prednisonaprednisolona

Prednisone and prednisolone are synthetic glucocorticoids used to treat inflammatory and autoimmune diseases. The term prednisonaprednisolona is sometimes encountered in multilingual texts to refer to either drug or, less commonly, to a combined formulation. Prednisone is a prodrug that is converted in the liver to prednisolone, the active metabolite. Prednisolone is active without metabolism and is preferred in some patients with liver impairment.

Mechanism of action: they bind the glucocorticoid receptor, modulating gene transcription to suppress inflammatory mediators (cytokines, chemokines, prostaglandins) and reduce immune cell activity. This yields anti-inflammatory and immunosuppressive effects.

Clinical uses: a wide range of inflammatory and autoimmune disorders, including rheumatoid arthritis, lupus, inflammatory bowel disease, asthma and COPD exacerbations, dermatologic conditions, allergic reactions, and suppression of transplant rejection. They can be given orally, by injection, topically, inhaled, or as eye drops, depending on condition and formulation.

Dosing and duration vary; therapy is typically the lowest effective dose for the shortest feasible period to minimize adverse effects.

Adverse effects and safety: short courses are usually well tolerated; long-term use may cause hyperglycemia, hypertension, weight gain, osteoporosis, peptic ulcers, infections, mood changes, cataracts, adrenal suppression, and growth retardation in children. Risk increases with dose and duration. Caution is needed in diabetes, existing infections, peptic ulcers, glaucoma, and osteoporosis. Use in pregnancy requires careful assessment.

Interactions: nonsteroidal anti-inflammatory drugs increase GI risk; vaccines may have reduced efficacy; enzymes like CYP3A4 modulators alter prednisone/prednisolone levels.

See also: corticosteroids, glucocorticoids.