Most commonly referred to in non-medical circles as a steroid or glucocorticoid, many people think it is a very dangerous drug and are very reluctant to accept treatment with this drug.
But in certain diseases, prednisolone is considered a mandatory and necessary drug of first choice in the treatment of the disease (e.g., nephrotic syndrome).
This is not about the drug itself and for which diseases it should be prescribed, but our information block about what doctors usually forget when prescribing prednisolone. Children usually come for consultation after taking prednisolone in combination with asparticam. Believe me, hypokalemia (low potassium in the blood) for which asparkam is prescribed is not the most common complication of prednisolone administration.
In our practice, almost 90% of patients treated with prednisolone are diagnosed with nephrotic syndrome.
Prednisolone is prescribed for a long period of time (the complete course of therapy before withdrawal may last 6-12 months) and additional medications must be prescribed to prevent side effects of prednisolone. These:
- To protect the mucosa of the upper gastrointestinal tract (esophagus, stomach, duodenum), prednisolone can cause indigestion, nausea, vomiting, and more serious complications like steroid ulcers. However, this can all be avoided by taking – gastroprotective drugs (t.е. Protecting the stomach literally). These include antacids (e.g., vitamin D), antacid medications (e.g., vitamin D) and vitamin B. Maalox, fosfalugel, etc.), H+ pump blockers (e.g., inhibitors of the H+ pump (e.g., inhibitors of the H+ pump). Omeprazole), drugs that improve gastrointestinal motility. All drug doses are adjusted individually based on age and body weight.
- protecting the bones. Prolonged use of steroids can cause a decrease in bone mass and so called steroid-induced osteoporosis (thinning of the bone tissue) may develop, which ultimately leads to bone fractures. But this condition can also be prevented by taking calcium and vitamin D preparations. The dose of the drugs is also chosen on an individual basis.
What else is necessary to pay attention to:
- Always monitor the blood pressure
- Ophthalmologist observation: vision control, intraocular pressure and lens condition.
- Check blood glucose levels if you take prednisolone for a very long time.
- Mental health condition. Children very often become moody, sometimes even aggressive. This condition resolves on its own after discontinuation of the drug.
- Keep an eye on your weight and your diet. Appetite increases greatly while taking prednisolone. However, you as a parent can check your child’s food, and you should limit the intake of digestible carbohydrates.
- In order to monitor and evaluate the effectiveness of gastroprotective therapy, the mucosa of the upper gastrointestinal tract is evaluated by — EGDS (gastroscopy).
This information was prepared by a member of staff (pediatrician) for information purposes. Be sure to consult with your doctor.
If you have questions on this topic or you have suggestions, we are happy to answer questions and accept your suggestions.