Drug Mechanism of Action Indication Contraindication Adverse Effects

PREDNISONE 2mg/kg/d Glucocorticosteroid; elicits

mild mineralocorticoid activity
and moderate anti-
inflammatory effects; controls
or prevents inflammation by
controlling rate of protein
synthesis, suppressing
migration of
polymorphonuclear
leukocytes (PMNs) and
fibroblasts, reversing capillary
permeability, and stabilizing
lysosomes at cellular level; in
physiologic doses,
corticosteroids are
administered to replace
deficient endogenous
hormones; in larger
(pharmacologic) doses, they
decrease inflammation

Inflammation
Acute Asthma
Nephrotic Syndrome
Untreated serious
infections
Documented
hypersensitivity
Varicella
Receipt of live or
attenuated live vaccine;
Advisory Committee on
Immunization Practices
(ACIP) and American
Academy of Family
Physicians (AAFP) state that
administration of live virus
vaccines usually is not
contraindicated in patients
receiving corticosteroid
therapy as short-term (<2
weeks) treatment, in low-
to-moderate dosages, as
long-term alternate-day
treatment with short-acting
preparations, or in
maintenance of physiologic
dosages (replacement
therapy)

Allergic: Anaphylaxis,
angioedema
Cardiovascular: Bradycardia,
cardiac arrest, cardiac
arrhythmias, cardiac
enlargement, circulatory
collapse, congestive heart
failure, fat embolism,
hypertension, hypertrophic
cardiomyopathy in premature
infants, myocardial rupture
after recent myocardial
infarction, pulmonary edema,
syncope, tachycardia,
thromboembolism,
thrombophlebitis, vasculitis
Dermatologic: Acne, allergic
dermatitis, cutaneous and
subcutaneous atrophy, dry
scalp, edema, facial erythema,
hyper- or hypopigmentation,
impaired wound healing,
increased sweating, petechiae
and ecchymoses, rash, sterile
abscess, striae, suppressed
reactions to skin tests, thin
fragile skin, thinning scalp
hair, urticaria
Endocrine: Abnormal fat
deposits, decreased
carbohydrate tolerance,
development of cushingoid
state, hirsutism,
manifestations of latent
diabetes mellitus and
increased requirements for
insulin or oral hypoglycemic
agents in diabetics, menstrual
irregularities, moon facies,
secondary adrenocortical and
pituitary unresponsiveness
(particularly in times of stress,
as in trauma, surgery, or
illness), suppression of growth
in children
Fluid and electrolyte
disturbances: Fluid retention,
potassium loss, hypertension,
hypokalemic alkalosis, sodium
retention
Gastrointestinal: Abdominal
distention, elevation of serum
liver enzymes levels (usually
reversible upon
discontinuance),
hepatomegaly, hiccups,
malaise, nausea, pancreatitis,
peptic ulcer with possible
perforation and hemorrhage,
ulcerative esophagitis
General: Increased appetite
and weight gain