Patient/caregiver was educated on the precautions to be observed while taking prednisone as follows:
- Prostaglandins in the stomach offer protection against development of stomach ulcers. Prednisone by inhibiting overall prostaglandin synthesis, as part of anti-inflammatory activity, reduce the synthesis of prostaglandins in the stomach. This can predispose an individual to increased risk for development of stomach ulcers. Prednisone should be carefully administered in individuals with history of stomach ulcers and be followed-up periodically for recurrence of peptic ulcer symptoms. Any symptoms of abdominal pain, indigestion, gastritis, and burning sensation in the stomach must be closely evaluated.
- Prednisone, as part of action of body metabolism, increases the breakdown of glycogen to glucose and result in elevated blood glucose levels. This can predispose diabetic patients to poor glycemic control and may necessitate change in dose of antidiabetic medications. Prednisone should be carefully administered in diabetic individuals with close monitoring of daily blood sugars. Report to your physician regarding any consistently elevated blood sugar readings and poor glycemic control. Compliance must be observed with periodical HbA1c evaluation.
- Prednisone carries risk for bone resorption and reduced calcium deposition in the bone. This can result in thinning out of bones and contribute to development of pathological fractures. Any skeletal pain must be reported to the physician and be evaluated for possibility of a fracture. Menopausal women are increasingly at risk for pathological fractures, due to absence of estrogens contributing heavily to the skeletal weakness. Compliance with hormone replacement, physical exercise as tolerated with weight bearing as allowed, vitamin D and calcium supplementation can help prevent development of these pathological fractures.
