um the things that really are associated
with side effects from prednisone are
the daily prednisone dose and then the
duration of therapy so the higher doses
you're on and the longer amount of time
that you're on the prednisone the more
likelihood you have of developing a lot
of the different side effects associated
with prednisone use a lot of them
luckily are partially partially
reversible as you come off the dose of
medicine and as we replace it with other
medications but cataracts some of the
bone effects and then the cardiac side
effects can be longer-lasting
overall we have significantly less side
effects if you can get people on doses
less than 10 milligrams a day so these
are some of the side effects that you
guys have seen or familiar with I know
there was another talk on prednisone and
some of the side effects so skin you can
get the steroid associated acne you can
get some hair loss on the top of your
head more hair growth in other areas
bruising right skin thinning and a lot
of these features luckily do improve as
the steroids are lowered but they still
affect your quality of life and there's
still something that you might be
concerned about obviously with some of
the extra hair growth there's hair
removal creams there's topic topical
acne medications even though you do have
some thinning of the capillaries with
increased bruising on your arms and legs
maybe from like a small bump that you
didn't even know happen few patients
will come in and have sort of this just
really thin easy break breakable skin it
will improve as your prednisone dose is
lowered but the good thing to know about
it it doesn't signify an increased risk
of internal bleeding because so just
because you're having those sort of
lesions on the hands and sort of
superficial areas it doesn't mean that
you have an increased risk of bleeding
into your organs or anything like that
um peptic ulcer disease a lot of people
will be all have some stomach upset and
irritation when they're taking
prednisone so you can take it with food
especially if you're taking
anti-inflammatories like and said so
ibuprofen I leave something like that if
you're taking that for pain control and
you're also taking prednisone you
actually have a significantly two times
higher risk of getting peptic ulcer
disease or gastritis so you want to
protect your stomach so you can ask your
doctor
either to prescribe you like a protonix
or an exome or something some sort of
stomach protection and make sure you
take it with food other effects include
sort of mental status changes so you can
get hypomanic and 30% depression and 10%
you can have some memory memory loss
psychosis so these are all different
side effects that can happen with
variable doses of prednisone and then
prednisone can affect your bones which
we all know and and a lot of your Doc's
will talk to you about bone protection
some of the way that it does this
there's two bones are constantly in a
state of turnover but there's two main
cells that are sort of building up and
then destroying your bones and this is
constantly happening in everybody but
when you get outside when steroids are
given to you basically the cells that
are responsible for building up your
bones are inhibited they're kind of shut
off a lot and the bones that are
responsible for their the cells that are
the osteoclast which is the other one up
there those are the ones that are
responsible for eating away and sort of
eating away at the bones and like I said
usually they're in a really nice balance
where they kind of are constantly eating
away bone and developing new bone but
because of the steroids it's shifted and
so you get a lot more bone loss and a
lot less bone development which leads to
a lot of the osteoporosis and worrisome
long-term side effects with being on
prednisone you have less calcium
absorption you get rid of more calcium
and like I said the cells shift is off
so you have more bone resorption and
less bone formation so things that we
will try to give you to try to prevent
some of those side effects include
calcium and vitamin D if your vitamin D
is really low we'll give you the weekly
dosing that high dose one but calcium
and vitamin D can be supplemented when
you're on prednisone especially above 20
milligrams a day and then in terms of
just long-term monitoring you want to
get a bone density scan especially if
you have risk factors for osteoporosis
within six months of starting the
steroids to try to see if you need to be
on a medication really to prevent your
bone bone health long-term
other effects and I'm moving on
prednisone shortly
obviously cardiac effects so elevated
blood pressure weight gain elevated
blood sugars so even patients on less
than 10 milligrams a day have almost two
times increased risk of needing to be on
a diabetic medication so while you're on
steroids obviously trying to do things
like you know watch your diet you can
make people more hungry so it's hard to
say watch your diet and you're more
hungry and you're taking this medicine
that's making you feel that way and
making you like hold on to more water
and feel bloated
so it's difficult but but trying to stay
within those a healthier eating habits
will help when you sort of decrease the
dose of prednisone too to be able to get
back closer to your baseline and then of
course infection so there's always
higher risk of infection with prednisone
and with all of the medications that we
use again this doesn't mean that you
can't go visit your you know go to a go
to a grade school play or go on a flight
or do anything like that you just have
to take standard precautions so you know
keep the hand sanitizer stuff with you
like make those decisions just so that
way you can minimize your risk but don't
you don't have to change your entire
life you can still go to visit your
relatives do whatever you need to do but
just if you know that there is someone
sick don't maybe wait a couple days
before you go you go see them until they
start feeling better because you are at
increased risk of infections and in fact
the reason that a lot of Vaska is
patients a lot of reasons for their for
issues and for death is because of
infection it's not from the vasculitis
in that first year so you really do need
to protect yourself from infections