What Are the Side Effects of Prednisone?

Prednisone has certain anti-inflammatory and anti-allergic effects. Daily administration should be carried out under the guidance of a doctor. If prednisone is taken in large quantities, it may cause an increase in blood sugar levels, and some patients may even develop peptic ulcer. If there are adverse reactions during the administration of prednisone, it is necessary to stop the medication and consult a doctor to determine whether to change the medication. Prednisone has anti-inflammatory and anti-allergic effects, can inhibit the proliferation of connective tissue, reduce the permeability of capillary walls and cell membranes, reduce inflammatory exudation, and can inhibit the formation and release of histamine and other toxic substances. This drug can also promote the breakdown of protein into sugar, reduce the utilization of glucose, thereby increasing blood sugar and liver glycogen, which may lead to diabetes mellitus, as well as increasing gastric juice secretion and appetite. When severe toxic infections occur, the combination of prednisone with a large amount of antibacterial drugs can have good effects in reducing temperature, detoxifying, anti-inflammatory, anti-shock, and promoting the relief of symptoms. Compared with corticosterone, its water and sodium retention and potassium excretion effects are smaller, its anti-inflammatory and anti-allergic effects are stronger, and its side effects are fewer, so it is commonly used. Indications: 1. Diseases such as systemic lupus erythematosus, rheumatoid arthritis, rheumatic fever, nephrotic syndrome, chronic active hepatitis, ulcerative colitis, autoimmune hemolytic anemia, and idiopathic thrombocytopenic purpura. 2. Shock: prednisone can be used as adjunctive treatment for cardiogenic shock caused by acute myocardial infarction or heart block. 3. Allergic diseases: prednisone can be orally administered for drug-induced dermatitis and allergic diseases. 4. Infectious diseases: glucocorticoid therapy such as prednisone can be given after antituberculous treatment to prevent the occurrence of fibrous proliferation and adhesion sequelae in tuberculosis with predominant exudation. 5. Rejection reactions after organ transplantation: prednisone and other immunosuppressive agents are commonly used to prevent or delay rejection reactions. 6. Leukemia, hematopoietic tissue tumors, and solid tumors. 7. Ophthalmic diseases: prednisone can be used to treat non-specific eye inflammation and allergic eye diseases such as conjunctivitis, keratitis, retinitis, and optic neuritis. 8. Skin diseases: such as severe drug-induced dermatitis, keloid, and hyperplastic scar, local skin lesions, etc. 9. Prednisone has weak mineralocorticoid activity, so it is not suitable for replacement therapy in primary adrenocortical insufficiency. Adverse reactions: glucocorticoid therapy at physiological doses generally does not cause significant adverse reactions. Adverse reactions mostly occur when pharmacological doses are used, and are closely related to the duration of treatment, dosage, type of medication, method of administration, and route of administration. Common adverse reactions include the following categories. (1) Rapid intravenous administration of large doses may cause systemic allergic reactions, including swelling of the face, nasal mucosa, and eyelids, urticaria, shortness of breath, chest tightness, and wheezing. (2) Long-term use can cause the following side effects: iatrogenic Cushing's syndrome facial features and posture, weight gain, lower extremity edema, purple striae, easy bleeding tendency, poor wound healing, acne, menstrual disorders, ischemic necrosis of the humerus or femoral head, osteoporosis or fractures (including vertebral compression fractures, long bone pathological fractures), muscle weakness, muscle atrophy, hypokalemia syndrome, gastrointestinal irritation (nausea, vomiting), pancreatitis, peptic ulcer or intestinal perforation, growth retardation in children, glaucoma, cataracts, benign intracranial hypertension syndrome, decreased glucose tolerance, and exacerbation of diabetes mellitus. (3) Patients may experience mental symptoms such as euphoria, excitement, anxiety, delirium, and disorientation, which can also manifest as inhibition. Mental symptoms are particularly prone to occur in patients with chronic consumptive diseases and those with a history of mental illness. These symptoms may appear within a few days to two weeks after starting a daily dose of prednisone reaching 40mg or more. (4) Concomitant infection is the main adverse reaction of glucocorticoid therapy. This is primarily caused by fungal, tuberculous, staphylococcal, proteus, pseudomonas, and various herpes virus infections. It mostly occurs during medium-term or long-term therapy, but can also occur after short-term use of large doses. (5) Inhibition of the hypothalamic-pituitary-adrenal axis is an important complication of hormone therapy, and its occurrence is related to factors such as the preparation, dosage, and duration of treatment. Consideration of adrenal insufficiency should be given when prednisone is used at a daily dose of 20mg or more for more than 3 weeks, as well as when iatrogenic Cushing's syndrome is present.