The glucocorticosteroid, prednisone, is a synthetic hormone similar to the adrenal hormone hydrocortisone (cortisol). It is sometimes referred to as a corticosteroid or as a cortisteroid. Prednisone is widely used in treatment of chronic conditions involving the immune system. Examples are arthritis, asthma, allergic reactions, bronchitis, systemic lupus and leukemias (www.medicinenet.com).
Prednisone, available in different registered, prescription brand names (Orasone, Deltasone, Meticorten, Sterapred) (,www.itzarion.com) is a man-made drug that mimics the natural corticosteroids produced in the body. Two functions of prednisone are to act as an anti-inflammatory and as an immunosuppressant (www.chemocare.com, www.itzarion.com). These are the two properties that makes prednisone useful in addressing various chronic diseases.
Prednisone must be administered very carefully, and more importantly, stopped very carefully because it causes the adrenal gland to atrophy and cease its natural functioning. Courses of treatment can be short term as for severe asthma or bronchitis, or long term as for lupus or psoriasis. The dose must be regulated, monitored and stopped with the utmost care. When stopping a course of prednisone, the dose must be tapered, slowly reduced by incremants, so that the adrenal glands can reactivate their normal function. Even after a course of prednisone is ended, care must be taken in highly stressful situations (trauma, going to the dentist, respiratory infection, etc.) and an individual may need an extra, short course of prednisone to help through the stressful situation (www.medicinenet.com).
It is because of these characteristics of the corticosteroid , prednisone, that side effects are a particular concern. Side effects can occur from short term treatment as well as from long term courses of treatment. Side effects can be quite dangerous, but most – though certainly not all – symptoms vanish after the treatment course is properly ended (www.chemocare.com, www.medicinenet.com). Some side effects that are immediately dangerous and require attention are fevers and chills, fast heart beats or shortness of breath, pain in your chest or jaw or sudden confusion (www.chemocare.com). Serious, but less dangerous, side effects are extreme and unusual fatigue, dizziness, severe mood swings, insomnia, bone pain, changes in vision, swelling or redness (www.chemocare.com).
The side effects that seem worst to me are the ones, generally associated with high dose and long term courses of treatment, that stay with you or have the potential for long term, irrevesible damage (www.medicinenet.com). These are high blood pressure, cataracts or glaucoma, osteoporosis (thinning of the bones resulting in easy fracture), and depression, mood swings, personality changes or even, in extreme side effcts, psychotic behavior.
With all the good benefit that comes with medical use of prednisone, it seems ungrateful to rail against the side effects. But when, fifteen-years after slowly discontinuing prednisone in a properly tapered dose, you sit with shadows over your eyes and blind spots where the sun reflects off your cataracts; when your back is bent foward and your reputation for perfect posture is lost to memories; when you wring out a rag you’re scrubing with and a bone in your hand (well, really, wrist, because it is below your finger knuckles) breaks; when your skin is covered with long, deep scars on flesh that thinned and wounded easliy but would not heal easily, you think, it kept me alive, I could raise my children and I got fifteen years down the road. And then you ask, was it worth it? And you know the answer is, yes, because you could never foresake your children. But still, even as everything within you says it was a necessary and worthwhile price, everything within you agrees that it was a high price to pay. An unavoidable and rather high price.
Reference:
- www.ndif.org/Terms/glucocorticoid.html www.chemocare.com/bio/orasone.asp www.itzarion.com/prednisone.html www.medicinenet.com/prednisone/article.htm en.wikipedia.org/wiki/Prednisone
