March 21, 2023

We look at the most common side effects of oral prednisone both short term, medium, and long term and some solution work arounds to avoid these side effects while keeping the benefits of this miracle medicine. Prednisone is one of the most useful modern medications for multiple indications. But there are also dangers in taking prednisone.

The doctor is in thank you so much for tuning in again it’s your pal dr sal and today we’re going to take a look at prednisone side effects and some solutions so first off a little bit of trivia about prednisone some fun facts about it one is it’s a steroid but it’s not the type of steroid that you consider um for bodybuilding it’s called a glucocorticoid

Steroid which actually acts as an anti-inflammatory in nature another cool thing is it’s actually made in your own body so unlike most drugs that we take or medications this is actually naturally produced in your own body unlike a lot of the other stuff that will prescribe you it’s produced just above your kidneys in some little glands called the adrenals

Now the other thing that’s really interesting about prednisone most other drugs are basically indicated for for one use so for example if i prescribe you um say sertraline that is basically one use it’s just for mood disorders if i prescribe you say some advil that’s predominantly for musculoskeletal pain prednisone on the other hand is like a master of all

Traits i’ve seen it use and use it prescribe it myself in multiple conditions ranging from allergy problems asthma copd or smoker’s lung exacerbations urticaria so bad rashes um what else pulmonary fibrosis ms or um multiple sclerosis gilliam bahrain is using some cancers for suppression of growth uh it’s using some kidney diseases nephropathies like nephrotic

Syndrome it’s also used in gastrointestinal disorders like crohn’s ulcerative colitis and it’s used for joint disorders used for rheumatoid and rheumatoid arthritis lupus and i mean the list just goes on and on this isn’t even a complete list of all the uses for so this is one of the most useful uh medication drug discoveries uh right now in medicine today now

That being said despite its incredible efficacy there’s also a lot not to be liked about it in terms of side effects so that’s what we’re going to go through next now with the side effects there’s a spectrum of side effects and a lot of it depends on the dose you’re taking but more importantly with prednisone is actually the duration how long you’re taking it

For is actually generally simple rule thumb more important than the actual dose itself so what i’m going to do is divide side effects it can expand look forward to a prednisone base on immediate so within days as opposed to within the first month or longer so then we’re looking at a scale of months and then for some unfortunate people with conditions like pmr

Where they need to be on it for over a year if you need to be on it for a year or longer all right so first off for days a lot of people will notice within the first few days of use a big increase in appetite you get really hungry but it’s a different type of weight gain than what you get in anabolic steroids with these the appetite is uh does increase weight

But it’s more of a fatty type of growth rather than muscular another thing a lot of my patients will come back in is complain of insomnia sometimes i can fix that by splitting the dose or instead of taking it all in the morning split in half until some at night or in other cases i might have to tell them okay we’ll try some melatonin or some over the counter

Sleeping it’s not usually severe enough for me to have to prescribe a drug to combat it now another important one not so much in normal people but with people with diabetes tend to see their sugars go up sometimes spectacularly so because they’re already vulnerable to problems with sugar metabolism so it tends to manifest really grotesquely in people with

Diabetes they can sometimes see their sugars go from single digits to double digits within a day or two so usually the solution that is just to alter their diabetic medication or in some cases may have to if the person really must be on it for one of these conditions that could be life-threatening um then sometimes they’ll actually have to institute institute

Um diabetic medication at least temporarily until they can come back off the prednisone um and another thing that a lot of people notice is uh mood changes and not always for the bad sometimes it’s actually like a euphoria um feeling a lot better and that would kind of make sense because if you’ve been feeling ill with one of these things dragging you down

For weeks or months and suddenly it’s virtually gone well you would expect your move is suddenly going to feel perked up and happy um also some people feel a lot of anxiety with it now continuing with the mood thing after months of use a lot of people experience uh depression so within a month or longer i have to use i again typically i don’t typically see it

Severe enough to have to alter treatment as a consequence of this spin-off but i’m sure there’s going to be a case here there um that i just haven’t come across um some other things to look forward to with within the first month or longer views is um because it’s a glucocorticosteroid or mineralocorticosteroid it tends to cause fluid retention so increase fluid

So people will notice this with their ankles swelling or their fingers getting like sausages their face looking a little more full that’s fluid retention in addition there’s also weight gain but the weight gain isn’t part of that is because of fluid but the other part of it is because of this change in metabolism of sugars it causes increased fatty deposition

As well especially as you’re on it longer then you really start to see spectacular weight gain and we’ll go into that in a sec but let’s finish the one month or or greater but less than one year another thing that’s uh relatively not that common but dangerous when it happens is in about two percent of patients will get stomach ulcers and i’ve actually seen

That before that usually manifests with um like gnawing pain in the pit of your stomach burning etc uh a solution to that is often just to prescribe an antacid if they if you can’t stop the therapy of the prednisone so the person still needs it you can continue the prednisone but just off off set it by prescribing that antacid at the same time what that does is

It reduces the the acid load on the stomach lining giving it a chance to tolerate the prednisone um all right so we mentioned the depression um all right so that’s some of the main things that people notice within a month of use in less than a year now let’s go into a year or longer so we’re looking into the long-term use of prednisone now one of the things

You’ll notice in some of these people is acne and then because of this weight gain and fluid retention these two phenomena here you get something called a moon phase so prolonged exposure actually gives a special looking faces which is kind of like a rounded face with most of the features the cheekbones etc washed out because of the the increasing uh ballooning

Of of the face from both fatty deposition and fluid retention over a long space of time uh some other problems is when you’ve been on it for a year or longer is something called adrenal suppression so as i was telling you up above your body also makes prednisone but if you keep taking a super physiological amount your body will shut down its own manufacturing

Of uh this chemical oh another important one i forgot to mention up here is addison’s disease which is what um what was it president kennedy had addison’s disease um so when you’re coming off of prednisone after you’ve been on it for a long time what we do is we don’t suddenly stop you or you’ll get a biological crash what we do is we gradually wean you down

So for example say you were taking i don’t say you were on 20 milligrams then go down to say 15 and 10 then five then one and maybe do that over several weeks each drop that just gives your body sufficient time to realize that there’s a shift in tide and to start stepping up its own production to meet the deficit so that’s usually not that big of a deal to fix

The key thing is just letting people know if they’ve been on it for a long time please don’t just suddenly stop because it’s not gonna end up nice another big problem with long-term use is osteoporosis it tends to cause thinning of the bones and sometimes people only realize this when they have a trivial fall and suddenly realize that they got a fracture what

We tend to do preventatively is when we know somebody is going to need to be on prednisone for a year or longer it will often do cereal bone mineral density testing what that does is it gives us an early warning sign that there’s uh thinning of their bones occurring again if the if we can’t quit the prednisone which would solve the problem if we can’t stop the

Prednisone because of one of these diseases we’ll continue it but then what we can do is prescribe something called a bisphosphonate we’ll also give them vitamin d and calcium and that can help to correct the bone mineral loss also later on when they’re finished the prednisone therapy you can continue those drugs and that will also help to lift the bone density

If not back to normal close enough that you’re not getting fractures from trivial insults now another serious complication with long-term use is in the eyes it promotes both cataract formation and glaucoma and one of the keys to um helping prevent with that is keeping those sugars normal because that’s one of the things that will help to accelerate cataracts

And glaucoma but sometimes with prednisone you you’re basically weighing the good versus the bad so there’s no perfect solution so say you’ve got um so you’ve had a episode of multiple sclerosis and you’re really doing bad you’re losing your logical function so which is worse put up with some of these side effects or put up with the loss of your neurology

So it’s not always clear-cut what you should do but in general we try to only use the prednisone if we have to also in a lot of conditions you only need it for about seven days for example in asthma i’ve used it many times in myself for asthma copda exacerbation so some of these conditions don’t need to be long-term prednisone solutions very often it’s only

About a week therapy that’s needed so generally with one week of therapy most people don’t notice very much side effects except just feeling better in general so ladies and gentlemen if um if you’re going to be on prednisone therapy i hope this helps and gives you some solutions of how we manage some of the spin-off nuisance side effects from prednisone again

Super effective medication on multiple domains like is rare to see a drug that effective in so many different conditions it’s incredible so anyway thank you for watching and we’ll be in touch again soon thanks for watching get notified of new videos subscribe now if you found this video helpful support us by sharing it with all of your friends and throw us a

Like below you’re a star cheers and cheerio

Transcribed from video
Most Common Prednisone Side Effects : Short Term and Long Term, and Solutions | Corticosteroids By DoctorSecrets