Medication Card: Prednisone

Use: Addison’s Disease (Chronic Adrenal Insufficiency)

Actions

Synthetic glucocorticoid that mimics cortisol.
Suppresses inflammation and affects carbohydrate, protein, and fat metabolism.
Replaces deficient endogenous cortisol in Addison’s disease.

Indications

Primary: Inflammatory and autoimmune disorders (e.g., asthma, rheumatoid arthritis).
Addison’s Disease: Provides baseline glucocorticoid replacement.

Dosage (for Addison’s Disease)

Maintenance dose: Typically 5–10 mg PO daily (often split into two doses: larger in the morning, smaller in the afternoon).
Dosing is individualized based on clinical response, stress, and labs.
May require dose increase during stress, illness, or surgery.

Contraindications

Systemic fungal infections.
Hypersensitivity to prednisone or its components.
Caution in patients with active infections, uncontrolled diabetes, or osteoporosis.

Caution

Taper slowly when discontinuing to avoid adrenal crisis.
Monitor for signs of Cushingoid features (if overdosed).
Use caution in hypertension, CHF, diabetes, peptic ulcer disease.

Adverse Effects

Long-term use: Osteoporosis, weight gain, moon face, hypertension, hyperglycemia, muscle weakness.
Mood changes, insomnia.
Immunosuppression.
Gastric irritation, peptic ulcers.
Adrenal suppression with abrupt discontinuation.

Drug-Drug Interactions

May increase blood glucose with antidiabetics.
Enhanced GI bleed risk with NSAIDs.
Decreased efficacy with phenytoin, rifampin.
Live vaccines contraindicated during therapy.

Assess

Monitor vital signs, electrolytes, glucose, and weight.
Check for signs of infection (immunosuppressed state).
Monitor for signs of adrenal insufficiency (fatigue, hypotension, N/V).
Periodic bone density tests if long-term use.

Teach

Take with food or milk to prevent GI upset.
Do not stop abruptly—must taper to avoid adrenal crisis.
Increase dose during stress, illness, or surgery (consult provider).
Monitor for signs of infection, hyperglycemia, fluid retention.
Wear a medical alert bracelet indicating steroid dependence.
Avoid exposure to live vaccines.