Bronchial asthma is a chronic respiratory disease. For the treatment of the inflammatory process, drugs are used to stop an acute attack, to control the patient’s condition during remission.
Medicines are selected individually. Effective dosages are increased in the acute period and decreased after the attack has stopped.
Since 1972, the therapy of bronchial asthma has been carried out with the use of corticosteroids in injectable, inhalation, tablet form.
Prednisolone is the drug of choice for asthma. It is included in the protocols for the treatment of bronchial asthma and is used to relieve an acute attack, reduce bronchial obstruction, and for maintenance treatment.
Briefly about Prednisolone
Prednisolone, used in the treatment of asthma, belongs to the pharmaceutical group “general action corticosteroids”. Code – АТХ Н02А В06.
Glucocorticoid has the following effects:
- immunosuppressive .
In the treatment of bronchial asthma, Prednisolone allows you to stop an acute attack of the disease, reduce the severity of the pathological process, normalize the activity of the respiratory system, and reduce the risk of side effects when taking other drugs.
Forms of drug release
The drug is available in 2 dosage forms – tablets and solution for injection. It belongs to prescription drugs.
Prednisolone tablets contain 5 mg of the active substance. They are white, with a chamfer on one side. Packed in blisters and plastic boxes. Available in 10, 20, 30, 50 and 60 pcs. packaged.
The injection form is a clear solution packed in a glass ampoule. The color of the drug can vary from pale yellow to greenish, which does not affect its properties.
The dosage of the active substance is 30 mg / 1 ml. Ampoules are packed in plastic pallets of 3, 5 or 10 pcs. packaged. The injectable form is used for intramuscular and intravenous administration.
The dosage and type of dosage form of Prednisolone in the treatment of asthma is chosen by the doctor depending on the severity of the disease, the patient’s age, and his response to therapeutic measures.
Action of Prednisolone in bronchial asthma
Prednisolone has anti-inflammatory, anti-allergic effect, suppresses the immune response to various stimuli.
Anti-inflammatory activity consists in reducing the production of inflammatory mediators by eosinophils and mast cells, increasing the resistance of cell membranes to external influences, inhibition of prostaglandin production.
Antiallergic effect is manifested in a decrease in the synthesis of mediators of an allergic reaction, a change in the body’s immune response.
With obstruction of the respiratory system, with an asthma attack, Prednisolone has an anti-inflammatory effect. While taking the drug occurs:
- reduction of mucosal edema, infiltration of the membranes of the bronchial tree and the production of eosinophils;
- liquefaction of viscous sputum;
- minimizing the risk of ulceration, exfoliation of mucous membrane cells, and scar tissue formation;
- change in the production of adrenocorticotropic hormone.
Against the background of the use of Prednisolone, asthma attacks are stopped, the bronchi are freed from the resulting phlegm. Treatment begins with the administration of injectable forms of the drug to asthmatics.
After stopping an acute attack, continue to use Prednisolone tablets for bronchial asthma.
The effective dosage in the treatment of bronchial asthma with Prednisolone and the method of administration of the drug are prescribed by the doctor individually.
The pulmonologist takes into account the patient’s age and the severity of the pathological process. Scheme of administration and dosage of injectable forms:
- Bronchial asthma: as part of complex therapy – from 65 to 675 mg of the drug. Duration of use – 3-16 days. With mild severity of the pathological process, the course of treatment should not exceed 10 days. With a severe degree of the disease, it is possible to increase the dosage to 1400 mg for the entire period of treatment.
- Acute asthmatic status: the initial dosage is 500–1200 mg / day in the initial period, then it is reduced to 300 mg / day, followed by a switch to tablet forms.
- Children from 6 to 12 years old – the maximum dosage is 25 mg / day, over 12 years old – 50 mg / day.
In injectable form, Prednisolone is administered intravenously. If this method is impossible, it is allowed to use intramuscular administration. But in this case, the rate of absorption and distribution of the drug decreases.
When using tablets, the daily dose is taken once between 6 and 8 a.m. Large doses of the drug are distributed over 2-4 doses, but most of it should be in the morning.
For the relief of an acute condition, adult patients are prescribed 20-30 mg of Prednisolone. Then they switch to maintenance therapy at 5-10 mg of the drug. According to indications, the initial dosage can be increased to 100 mg / day, and the maintenance dosage – up to 15 mg / day.
The effective dosage of Prednisolone for asthma for children over 3 years old is calculated based on body weight. The initial dosage is 2 mg / 1 kg per day and is divided into 4 doses. After stopping the attack – 0.3-0.6 mg / 1 kg of body weight.
After the patient’s condition is normalized, effective dosages are reduced by 5 mg per day with an interval of 3 days. Then – 2.5 mg per day in the same time frame. It is strictly forbidden to abruptly stop treatment with the drug!
There are many contraindications for using the drug. It is forbidden to prescribe Prednisolone for asthma in the following cases:
- individual intolerance to the components of the product;
- parasitic invasion;
- viral infections – exacerbation of herpes, chickenpox, shingles, measles;
- active tuberculosis;
- systemic mycoses;
- vaccination while taking Prednisolone is prohibited. It is not used for 8 weeks before vaccination and 2 weeks after;
- immunodeficiencies of various etiologies, including HIV;
- ulcer, other inflammatory processes in the gastrointestinal tract;
- a heart attack in the recent past;
- heart failure;
- the presence of blood clots;
- endocrine diseases in the stage of decompensation;
- severe forms of renal failure;
- osteoporosis, myopathy;
- progressive mental illness;
- glaucoma, cataracts.
The injectable form of Prednisolone is prohibited in pediatric practice for children aged 0 to 6 years, tableted – up to 3 years. Lactation is a relative contraindication, but breastfeeding should be discontinued during treatment.
The development of side effects depends on the age of the patient, the dose of the drug, and the duration of treatment. With short courses, the occurrence of a negative reaction is unlikely.
Table 1. Side effects of Prednisolone
|Body system||Typical manifestations|
|Circulatory||Leukocytosis, increased coagulation activity , thrombosis and the appearance of emboli|
|Organs of vision||Increased intraocular pressure, glaucoma, swelling of the optic nerve, dystrophy and thinning of the cornea|
|Endocrine||Diabetes, decreased glucose tolerance.|
|Increased blood glucose levels.|
|The need to increase the dose of insulin.|
|Imbalance in the work of the endocrine glands.|
|Atrophy of the adrenal cortex. Amenorrhea, hormonal disorders, Itsenko-Cushing’s disease. Symptoms of hyperandrogenism|
|Exchange processes||Electrolyte imbalance, sodium and fluid retention in the body with the development of peripheral edema|
|Psyche||Aggression, delirium, euphoria, senile dementia, insomnia, anxiety, development of manias and psychosis|
|Nervous||Neuropathies, headaches, increased ICP, seizures.|
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With prolonged treatment or the use of the drug in a stressful situation, against the background of surgical intervention, a lethal outcome is possible. During the appearance of side effects of the drug, you should inform the doctor about this and correct the treatment.
With a sharp withdrawal of glucocorticoid, the development of withdrawal symptoms is possible. Patients complain of headaches, nausea, vertigo , mood swings, bouts of aggression, myalgia, the development of inflammatory processes in the musculoskeletal structures, and excruciating itching of the skin.
Interaction with other drugs and monitoring of treatment
When prescribing Prednisolone for bronchial asthma, it is necessary to clarify the patient’s information about the drugs taken constantly.
Important! It is forbidden to mix glucocorticoid with any other drugs in a syringe or dropper.
Concomitant use of neuroleptics and Prednisolone increases the risk of developing cataracts. In addition, glucocorticoid reduces the effect of vitamin D on the absorption of calcium ions in the intestine. Against the background of treatment, vaccinations should not be given, since when using live vaccines, the risk of activation of viruses and pathogenic flora increases.
Important! The use of alcoholic beverages while taking Prednisolone is strictly prohibited! If the patient has a history of seizures, then treatment with a hormonal agent is carried out in a hospital setting and with the lowest possible doses.
During Prednisolone therapy, blood pressure, blood sugar and urine should be monitored, fecal occult blood tests, coagulogram, X-ray examination of the spine should be carried out. It is recommended to have your vision checked by an ophthalmologist once every 3 months.
Prednisolone affects the absorption and redistribution of calcium in tissues. During treatment, osteoporosis prevention is indicated for postmenopausal patients, patients with this disease in a family history, and smokers. In this case, calcium and vitamin D preparations are prescribed.
Important! Before prescribing a glucocorticoid, the doctor must rule out any viral or bacterial infections, mycoses. Taking Prednisolone masks their symptoms, which is fraught with the development of complications.
Important! The simultaneous use of sympathomimetics in the form of an aerosol and a glucocorticoid in the treatment of bronchial asthma in children is prohibited due to the risk of paralysis of the respiratory system.
According to the treatment protocols for bronchial asthma, Prednisolone is part of the complex therapy for exacerbation of the disease of mild severity, moderate severity and severe course. But this is not the only possible drug treatment option.
Currently, inhaled glucocorticoids have been developed. The active components act directly in the lesion focus, practically not being absorbed and without exerting a general systemic effect. Some of them are approved for use in early childhood and have a minimum of contraindications.
Use Prednisolone and other glucocorticoids as directed by your doctor. Self-medication for bronchial asthma is unacceptable!