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Endocrine Drugs


    IV / Oral
    Prednisolone / Prednisone
    Panafcort, Predsone, Sone 
    IV / Topical


  • Glucocorticoids such as hydrocortisone and prednisolone are used to replace deficient endogenous steroid in the context of adrenocortical insufficiency.
    • Mechanism of Action

      Suppress the body's normal inflammatory response through:
    • Reduced monocyte recruitment
    • Suppression of arachidonic acid metabolites - prostaglandin, leukotriene, platelet-activating factor
    • Reduced production of interleukins, TNF-α, GM-CSF
    • Non-Inflammatory Effects of Corticosteroids

    • Increased circulating glucose - ↑gluconeogenesis, ↓glucose usage
    • Redistribution of fats - in face, neck, shoulder
    • ↓ Absorption of Ca²⁺
    • Muscle homeostasis

Clinical Use

    • Indications

    • Replacement therapy for adrenocortical insufficiency
    • Acute asthma
    • Exacerbations of COPD
    • Croup
    • Other inflammatory conditions - dermatitides, ulcerative colitis, autoimmune haemolytic anaemia, acute gout, rheumatoid arthritis, seronegative arthritides, systemic lupus erythematosus, polyarteritis nodosa
    • Cerebral oedema
    • Nephrotic syndrome
    • Immunosuppression post organ transplant
    • Adverse Effects

    • Immunosuppression (risk of infection)
    • Osteoporosis
    • Steroid-induced diabetes mellitus
    • Cushing’s - central obesity, ‘moon’ face, buffalo hump, thin skin, peripheral oedema, striae, bruising
    • CNS - cognitive impairment / emotional instability / fatigue
    • Renal - sodium & water retention / hypertension / oedema
    • GIT - peptic ulceration, nausea / vomiting
    • Muscle wasting
    • Ocular - cataract / glaucoma
    • Signs of Withdrawal

    • Worsening of underlying disease
    • Acute adrenal insufficiency
    • Raised ICP / papilloedema
    • Avoiding Withdrawal

    • Taper the dose by 2.5-5mg prednisone every 3-7 days prior to ceasing.
  • Give in the morning between 6-10am in order to mimic the normal diurnal cycle
Last updated on January 1st, 2017


The information in this section has been adapted in part from the Australian Therapeutic Goods Association website's repository of product information documents, which are available at https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/PICMI.
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