virtually all of the immune system. It can therefore be used in autoimmune diseases, inflammatory diseases (such as severe asthma, severe poison ivy, and Crohn's disease), various kidney diseases including nephrotic syndrome, and to prevent and treat rejection in organ transplantation.

Prednisone tablets are furthermore used in the pharmaceutical industry for the calibration of dissolution testing equipment according to the USP (United States Pharmacopeia).

[edit] History

Prednisone was invented in the early 1950s when Arthur Nobile at Schering demonstrated that the side effects of cortisone such as water retention, high blood pressure and muscle weakness could be removed by oxidisation of the drug through exposure to microbes. The drug was introduced by Schering in the mid-1960s.

[edit] Dependency

Adrenal suppression occurs if prednisone is taken for longer than 7 days, a condition which means the body is unable to synthesize natural corticosteroids and becomes dependent on the prednisone taken by the patient. For this reason, prednisone should not be stopped abruptly if taken for longer than seven days, but needs to be reduced slowly; this reduction may be over a few days if the course of prednisolone was short, but may take weeks or months if the patient has been on long-term treatment. Abrupt withdrawal will lead to an Addisonian crisis, which may be life-threatening.

[edit] Side effects

Short-term side effects, as with all glucocorticoids, include high blood glucose levels, especially in patients who already have diabetes mellitus or are on other medications that increase blood glucose (such as tacrolimus), and mineralocorticoid effects such as fluid retention. Additional short-term side effects include insomnia and rarely mania. Long-term side effects include Cushing's syndrome, weight gain, osteoporosis, glaucoma, type II diabetes mellitus, and depression upon withdrawal.

Ocular side effects of glucocorticoids include glaucoma and cataract formation. While most commonly associated with topical or intraocular administration, these ocular complications may also occur with oral, intravenous, or even inhaled administration.

[edit] Major

[edit] Minor

[edit] External links



Corticosteroids - glucocorticoid/receptor and mineralocorticoid/receptor edit
(A07EA, C05AA, D07, D10AA, H02, R01AD, R03BA, S01BA, S02B, and S03B)

Alclometasone, Aldosterone, Amcinonide, Beclometasone, Betamethasone, Budesonide, Ciclesonide, Clobetasol, Clobetasone, Clocortolone, Cloprednol, Cortisone, Cortivazol, Deflazacort, Deoxycorticosterone, Desonide, Desoximetasone, Desoxycortone, Dexamethasone, Diflorasone, Diflucortolone, Difluprednate, Fluclorolone, Fludrocortisone, Fludroxycortide, Flumetasone, Flunisolide, Fluocinolone acetonide, Fluocinonide, Fluocortin, Fluocortolone, Fluorometholone, Fluperolone, Fluprednidene, Fluticasone, Formocortal, Halcinonide, Halometasone, Hydrocortisone/cortisol, Hydrocortisone aceponate, Hydrocortisone buteprate, Hydrocortisone butyrate, Loteprednol, Medrysone, Meprednisone, Methylprednisolone, Methylprednisolone aceponate, Mometasone furoate, Paramethasone, Prednicarbate, Prednisone/Prednisolone, Prednylidene, Rimexolone, Tixocortol, Triamcinolone, Ulobetasol