Nurses Compass
Drug Guide
Prednisolone Sodium Phosphate
Classification
Therapeutic: Anti-inflammatory, Immunosuppressant
Pharmacological: Corticosteroid
FDA Approved Indications
- Inflammatory conditions (e.g., asthma, allergic reactions, rheumatic disorders, dermatologic conditions)
- Autoimmune diseases
- Certain cancers
Mechanism of Action
Prednisolone Sodium Phosphate suppresses inflammation and immune responses by inhibiting multiple inflammatory cytokines and mediators; it modulates transcription of anti-inflammatory genes and represses pro-inflammatory genes.
Dosage and Administration
Adult: Dosing varies widely depending on condition; typically 5-60 mg daily in divided doses. Adjust based on clinical response.
Pediatric: Dose based on weight or surface area; typically 1-2 mg/kg/day, divided. Titration required.
Geriatric: Use with caution; start at lower end of dosing range due to increased risk of side effects.
Renal Impairment: Adjust dose based on severity; monitor closely.
Hepatic Impairment: Use with caution; dose adjustments may be necessary.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed, crosses placenta.
Metabolism: Metabolized in the liver.
Excretion: Excreted in urine and feces.
Half Life: Approximately 2-3 hours, but clinical effect lasts longer due to steroid activity.
Contraindications
- Systemic fungal infections
- Known hypersensitivity to prednisolone
Precautions
- Patients with infections, diabetes, osteoporosis, hypertension, peptic ulcers, glaucoma, or psychiatric conditions. Use with caution during pregnancy and lactation; weigh benefits and risks.
Adverse Reactions - Common
- Increased appetite (Common)
- Insomnia (Common)
- Weight gain (Common)
Adverse Reactions - Serious
- Adrenal suppression (Serious)
- Increased risk of infection (Serious)
- Osteoporosis (Serious)
- Psychiatric disturbances (Serious)
Drug-Drug Interactions
- NSAIDs (increased risk of gastrointestinal bleeding)
- Diuretics (potassium loss)
- Live vaccines (increased risk of infection)
Drug-Food Interactions
- None specific
Drug-Herb Interactions
- Potential interactions with herbal supplements affecting coagulation or immune response
Nursing Implications
Assessment: Monitor for signs of infection, hyperglycemia, osteoporosis, mood changes. Monitor blood glucose in diabetic patients.
Diagnoses:
- Risk for infection
- Imbalanced nutrition: less than body requirements
- Risk for osteoporosis
Implementation: Administer with food to reduce gastrointestinal irritation. Taper dose slowly to prevent adrenal insufficiency.
Evaluation: Assess for resolution of symptoms, monitor side effects, adjust dosage accordingly.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Do not stop abruptly; taper under medical supervision.
- Report signs of infection, mood changes, or gastrointestinal bleeding.
- Maintain a healthy diet rich in calcium and vitamin D.
- Use caution with activities that may lead to injury due to osteoporosis risk.
Special Considerations
Black Box Warnings:
- Increased risk of secondary infection, potential for psychological effects, osteoporosis, and adrenal suppression with systemic corticosteroids.
Genetic Factors: Genetic variations may influence metabolism; pharmacogenetic testing not routinely performed.
Lab Test Interference: May alter glucose, thyroid function tests, and electrolyte levels.
Overdose Management
Signs/Symptoms: Cushingoid appearance, electrolyte disturbances, suppressed adrenal function.
Treatment: Discontinue drug gradually; support symptomatic treatment; consider activated charcoal if ingestion recent; manage complications.
Storage and Handling
Storage: Store at room temperature, away from light and moisture.
Stability: Stable until expiration date on packaging.