Re: Here is a 2003 message about Pred. from Fran

[Guest guest]

WOW...I found Fran's information very helpful. I know it's dated, but it

answered a ton of questions I have about Predisone. Let me know if things have

changed since you last wrote this Fran?

Thanks!

hannahlsmith73 <hlsmith73@...> wrote:

There has been a lot of talk about pred. lately and since I have been

giving it since November I have been feeling lately if I am making

the right decision. Even though I LOVE how quickly Aidan feels

better - I still worry deep down if I am doing the right thing.

I had one doc tell me to use it for " disneyland and tests " and

another doc tell me that the one tsp. he is getting once or twice a

month is hardly anything to worry about.

So - I searched our board and found a message from Fran back in 2003

about it all. Fran - I hope you don't mind me reposting this - and I

am hoping that you can tell us (since I really think of you as the

guru) if this information is still accurate 4 years later - you

know how things change.

And - if this is still correct information - I am wondering about

the " long term " part of it. Would 7 months of 1-2 tsp. a month be

considered long term - or is that years of use?

Also - no one has ever checked Aidan's blood sugar while he's been

taking the pred. Is that more of a complication for daily long term

use therapy?

And (sorry) - its says that they are more susceptible to illnesses.

For how long after taking one dose? A week? A day? A month?

Thanks and I'm sorry if I am wrong in posting this.

Frans message:

Sally,

Prednisone with long term administration has significant problems...

The reading below is not meant to scare anyone, BUT it is IMPORTANT

for ALL parents to understand that Prednisone is a VERY VERY potent

drug.... In if it works as some of the specialists tell us it

should work ... it would be great... I remember speaking with my

specialist and later with Dr Feder, Dr Lawton and Dr ... and

they all felt that Prednisone would stop the fever and possibly

lengthen the episodes. From my one on one experience with hundreds of

parents with kids with , their information is not quite

accurate. It does halt the fevers. BUT in the majority of kids,

it increases frequency. Therefore once a few testing doses are given,

it will be up to the parent who is the child's ONLY advocate... to

decide if this medication is helping or hurting. Here in the group

there is about a 10% positive effect with Prednisone aside from

stopping the fever... thus majority of parents have opted to stop the

steroid because of a significant increase in episodes and concern of

over medicating and side effects.

However there are a small number that the steroid has helped and the

cycles were either the same or spread.... Soooooooo this is where is

becomes difficult for parents to decide.

I do not like steroids... as a healthcare professional I do know they

are needed sometimes (Kids with asthma, cancer patients, other auto

immune problems) but with I think there needs to be a trial...

if the child really only needs the minimum dose and the episodes are

uneffected or spread out over the course of treatment, I think there

is a benefit.... (IF THE FEVERS run high.... some kids have mild

cases) But for those who get more frequent episodes and more and more

medication is needed... I would really be concerned about the side

effects. I gave it 4 months... and took ph off... I hope the

information below is used as a tool to assist any parent with the use

of the steroid.

Due to the fact that prednisone is an oral medication, it's

distributed to and effects every part of the body, not just the

desired point of action.

This is a big factor, along with its hormonal nature, in why

Prednisone's side effects are so pervasive, serious, and numerous.

Side effects occurs both with short-term and long-term use. Most side

effects encountered with short-term use begin to lessen with

diminished dosage and disappear with the end of Prednisone use.

a.. Weight gain is one of the first side effects due to two reasons.

Prednisone increases appetite and causes fluid retention. A careful

diet and schedule for meals can help control appetite. If you just

eat whenever you want, you'll be eating all the time. Fluid retention

is more complicated and needs to watched carefully and closely

monitored by a physician.

b.. Other early side effects are mood changes and insomnia. Scheduling

your prednisone dosage for early morning and/or at least 3 hours

before bedtime can help.

c.. Upset stomach is another side effect. Prednisone tends to increase

stomach acids, taking Prednisone with meals helps prevent this.

Prednisone should not be taken on an empty stomach. There is also the

danger of ulcers due to this side effect.

d.. Prednisone's ability to decrease inflammation by decreasing the

immune response also results in an impaired response to infection.

This make you more prone to develop infections. Contact with infected

individuals should be avoided. Any signs of infection should be

reported to your physician immediately.

e.. Hyperglycemia (increased blood sugar) and Hypertension (increased

blood pressure) are possible and should be monitored. These should be

treated by your physician is they occur.

Some of the long-term side effects include:

a.. Osteoporosis, a loss of calcium in the bones, which can make bones

more brittle and more susceptible to breaks. This can be treated with

calcium supplements and diet.

b.. Occasionally patients will develop cataracts.

c.. Changes in capillary walls can result in skin bruising from

relatively minor impacts.

d.. Steroid therapy can also result in growth suppression in children.

Cautions Caution should be exercised in patients with preexisting

conditions such as osteoporosis, colitis, diverticulitis, diabetes,

fungal/bacterial infections, recent surgery or trauma, tuberculosis,

glaucoma, heart disease,hypertension, kidney/thyroid/liver disease,

myasthenia gravis, or lupus erythematosus.

Sudden discontinuation of steroid therapy can have grave

consequences. Close attention to following doctor's orders is very

important. A sudden stop in steroid therapy can result in nausea,

vomiting, pain, fever, sudden flare-up of the disease being treated,

or death.

Drug Interaction

Other drugs can effect or be effected by Prednisone. The physician

should be aware of all medications, including OTC (over-the-counter)

drugs and home remedies. Drugs such as aminoglutethimide, antacids,

barbiturates,carbamazepine, grizeofulvin, mitotane, pheylbutazone,

phenytoin, primidone,and rifampin can interfer with Prednisone's

effectiveness. Diruetics and Prednisone can cause electrolyte

imbalances (low blood potassium) and can result in cardiac

arrythmias. For this reason, patient's on digoxin or

digitalis may experience serious side effects. Immunizations and

vaccination can be dangerous to individuals on long-term Prednisone.

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