March 22, 2023


Continues with monitoring prednisone we’re going to discuss the common side effects that we need to be watching for and specific things for each of those common side effects that we we and especially working with our doctors need to check and then we’ll end with where to find more help with more answers the number one complaint of people on prednisone is weight

Gain and it’s reported that 70% of people on prednisone experience weight gain so we need to be watching for that obviously the simplest thing that we need to be checking is weight and that can be used along with the height to calculate a bmi or body mass index and it’s important to see what your weight was when you started prednisone compared to where you end up

At high doses and if it changes when you get to lower doses and i’ve got a whole series of how to cope with the weight gain so if you’re wondering about what those are check out the video the weight gain video series next and to me the very most important one to be checking is bones so bones are so important that the doctors who prescribe prednisone the most the

Rheumatologists who prescribe it for things like rheumatoid arthritis they say that they are so concerned about it they got together and created a guideline and these are from that guideline of things they wish that people were checking this especially the doctors and so when you start putting a zone they want to know how high how high you are what is your height

What how tall are you and the reason they’re checking that is because your spine can get compression fractures and so you can actually lose height if the if your spine is collapsing on itself and that’s from the osteoporosis so we want to make sure that your spine is in good health and so height and then asking about fractures and now those spine fractures you can

Actually feel them usually occasionally you might have back pain but sometimes it’s totally undetectable except they’ll try doing an x-ray you can see that’s the second to last thing there or that often can’t even cap catch these little tiny tiny cracks that smash the spine together and they often have to do an mri especially of another type of bone complication

Called osteo necrosis that’s when there’s joint bone death especially of the hips and when that happens the x-rays often can’t detect it either and so they’ll have to do an mri of your hip or whatever other joint but you usually can feel the osteonecrosis where you might not be able to feel that osteoporosis then they’ll also it’s important if you’re on prednisone

For longer than three months to get a bone mineral density test and the most common one is called a dexa scan and using that they can calculate a z-score and that just shows how dense your bones are compared to people who have healthy bones because then they can track if you’re on prednisone long-term if you are losing bone density and if you are losing bone density

Then they need to prescribe prescription medications for you to stop that bone loss because we don’t want you breaking a hip or breaking your wrist or any other bone and especially not your spine so it’s important to check these things for good bone health x is your heart so in other videos in the side-effects series i’ve talked a lot about heart complications and

So some of the things that we need to check include blood pressure and your lipids or your cholesterol and there are lots of blood tests that your doctor can run and then using that and some other information like your family history of heart disease they can calculate what’s called a framingham risk score and this can help decide whether you need certain things

Like aspirin or a statin drugs for high cholesterol or high blood pressure medications diabetes so this goes back to that weight gain often the weight gain is from the high glucose or hyperglycemia but when hyperglycemia is out of control too long and the insulin isn’t doing its job in the right way anymore then it can turn into diabetes and when it becomes frank

Diabetes when that’s when it’s so bad there will be really really strong urination thirst and weight loss so it’s like you can’t drink enough water you’re always thirsty and you’re going to the bathroom all night long just lots of urination and weight loss and that’s a real big sign because on prednisone you’re usually gaining weight and if you’re suddenly losing

Weight and you’re thirsty and you’re going to the bathroom all the time you definitely need a gate checked by your doctor to make sure that you your blood glucose is in a stable range so they can test that in your blood they can do an a1c which will check the last three months of how your blood glucose is they can do a test to see how your insulin balance is called

A two hour oral glucose tolerance test and that is what they often do for pregnant women sure that they’re not getting gestational diabetes and so this is a longer test than just like a little quick blood reitz takes at least two hours next is eyes i’ve talked about these complications in the past as well but if you’re on prednisone long-term you need an annual

Eye exam period you just need to be going to the eye doctor every year if you’re on prednisone and they’ll know what to look for when you tell them that you’re taking prednisone there are classic things that they can be checking and looking for to make sure you’re not having those complications and they especially if you have these things here the intraocular they

Will check your intraocular pressure if you have a personal or a family history of glaucoma if you have diabetes if you have rheumatoid arthritis or other connective tissue diseases or high myopia so these are important to even know that it’s a possibility that prednisone isn’t going to have complications on your vision and so go to the eye doctor get your eyes

Checked every year finally if you want a list of what these things are that you need to get checked and what you can do aside from just getting checked to cope with those side effects get your prednisone checklist and you can find it at prednisone pharmacist calm and if you already have one let us know which of these checkups you’ve been getting done have you been

Getting your eye exam have you been getting your bone scan have you begin of your blood tested for your cholesterol or your sugar or how about your blood pressure how’s it doing which thing are you working on you’d love to know let us know signing off as dr. meghan your prednisone pharmacist

Transcribed from video
Monitoring Prednisone – What side effects should I check and when? By Dr. Megan – Prednisone Pharmacist