Tuesday, June 14, 2011

Oh, Prednisone!

Medication blog #2: Prednisone

This is the second in a series of what I'm calling medicine blogs.  Some new patients get overwhelmed with the amount of medication options, and it can get stressful trying to explain our treatment to family and friends.  I figured it'd be a good idea to do a bunch of blogs of different medicines that I am familiar with, so I can help those who'd like to, to understand them a bit better. I hope they help, and as always feel free to share my blog with friends and family! :)
Prednisone is in a category of medicines known as a corticosteroid. Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Prednisone is very effective as an immunosuppressant drug, which means to inhibit or prevent the activity of the immune system.  It is used to treat: asthma, COPD, rheumatoid arthritis, allergic disorders, ulcerative colitis and Crohn’s disease, adrenocortical insufficiency, hypercalcemia due to cancer, thyroiditis, severe tuberculosis, lipid pneumonitis, multiple sclerosis, nephrotic syndrome, myasthenia gravis, and as part of a drug regime to prevent rejection post organ transplant.

I have been on and off Prednisone ever since I was diagnosed, that was almost 23 years ago.  Prednisone works great as a short-term medicine, but it can cause problems when used long-term because of the many adverse side effects.  I know some short-term side effects include: increased appetite, fluid retention resulting in weight gain, puffyness of the face (also known as moon face), high blood glucose levels,  insomnia, euphoria and, rarely, mania (in particular, in those suffering from Bipolar disorders I and II).   I know when I am on Prednisone, especially higher doses, I get increased appetite, moodiness and weight gain. 

Long-term side effects include:  Cushing's syndrome, truncal weight gain, osteoporosis, glaucoma and cataracts, type II diabetes mellitus, and depression upon dose reduction or cessation.  Of these long-term side effects, I have been diagnosed with glaucoma, a cataract and osteopenia. 

Major side effects include: increased blood sugar for diabetics, difficulty controlling emotion, difficulty in maintaining train of thought, weight gain, facial swelling, depression, mania, psychosis, or other psychiatric symptoms, unusual fatigue or weakness, mental confusion / indecisiveness, blurred vision, abdominal pain, peptic ulcer, infections, painful hips or shoulders, steroid-induced osteoporosis, osteonecrosis, long-term migraines, insomnia, severe joint pain, cataracts or glaucoma, anxiety, black stool, stomach pain or bloating, severe swelling, mouth sores or dry mouth, avascular necrosis, hepatic steatosis. 

Minor side effects are: nervousness, acne, rash, increased appetite, hyperactivity, frequent urination, diarrhea, removes intestinal flora, leg pain/cramps, sensitive teeth.

*Obviously this isn't an entire list of possible side effect.  As with any medication, no matter how long you've been on it, you should contact your doctor with any changes you notice and side effects that may come up.

From being on prednisone for so long, I have had some long-term side effects develop over the years.  My growth has been stunted - I'm 26 and only 5 feet tall, I officially stopped growing when I was still in middle school.  My jaw and face are probably the most effected, I've had teeth pulled and have difficulty opening my mouth very far.  As I stated above, I also was diagnosed with glaucoma and a cataract only a few years after being on prednisone.  I also have recently been diagnosed with Osteopenia, even after being an avid milk drinker and dairy eater for years to prevent this from happening. 

While some of these side effects sound scary, prednisone is an excellent short-term medicine. It has helped me countless times feel so much better during an awful flare-up from my RA. Prednisone can be used to treat many things, but as always it's important to discuss treatment before-hand with your doctor, to make sure you're on the right treatment for you.

2 comments:

  1. I have been on pregnisone long term also but not nearly as long as you. Like you I do have some side effects including: high cholesterol, some weight gain but I think this is also related to my thyroid med change as this happened recently, vit D deficiency and osteopenia. You may want to ask your doc to do a vit D test on you also. It was my endo doc that did this test not my ra doc. And it is wonderful to have a verteran ra person blogging :-) Keep up the great posts!

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  2. So glad you are posting these medical posts. I have a relatively new diagnosis of RA, and I am old enough to be your grandmother (or mother, since I also have a 26 year old son). You are brave. Thank you for your blog and your honesty.

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