PREDNISOLONE

Question 1

Drug class

Answer 1

corticosteroids

Question 2

How does it work? (2)

Answer 2

1. gene expression

• bind to cytosolic glucocorticoid receptors
• these are involved in regulation of gene expression

2. Immune response

• modify the immune response
• up regulating the anti-inflammatory genes
• down regulate pro-inflammatory genes

Question 3

What are examples of pro-inflammatory genes? (2)

Answer 3

• cytokines

- tumour necrosis factor alpha

Question 4

What does prednisolone also suppress? (2)

Answer 4

• circulating monocytes

- eosinophils

Question 5

What is the metabolic effect of prednisolone?

Answer 5

1. increased gluconeogenesis

Question 6

What is the mineralocorticoid effects of prednisolone? (3)

Answer 6

• stimulate Na+
• stimulate water retention
• K+ excretion in the renal tubule

Question 7

Indications (5)

Answer 7

1. allergic disorders
2. anti-inflammatory disorders
3. cancers
4. adrenal insufficiencies
5. hypopituitarism

Question 8

Contraindications (2)

Answer 8

1. infection

2. children

Question 9

Side effects (6)

Answer 9

1. immunosuppression
2. metabolic effects

• diabetes
• osteoporosis
• proximal muscle weakness
• skin thinning
• brusing
• gastritis

3. mood and behavioural changes

• insominia
• confusion
• psychosis
• suicidal thoughts

4. Mineralocorticoid action

• hypertension
• oedema
• hypokalemia

5. Adrenal atrophy
   - Addisonian crisis
6. Withdrawal symptoms

Question 10

Elimination

Answer 10

urine

Question 11

Interactions and examples (3)

Answer 11

• cytochrome p450 inducers

e. g. pheytoin, carbamazepine, rifampicin