Prednisone

Provider Level

RN/Paramedic

Class

Synthetic glucocorticoid, Corticosteroid

Mechanism of Action

Binds to intracellular corticosteroid receptors and initiates complex biologic effects including reduction of inflammation, suppression of the immune system, and modification of the normal immune response.

Indications

Asthma exacerbation, COPD exacerbation, severe allergic reactions, anaphylaxis (as an adjunct to epinephrine).

Contraindications

Known hypersensitivity, systemic fungal infections, administration of live attenuated vaccines.

Routes

PO

Onset / Duration

Onset is typically 1 to 2 hours. Duration is 18 to 36 hours.

Adverse Effects

Fluid retention, hypertension, hyperglycemia, nausea, vomiting, headache, mood changes, insomnia.

Precautions & Interactions

Use with caution in patients with gastrointestinal ulceration, diabetes mellitus, hypertension, and congestive heart failure. May mask signs of infection.

Special Considerations

Authorized for RN/Paramedic use. Prehospital administration is typically a single dose, so tapering is not an immediate concern. Monitor blood glucose closely in diabetic patients as it can cause significant hyperglycemia.