Prednisolone
Prednisolone, which is a type of medicine known as a corticosteroid. Corticosteroids are hormones produced naturally by the adrenal glands which have many important functions, including control of inflammatory responses. Prednisolone is a synthetic corticosteroid that is used to decrease inflammation in various different diseases and conditions. Corticosteroids are often simply called steroids, but it should be noted that they are very different from another group of steroids, called anabolic steroids, which have gained notoriety because of their abuse by some athletes and body builders. The chemical name for Prednisolone is pregna-1,4-diene-3,20-diane,11,17,21-tridihydroxy. Its molecular weight is 360.45. The molecular formula is C21H28O5. Prednisolone is a white to practically white, odorless, crystalline powder. It is very slightly soluble in water, slightly soluble in alcohol, in chloroform, in dioxane, and in methanol.
Prednisolone works by acting within cells to prevent the release of certain chemicals that are important in the immune system. These chemicals are normally involved in producing immune and allergic responses, resulting in inflammation. By decreasing the release of these chemicals in a particular area, inflammation is reduced. This can help control a wide number of disease states, characterised by excessive inflammation. They include severe allergic reactions, inflammation of the lungs in asthma and inflammation of the joints in arthritis.
In high doses, prednisolone also decreases the numbers of white blood cells circulating in the blood. This, along with the decrease in inflammatory chemicals, can prevent the rejection of organ transplants, as it prevents the body from attacking foreign tissue. It is useful for the treatment of certain types of leukaemia, where there is an abnormally large production of certain white blood cells. It is also used to treat some diseases which are caused by the immune system attacking itself (auto immune diseases).
Prednisolone is used to achieve prompt suppression of inflammation in many inflammatory and allergic conditions. Prednisolone is also used in the treatment of blood cell cancers (leukemias), and lymph gland cancers (lymphomas). Blood diseases involving destruction of platelets by the body's own immune cells (idiopathic thrombocytopenia purpura), and destruction of red blood cells by immune cells (autoimmune hemolytic anemia) can also be treated with prednisolone. Finally, prednisolone is used as a hormone replacement in patients whose adrenal glands are unable to produce sufficient amounts of corticosteroids. It is particularly effective as an immunosuppressant and affects virtually all of the immune system. It can therefore be used in autoimmune diseases, inflammatory diseases (such as asthma and Crohn's disease), and to prevent and treat rejection in organ transplantation.
Prednisolone and other corticosteroids can mask signs of infection and impair the body's natural immune response to infection. Patients on corticosteroids are more susceptible to infections, and can develop more serious infections than healthy individuals. For instance, chicken pox and measles viruses can produce serious and even fatal illnesses in patients on high doses of prednisolone. Live virus vaccines, such as small pox vaccine, should be avoided in patients taking high doses of prednisolone, since even vaccine viruses may cause disease in these patients. Some infectious organisms, such as tuberculosis (TB) and malaria, can remain dormant in a patient for years. Prednisolone and other corticosteroids can reactivate dormant infections in these patients and cause serious illnesses. Patients with dormant TB may require anti-TB medications while undergoing prolonged corticosteroid treatment.
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