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Posted by Ueli (195.162.170.247) on January 27, 2001 at 18:32:09:

In Reply to: response posted by Derek on January 27, 2001 at 15:55:52:

Derek, you claim the right to recommend some drug to others, on the ground it helped you. But when Pinky points out that not all people have the same results and hints at the nasty side effects of this nasty drug, you feel compelled to write two nasty replies. Is this one of the nasty sides of Prednisone too?

Since you apparently use and recommend this drug without informing yourself about it, here an excerpt from RxList.com:

ADVERSE REACTIONS OF PREDNISONE

Fluid and Electrolyte Disturbances: Sodium retention, fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, and hypertension.

Musculoskeletal: Muscle weakness, steriod myopathy, loss of muscle mass, osteoporosis, tendon rupture, particularly of the Achilles tendon, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, and pathologic fracture of long bones.

Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage; pancreatitis; abdominal distention; ulcerative esophagitis; Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT) and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.

Dermatologic: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, and may suppress reactions to skin tests.

Metabolic: Negative nitrogen balance due to protein catabolism.

Neurological: Increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment, convulsions, vertigo, and headache.

Endocrine: Menstrual irregularities; development of Cushingoid state; secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness; suppression of growth of children; decreased carbohydrate tolerance; manifestations of latent diabetes mellitus; increased requirements for insulin or oral hypoglycemic agents in diabetics.

Ophthalmic: Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, and exophthalmos.

Additional Reactions: Urticaria and other allergic, anaphylactic or hypersensitivity reactions.

DRUG INTERACTIONS

The pharmacokinetic interactions listed below are potentially clinically important. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity. Corticosteroids may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia. The effect of corticosteroids on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulants when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

I think Pinky is to be highly commended for writing his thoughtful followup,
Ueli






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