Prednisolone is a drug that belongs to the artificially produced glucocorticoids. In the body, it shows the same effect as the body’s own hydrocortisone produced in the adrenal cortex.
What is prednisolone?
Therapeutically, prednisolone is used particularly to inhibit inflammation as well as to reduce swelling. Prednisolone is an active ingredient from the group of cortisone preparations. Cortisone is a hormone produced naturally in the body. It is produced in the adrenal glands and exerts various effects in the body. Therapeutically, prednisolone is used in particular to inhibit inflammation and to reduce swelling. It prevents the penetration of inflammatory cells into damaged tissue and the release of immunomodulatory substances. Prednisolone has anti-inflammatory, immunosuppressive, and antiallergic effects and influences lipid metabolism and carbohydrate metabolism.
Pharmacological action
In addition to its influence on carbohydrate and lipid metabolism, prednisolone also affects the hematopoietic and lymphatic systems. In addition, it exhibits effects on mineral corticoid and calcium balance. Likewise, there are influences on inflammation, inflammation-related secretions (exudation), and the growth of certain tissues. With regard to carbohydrate metabolism, the compound promotes gluconeogenesis, the buildup of glucose from protein and intermediates. In fat metabolism, prednisolone leads to redistribution of fat storage with increased fat breakdown. The amount of fat is reduced in the extremities, but accumulated in the liver and trunk. In the lymphatic tissues the number of white blood cells increases due to the intake of the active substance. However, the quantity of the subsets of eosinophilic granulocytes and lymphocytes decreases. The resulting impaired defense system results in greater susceptibility to infections. In the hematopoietic system, the administration of prednisolone leads to increased formation of red blood cells and platelets. At the same time, the amount of clotting-promoting substances is reduced, so that there is an increased risk of blood clots in the vessels. The inhibition of inflammation, exudation and cell proliferation initiated by this active ingredient results in an anti-inflammatory effect, which is accompanied by delayed wound healing and increased ulcer formation (ulcer = deep-seated defects of the skin or mucous membrane). In addition, prednisolone lowers blood calcium levels by inhibiting calcium absorption, which normally occurs in the intestine, while increasing excretion via the kidneys. In addition, a mineral corticoid component of action is observed, the consequence of which is a decrease in sodium excretion with a concomitant increase in potassium excretion.
Medicinal use and application
Prednisolone is used both in the form of substitution therapy as a physiologically dosed hormone replacement therapy and in the form of nonphysiologically high-dose pharmacotherapy. The latter is used in rheumatological diseases such as rheumatoid arthritis or vasculitis, in lung diseases such as bronchial asthma, acute exacerbation of COPD or hay fever. Other areas of use include changes in the skin (allergic reactions), cancer therapy for certain forms of leukemia, diseases of the hematopoietic system, or neurological clinical pictures such as multiple sclerosis. Prednisolone can also be used for eye diseases such as optic neuropathy, gastrointestinal disorders, kidney diseases and infections. If this agent is prescribed, regular medical checks must be carried out. Particular attention should be paid to potassium intake (increased) and sodium restriction (restrained). Accompanying osteoporosis prophylaxis, consisting of calcium and vitamin D administration and plenty of exercise, is also one of the medical tasks when prescribing prednisolone. As a rule, the dose must be increased in acute stress situations such as operations, accidents or births, since the need increases due to stress. If persons in the patient’s environment contract chickenpox or measles, prophylactic treatment should be given, since there is an increased risk of infection due to the immunodeficiency caused by the drug.
Risks and side effects
The use of prednisolone can lead to the development of Cushing’s syndrome with the typical full moon face and truncal obesity due to its effect on hormonal balance.Under certain circumstances, disturbances of the potassium and sodium balance, an increase in blood lipids, weight gain, a disturbance of the sex hormone balance as well as the development of diabetes mellitus may occur. So-called stretch marks may form on the skin. Atrophy (parchment skin), petechiae (under bleeding of the skin), telangiectasia, pigmentation disorders and steroid acne are also among the side effects of prednisolone. With regard to the muscles and skeleton, muscle weakness, muscle wasting and osteoporosis are among the side effects of treatment with this agent. Furthermore, depression, sleep disorders or psychoses are possible under the influence of prednisolone. In the gastrointestinal tract, ulcers, bleeding and pancreatitis can develop. In the eyes, for example, cataracts or glaucoma occur as prednisolone side effects.
