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Corticosteroids
Prednisone, Prednisolone, Decadron (Dexamethasone) and DeflazacortCorticosteroids (cortisone-like medicines) are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are often used for a number of other diseases such as asthma or other auto immune diseases. Because corticosteroids help the body maintain the integrity of the walls of the veins and arteries, they are helpful in stopping or preventing unwanted bleeding. Dosage For ITP, typically the dose is initially quite high, then gradually tapered. Sometimes the platelets remain elevated after the steroid is tapered. In most cases the platelet count recedes as the steroid is reduced. Some patients with ITP are maintained for years on low doses of corticosteroids. Prednisone and Prednisolone The average Prednisone dose for ITP is 1 mg per kilogram of body weight. 1 kilogram is equal to 2.2 pounds; so you would divide your body weight by 2.2 to figure the starting dosage i.e.-120 pounds would be a dose of 60 mg. 200 pounds would be a dose of 100 mg. However, your doctor may want to start you at a higher, or lower dose than what is recommended. Decadron 0.75 mg of Decadron is equal to 5 mg of Prednisone. This is usually given in pulse doses, doses administered for a short period of time, repeated at set intervals. Deflazacort 6 mg of Defazacort is equal to 5 mg of Prednisone. Side Effects Corticosteroids are very strong medicines. In addition to their helpful effects in treating your medical problem, they have side effects that can be very serious. Be sure that you discuss the risks and benefits of this medicine with your doctor. Corticosteroids may lower your resistance to infections. Also, any infection you get may be more difficult to treat. A partial list of the possible problems contains the following: glaucoma, cataracts, gastrointestinal bleeding, peptic ulcers, pancreatitis, aseptic bone necrosis, osteoporosis, myopathies, obesity, edemas, hypertension (high blood pressure), diabetic metabolism (blood sugar changes), sleep disturbances (insomnia), psychiatric syndromes (mood changes), delayed wound healing, atrophy (muscle wasting), potassium loss, and fragility of the skin. (Note: black licorice exacerbates potassium loss) The side effects can be uncomfortable and grow in severity if the treatment is continued for a long period of time. With prolonged use, the drug halts the communication between the pituitary gland and the adrenals. It can impair the response to stress for up to one to two years following the cessation of the drug. "Coping with Corticosterioids" by Dr. Andrew Weil our Spring 2002 newsletter. Related Web Sites Prednisone: http://nationaljewish.org/medfacts/corticosteroids.html http://www.naturalessentials.com/prednisone.htm Suggested Reading: Coping with Prednisone: it may work miracles, but how do you handle the side
effects? - by Eugenia Zukerman and Julie
Ingelfinger, MD, St Martin's Press, 1997.
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