What are the New Contraindications of Prednisone?

I believe everyone has used a drug called prednisone when allergic, prednisone anti-inflammatory and anti-allergic effect is strong, then do you know what are the contraindications of taking prednisone? The following is the related content of the contraindications of taking prednisone for you, I hope it will be useful to you!

1.Medication during pregnancy

Glucocorticoids can cross the placenta. Animal studies have shown that prenatal administration can increase the incidence of fetal cleft, placental insufficiency, spontaneous abortion, and intrauterine growth retardation. Pharmacological doses of glucocorticoids in humans may increase the incidence of placental insufficiency, neonatal weight loss, or stillbirth. Teratogenic effects have not been demonstrated in humans. Infants who have received a certain dose of glucocorticoids during pregnancy should be observed for signs of adrenal cortical dysfunction. In premature infants, in order to avoid respiratory distress syndrome, dexamethasone is given to the mother before delivery to induce the formation of lung surface activated protein in premature infants, which has no adverse effects on the growth and development of infants due to short-term application.

2.Breastfeeding

Physiological or low pharmacological doses (25mg cortisone or 5mg prednisone per day, or less) generally have no adverse effects on infants. However, if the lactating mother receives large doses of glucocorticoids, she, should not breastfeed, because glucocorticoids can be excreted from the milk, causing adverse effects on the baby, such as growth inhibition and adrenal cortical function inhibition.

3.Pediatric medication

Children such as long-term use of adrenal corticosteroids, need to be very careful, because hormones can inhibit the growth and development of children, if it is necessary for long-term use, should use short-acting (such as cortisone) or medium-acting preparations (such as prednisone), avoid the use of long-acting preparations (such as dexamethasone). The inhibitory effect on growth can be alleviated by oral intermediate-acting preparation on alternate days. Long-term use of glucocorticoids in children or adolescents must be closely observed, and the risk of osteoporosis, avascular necrosis of the femoral head, glaucoma and cataract in children is increased. The dosage of hormones used in children should be based on the severity of the disease and the child’s response to treatment, in addition to the general age or weight determination. For the treatment of children with adrenal cortical dysfunction, the dosage of hormones should be based on body surface area, if it is determined by weight, it is prone to excessive, especially in infants and small or obese children.

4.Elderly medication

Elderly patients with glucocorticoids are prone to hypertension. Elderly patients, especially women after the use of glucocorticoids, are prone to osteoporosis.

5.Glucocorticoids and infection

Patients with adrenal hypocorticosis are prone to infection, and how severe it is is an important cause of death. Physiological doses of adrenal corticosteroids can improve patients’ resistance to infection. Non-adrenocortical hypofunction patients are prone to infection after receiving pharmacological doses of glucocorticoids, which is because the patient’s original disease has often weakened the cellular and/or humoral immune function, and a long course of ultra-physiological dose of corticosteroids can weaken the inflammatory response, cellular and humoral immune function of patients, and the pathogenic bacteria invading from the skin, mucous membranes and other parts can not be controlled. Under hormonal action, previously controlled infections can become active, most often with recurrent tuberculosis infection. Patients receiving glucocorticoids are easy to miss diagnosis after infection due to mild inflammatory response and not obvious clinical symptoms. This suggests that non-physiological glucocorticoids are not good for fighting infection. But on the other hand, the application of hormones in some infections can reduce the destruction of tissue, reduce exudation, reduce the symptoms of infection poisoning, but must be treated with effective antibiotics at the same time, closely observe the changes in the condition, after short-term use, that is, should be rapidly reduced, stop the drug.

6.The following situations should be used with caution

Heart disease or acute heart failure, diabetes mellitus, diverticulitis, emotional instability and tendency to psychosis, systemic fungal infection, glaucoma, liver dysfunction, herpes simplex oculi, hyperlipoproteinemia, hypertension, hypothyroidism (when glucocorticoid action is increased), myasthenia gravis, osteoporosis, gastric ulcer, gastritis or esophagitis, renal impairment or lithiasis, tuberculosis, etc.

7.Glucocorticoids should not be used in the following cases

A history of severe mental illness, active gastric and duodenal ulcers, recent gastrointestinal anastomosis surgery, severe osteoporosis, significant diabetes, severe hypertension, and viral, bacterial, or fungal infections that cannot be controlled with antibiotics. Hyperadrenocorticosis, hypertension, atherosclerosis, heart failure, diabetes, psychosis, epilepsy, scale, stomach, duodenal and corneal ulcers, intestinal diseases, chronic malnutrition should be avoided. Prohibited for pregnant women. Use with caution for viral infection.

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