Are you sufering from droopy eyes or pufy eyes? This is a symptom which tells you that your eyes are tired. Pufness of the eyes is caused by many reasons including lack of sleep and crying for a long time. The skin around our eyes is thin and sensitive and contains many blood vessels. Stress, lack of sleep etc afects the skin and cause excess fuids to get trapped in the skin around the eye causing an eye bag. Aging is one of the major causes of bags under the eyes. Fat deposition under the eyes also results in bags under the eye. There are some efective home remedies to treat the bags under the eye or the Pufy eyes. These home remedies are cheaper and safer than the alternative methods of treating under eye bags. Here are some of the home remedies to get rid of pufy eyes.1.Chilled Tea BagsIf you get up in the morning with pufy eyes and if you do not want people to see the under eye bags then chilled tea bags are the best option. Put the tea bags in hot water for a minute and then refrigerate it for some time. Lie back and place the tea bags over the eyes. Leave it on the eyes for 20-30 minutes. Wash your eyes after 30 minutes in cold water. You will have refreshed eyes. You canuse either green tea bags or black tea bags for this purpose. The cafeine present in the tea constricts the blood vessels around the eyes and reduces the swelling and redness.2.CucumbersThis is one of the most efective natural remedy for pufness under the eye. The coolness of the cucumbers will soothe the eye and the anti-infammatory properties help to reduce the infammation of the skin.Take two slices of refrigerated cucumber and place it over the eyes. Relax with the cucumbers on the eyes for 25 minutes. This will soothe and refresh your eyes and reduce the pufness.3.PotatoThe potato has antiinfammatory properties and this will help in reducing the swelling under the eye due to water retention. Refrigerate the potato for some time and slice it into thin circles. Close the eyes and place the sliced potatoes over the eyes. It should cover the pufed areas of the eye. Leave the potatoes over the eyes for at least 20 minutes. You will fnd a great change in pufness once you remove the potato slices.4.MilkIf you are regularly having pufy eyes in the morning then milk is one of the best remedy to combat it.Milk will help to cool and soothe the tired eyes and also reduces water retention by the tissues under the eyes.Take two cotton pads and dip them in chilled milk. Now place the cotton pads over the eyes and rest for 20-30 minutes. Wash of with cold water to see normal looking eyes. Repeat this remedy for a few days, if you are constantly having this problem.5.Almond OilAlmond oil reduces pufness and dark circles around the eye.The vitamins present in the oil nourish the skin and the oil moisturizes the skin. Take two to three drops of almond oil and apply it under your eye and massage the area lightly using your ring fnger before going to bed. Do not apply pressure while massaging. Massaging improves the blood circulation around the eyes and reduces water retention around the eyes.. !itamin " OilVitamin E is necessary for the skin health and applying vitamin E will help to keep the skin under the eye healthy. This also helps to reduce the swelling around the eyes.Mix few drops of vitamin E oil inchilled water taken in a bowl.Mix it thoroughly. Now dip the cotton pads in this and place it on the eyes. Leave the cotton pads over the eyes for about 20 minutes to reduce swelling under the eyes.#."gg $hiteEgg White has the ability to absorb water and reduce infammations in the body.This is a natural remedy for infammations in the body. This can be used to get rid of the excess water retained under the eye. Beat the egg white till it is stif. Apply this around the eyes using a smooth make up brush or soft cloth.Leave the egg white over the pufed area for 20 minutes. Rinse the face with cold water after 20 minutes. You will see that the area under the eye has become less pufy and tighter.%.Chilled &'oonsThis is another easily available remedy for pufy eyes.Take a glass of chilled water and four stainless steel spoons. Put the spoons in the chilled water for some time. Take out two spoons and place the spoons over the eyes. The chillness will help to constrict the blood vessels and reduce the pufness.Switch the spoons after some time and take the other two chilled spoons and repeat the procedure till there is a reduction in pufness.(.Cold &'lashThis is the most simple way to reduce the under eye bags.In most of the cases pufness of the eye will be caused by the fuid retention under the eyes.This is due to poor circulation of fuids.You canbring back your eyes to the normal condition by splashing cold water on the pufed areas around the eye as well as to the rest of the face.The cold splash will help to correct the fuid circulation and to remove the retained liquid under the eye.Apart from using these natural remedies, you can do certain things to prevent the under eye bags or pufy eyes. Drink plenty of water to remove the toxins from your body. Reduce the intake of sodium. Excess sodium in the body causes water retention in diferent areas of the body. Do not stay up till late night. Do not keep the head bend down for a long time Do exercises to improve blood circulationPREDNISONE5-60 mg/day PO in single daily dose or divided q6-12hr)osing considerations When converting from immediate-release to delayed-release formulation, note that delayed-release formulation taes a!out " hours to release active su!stances #ote that e$ogenous steroids su%%ress adrenal corte$ activity least during ma$imal natural adrenal corte$ activity &!et'een "(00 and )(00 *+,Acute Asthma"0-60 mg/day PO in single daily dose or divided q12hr for --10 days*iant Cell Arteritis"0-60 mg PO q.ay &1-2 years usual duration of treatment,+dio'athic Thromboc,to'enic Pur'ura1-2 mg/g/day POAllergic Conditions.ay 1( 10 mg PO !efore !reafast, 5 mg after lunch and after dinner, and 10 mg at !edtime.ay 2( 5 mg PO !efore !reafast, after lunch, and after dinner and 10 mg at !edtime.ay -( 5 mg PO !efore !reafast, after lunch, after dinner, and at !edtime.ay "( 5 mg PO !efore !reafast, after lunch, and at !edtime.ay 5( 5 mg PO !efore !reafast and at !edtime.ay 6( 5 mg PO !efore !reafast-heumatoid Arthritis/mmediate-release( 010 mg/day PO added to disease-modifying antirheumatic drugs &.+*1.s,.elayed-release( 5 mg/day PO initially2 maintenance( lo'est dosage that maintains clinical res%onse2 may!e taen at !edtime to decrease morning stiffness 'ith rheumatoid arthritisAd.anced Pulmonar,/"0tra'ulmonar, Tuberculosis"0-60 mg/day PO, ta%ered over "-) 'eesPneumoc,stis 1carinii2 3iro.eci Pneumonia in Patients $ith A+)& 1O445label2"0 mg PO q12hr for 5 days, then "0 mg PO q2"hr for 5 days, then 20 mg q2"hr for 11 daysCrohn6s )isease 1O445label2"0-60 mg PO q.ay until resolution and resum%tion of 'eight gain &3-2) days usual duration,Autoimmune 7e'atitis60 mg PO q.ay for 1 'ee2 456# "0 mg q.ay for 1 'ee2 456# -0 mg q.ay for 2 'ees2 follo' !y 20 mg q.ay2 give half this dose if giving in com!inaiton 'ith a7athio%rineAdministration4ae 'ith meal or snac5igh-dose glucocorticoids may cause insomnia2 immediate-release formulation is ty%ically administered inmorning to coincide 'ith circadian rhythm.elayed-release formulation taes a!out " hours to release active su!stances2 thus, 'ith this formulation,timing of dose should tae into account delayed-release %harmacoinetics and disease or condition !eingtreated &eg, may !e taen at !edtime to decrease morning stiffness 'ith rheumatoid arthritis,PREDNISONE TABLETS, 10 mgPREDNISONE TABLETSRx OnlyDESCRIPTIONPrednisone is a glucocorticoid. Glucocorticoids are adrenocortical steroids, ot! naturally occurring and synt!etic, "!ic! are readily asored #ro$ t!e gastrointestinaltract. T!e $olecular #or$ula #or %rednisone is &'()'*O+. &!e$ically, it is (,,'(-di!ydroxy%regna-(, .-diene-/,((, '0-trione and !as t!e #ollo"ing structural #or$ula1Prednisone is a "!ite to %ractically "!ite, odorless, crystalline %o"der and !as a $olecular "eig!t o# /+2.... It $elts at aout '/03& "it! so$e deco$%osition. Prednisone is 4ery slig!tly solule in "ater, slig!tly solule in alco!ol, c!loro#or$, dioxane, and $et!anol.Eac! talet, #or oral ad$inistration, contains + $g or (0 $g o# %rednisone.Inacti4e ingredients1+ $g1 an!ydrous lactose, colloidal silicon dioxide, $agnesiu$ stearate, $icrocrystalline cellulose, sodiu$ starc! glycolate, and talc.(0 $g1 an!ydrous lactose, colloidal silicon dioxide, $agnesiu$ stearate, $icrocrystalline cellulose, sodiu$ starc! glycolate, and talc.CLINICAL PHARMACOLOGYNaturally occurring glucocorticoids 5!ydrocortisone and cortisone6, "!ic! also !a4e salt-retaining %ro%erties, are used as re%lace$ent t!era%y in adrenocortical de#iciency states. T!eir synt!etic analogs, suc! as %rednisone, are %ri$arily used #or t!eir %otent anti-in#la$$atory e##ects in disorders o# $any organ syste$s.Glucocorticoids, suc! as %rednisone, cause %ro#ound and 4aried $etaolic e##ects. In addition, t!ey $odi#y t!e ody7s i$$une res%onse to di4erse sti$uli.INDICATIONS AND USAGEPrednisone talets are indicated in t!e #ollo"ing conditions1Endocrine disorders1 %ri$ary or secondary adrenocortical insu##iciency 5!ydrocortisone or cortisone is t!e #irst c!oice8 synt!etic analogs $ay e used in con9unction "it! $ineralocorticoids "!ere a%%licale8 in in#ancy $ineralocorticoid su%%le$entation is o# %articular i$%ortance6, congenital adrenal !y%er%lasia, nonsu%%urati4e t!yroiditis, !y%ercalce$ia associated "it! cancer.R!eu$atic disorders1 as ad9uncti4e t!era%y #or s!ort-ter$ ad$inistration 5to tide t!e %atient o4er an acute e%isode or exaceration6 in8 %soriatic art!ritis8 r!eu$atoid art!ritis, including 9u4enile r!eu$atoid art!ritis 5selected cases $ay re:uire lo"-dose $aintenance t!era%y68 an;ylosing s%ondylitis8 acute and suacute ursitis8 acute nons%eci#ic tenosyno4itis8 acute gouty art!ritis8 %ost-trau$atic osteoart!ritis8 syno4itiso# osteoart!ritis8 e%icondylitis.&ollagen diseases1 during an exaceration or as $aintenance t!era%y in selected cases o#1 syste$ic lu%us eryt!e$atosus, syste$ic der$ato$yositis 5%oly$yositis6, acute r!eu$atic carditis.Der$atologic diseases1 %e$%!igus, ullous der$atitis !er%eti#or$is, se4ere eryt!e$a $ulti#or$e 5Ste4ens-INISTRATION6.Since co$%lications o# treat$ent "it! glucocorticoids are de%endent on t!e si=e o# t!edose and t!e duration o# treat$ent, a ris;Aene#it decision $ust e $ade in eac! indi4idual case as to dose and duration o# treat$ent and as to "!et!er daily or inter$ittent t!era%y s!ould e used.&on4ulsions !a4e een re%orted "it! concurrent use o# $et!yl%rednisolone and cyclos%orin. Since concurrent use o# t!ese agents results in a $utual in!iition o# $etaolis$, it is %ossile t!at ad4erse e4ents associated "it! t!e indi4idual use o# eit!er drug $ay e $ore a%t to occur.Drg In!era"!#$n%T!e %!ar$aco;inetic interactions listed elo" are %otentially clinically i$%ortant. Drugs t!at induce !e%atic en=y$es suc! as %!enoarital, %!enytoin and ri#a$%in $ay increase t!e clearance o# corticosteroids and $ay re:uire increases in corticosteroid dose to ac!ie4e t!e desired res%onse. Drugs suc! as troleando$ycin and;etocona=ole $ay in!iit t!e $etaolis$ o# corticosteroids and t!us decrease t!eir clearance. T!ere#ore, t!e dose o# corticosteroid s!ould e titrated to a4oid steroid toxicity. &orticosteroids $ay increase t!e clearance o# c!ronic !ig! dose as%irin. T!is could lead to decreased salicylate seru$ le4els or increase t!e ris; o# salicylate toxicity "!en corticosteroid is "it!dra"n. As%irin s!ould e used cautiously in con9unction "it! corticosteroids in %atients su##ering #ro$ !y%o%rot!ro$ine$ia. T!ee##ect o# corticosteroids on oral anticoagulants is 4ariale. T!ere are re%orts o# en!anced as "ell as di$inis!ed e##ects o# anticoagulants "!en gi4en concurrently "it! corticosteroids. T!ere#ore, coagulation indices s!ould e $onitored to $aintain t!e desired anticoagulant e##ect.In&$rma!#$n &$r Pa!#en!%Persons "!o are on i$$unosu%%ressant doses o# corticosteroids s!ould e "arned to a4oid ex%osure to c!ic;en%ox or $easles. Patients s!ould also e ad4ised t!at i# t!ey are ex%osed, $edical ad4ice s!ould e soug!t "it!out delay.AD'ERSE REACTIONSDluid and electrolyte disturances1 sodiu$ retention, #luid retention, congesti4e !eart #ailure in susce%tile %atients, %otassiu$ loss, !y%o;ale$ic al;alosis, !y%ertension.>usculos;eletal1 $uscle "ea;ness, steroid $yo%at!y, loss o# $uscle $ass, osteo%orosis, tendon ru%ture, %articularly o# t!e Ac!illes tendon, 4erteral co$%ression #ractures, ase%tic necrosis o# #e$oral and !u$eral !eads, %at!ological #racture o# long ones.Gastrointestinal1 %e%tic ulcer "it! %ossile %er#oration and !e$orr!age, %ancreatitis, ado$inal distention, ulcerati4e eso%!agitis, increases in alanine transa$inase 5ALT, SGPT6, as%artate transa$inase 5AST, SGOT6 and al;aline %!os%!atase !a4e een oser4ed #ollo"ing corticosteroid treat$ent. T!ese c!anges are usually s$all, not associated "it! any clinical syndro$e are re4ersile u%on discontinuation.Der$atologic1 i$%aired "ound !ealing, t!in #ragile s;in, %etec!iae and ecc!y$oses, #acial eryt!e$a, increased s"eating, $ay su%%ress reactions to s;in tests.Neurological1 con4ulsions, increased intracranial %ressure "it! %a%illede$a 5%seudo-tu$or cereri6 usually a#ter treat$ent, 4ertigo, !eadac!e.Endocrine1 $enstrual irregularities8 de4elo%$ent o# &us!ingoid state8 su%%ression o# gro"t! in c!ildren8 secondary adrenocortical and %ituitary unres%onsi4eness, %articularly in ti$es o# stress, as in trau$a, surgery or illness8 decreased caro!ydrate tolerance8 $ani#estations o# latent diaetes $ellitus8 increased re:uire$ents #or insulin or oral !y%oglyce$ic agents in diaetics.O%!t!al$ic1 %osterior suca%sular cataracts, increased intraocular %ressure, glauco$a,exo%!t!al$os.>etaolic1 negati4e nitrogen alance due to %rotein cataolis$.Additional reactions1 Erticaria, and ot!er allergic, ana%!ylactic or !y%ersensiti4ity reactions.DOSAGE AND ADMINISTRATIONDosage o# %rednisone talets s!ould e indi4iduali=ed according to t!e se4erity o# t!e disease and t!e res%onse o# t!e %atient. Dor in#ants and c!ildren, t!e reco$$ended dosage s!ould e go4erned y t!e sa$e considerations rat!er t!an strict ad!erence to t!e ratio indicated y age or ody "eig!t.)or$one t!era%y is an ad9unct to, and not a re%lace$ent #or con4entional t!era%y.Dosage s!ould e decreased or discontinued gradually "!en t!e drug !as een ad$inistered #or $ore t!an a #e" days.T!e se4erity, %rognosis, ex%ected duration o# t!e disease, and t!e reaction o# t!e %atient to $edication are %ri$ary #actors in deter$ining dosage.I# a %eriod o# s%ontaneous re$ission occurs in a c!ronic condition, treat$ent s!ould e discontinued.Blood %ressure, ody "eig!t, routine laoratory studies, including t"o-!our %ost%randial lood glucose and seru$ %otassiu$, and a c!est F-ray s!ould e otained at regular inter4als during %rolonged t!era%y. E%%er Gl F-rays are desirale in %atients "it! ;no"n or sus%ected %e%tic ulcer disease.T!e initial dosage o# %rednisone $ay 4ary #ro$ + $g to *0 $g %er day, de%ending on t!e s%eci#ic disease entity eing treated. In situations o# less se4erity lo"er doses "ill generally su##ice, "!ile in selected %atients !ig!er initial doses $ay e re:uired. T!e initial dosage s!ould e $aintained or ad9usted until a satis#actory res%onse is noted. I# a#ter a reasonale %eriod o# ti$e t!ere is a lac; o# satis#actory clinical res%onse, %rednisone s!ould e discontinued and t!e %atient trans#erred to ot!er a%%ro%riate t!era%y. IT S)OELD BE E>P)ASICED T)AT DOSAGE REGEIRE>ENTS ARE BARIABLE AND >EST BE INDIBIDEALICED ON T)E BASIS OD T)E DISEASE ENDER TREAT>ENT AND T)E RESPONSE OD T)E PATIENT. A#ter a #a4orale res%onse is noted, t!e %ro%er $aintenance dosage s!ould e deter$ined ydecreasing t!e initial drug dosage in s$all decre$ents at a%%ro%riate ti$e inter4als until t!e lo"est dosage "!ic! "ill $aintain an ade:uate clinical res%onse is reac!ed. It s!ould e ;e%t in $ind t!at constant $onitoring is needed in regard to drug dosage. Included in t!e situations "!ic! $ay $a;e dosage ad9ust$ent necessary are c!anges in clinical status secondary to re$issions or exacerations in t!e disease %rocess, t!e %atient7s indi4idual drug res%onsi4eness, and t!e e##ect o# %atient ex%osure to stress#ulsituations not directly related to t!e disease entity under treat$ent8 in t!is latter situation it $ay e necessary to increase t!e dosage o# %rednisone #or a %eriod o# ti$e consistent "it! t!e %atient7s condition. I# a#ter long-ter$ t!era%y t!e drug is to e sto%%ed, it is reco$$ended t!at it e "it!dra"n gradually rat!er t!an aru%tly.>ulti%le SclerosisIn t!e treat$ent o# acute exacerations o# $ulti%le sclerosis daily doses o# '00 $g o# %rednisolone #or a "ee; #ollo"ed y 20 $g e4ery ot!er day #or ( $ont! !a4e een s!o"n to e e##ecti4e. 5Dosage range is t!e sa$e #or %rednisone and %rednisolone.6ADTH 5Alternate Day T!era%y6ADT is a corticosteroid dosing regi$en in "!ic! t"ice t!e usual daily dose o# corticoid is ad$inistered e4ery ot!er $orning. T!e %ur%ose o# t!is $ode o# t!era%y is to %ro4ide t!e %atient re:uiring long-ter$ %!ar$acologic dose treat$ent "it! t!e ene#icial e##ects o# corticoids "!ile $ini$i=ing certain undesirale e##ects, including%ituitary-adrenal su%%ression, t!e &us!ingoid state, corticoid "it!dra"al sy$%to$s, and gro"t! su%%ression in c!ildren.T!e rationale #or t!is treat$ent sc!edule is ased on t"o $a9or %re$ises1 5a6 t!e anti-in#la$$atory or t!era%eutic e##ect o# corticoids %ersists longer t!an t!eir %!ysical %resence and $etaolic e##ects and 56 ad$inistration o# t!e corticosteroid e4ery ot!er$orning allo"s #or re-estalis!$ent o# $ore nearly nor$al !y%ot!ala$ic-%ituitary-adrenal 5)PA6 acti4ity on t!e o##-steroid day.A rie# re4ie" o# t!e )PA %!ysiology $ay e !el%#ul in understanding t!is rationale. Acting %ri$arily t!roug! t!e !y%ot!ala$us a #all in #ree cortisol sti$ulates t!e %ituitary gland to %roduce increasing a$ounts o# corticotro%in 5A&T)6 "!ile a rise in #ree cortisol in!iits A&T) secretion. Nor$ally t!e )PA syste$ is c!aracteri=ed y diurnal 5circadian6 r!yt!$. Seru$ le4els o# A&T) rise #ro$ a lo" %oint aout (0 %$ to a %ea; le4el aout * a$. Increasing le4els o# A&T) sti$ulate adrenocortical acti4ity resulting in a rise in %las$a cortisol "it! $axi$al le4els occurring et"een ' a$ and 2 a$. T!is rise in cortisol da$%ens A&T) %roduction and in turn adrenocortical acti4ity. T!ere is a gradual #all in %las$a corticoids during t!e day "it!lo"est le4els occurring aout $idnig!t.T!e diurnal r!yt!$ o# t!e )PA axis is lost in &us!ing7s disease, a syndro$e o# adrenocortical !y%er#unction c!aracteri=ed y oesity "it! centri%etal #at distriution,t!inning o# t!e s;in "it! easy ruisaility, $uscle "asting "it! "ea;ness, !y%ertension, latent diaetes, osteo%orosis, electrolyte i$alance, etc. T!e sa$e clinical #indings o# !y%eradrenocorticis$ $ay e noted during long-ter$ %!ar$acologic dose corticoid t!era%y ad$inistered in con4entional daily di4ided doses. It "ould a%%ear, t!en, t!at a disturance in t!e diurnal cycle "it! $aintenance o# ele4ated corticoid 4alues during t!e nig!t $ay %lay a signi#icant role in t!e de4elo%$ent o# undesirale corticoid e##ects. Esca%e #ro$ t!ese constantly ele4ated %las$a le4els #or e4en s!ort %eriods o# ti$e $ay e instru$ental in %rotecting against undesirale %!ar$acologic e##ects.During con4entional %!ar$acologic dose corticosteroid t!era%y, A&T) %roduction is in!iited "it! suse:uent su%%ression o# cortisol %roduction y t!e adrenal cortex. Reco4ery ti$e #or nor$al )PA acti4ity is 4ariale de%ending u%on t!e dose and duration o# treat$ent. During t!is ti$e t!e %atient is 4ulnerale to any stress#ul situation. Alt!oug! it !as een s!o"n t!at t!ere is consideraly less adrenal su%%ression #ollo"ing a single $orning dose o# %rednisolone 5(0 $g6 as o%%osed to a :uarter o# t!at dose ad$inistered e4ery * !ours, t!ere is e4idence t!at so$e su%%ressi4e e##ect on adrenal acti4ity $ay e carried o4er into t!e #ollo"ing day "!en%!ar$acologic doses are used. Durt!er, it !as een s!o"n t!at a single dose o# certain corticosteroids "ill %roduce adrenocortical su%%ression #or t"o or $ore days. Ot!er corticoids, including $et!yl%rednisolone, !ydrocortisone, %rednisone, and %rednisolone, are considered to e s!ort acting 5%roducing adrenocortical su%%ression #or ( I to ( J days #ollo"ing a single dose6 and t!us are reco$$ended #or alternate day t!era%y.T!e #ollo"ing s!ould e ;e%t in $ind "!en considering alternate day t!era%y1(6 Basic %rinci%les and indications #or corticosteroid t!era%y s!ould a%%ly. T!e ene#its o# ADT s!ould not encourage t!e indiscri$inate use o# steroids.'6 ADT is a t!era%eutic tec!ni:ue %ri$arily designed #or %atients in "!o$ long-ter$ %!ar$acologic corticoid t!era%y is antici%ated./6 In less se4ere disease %rocesses in "!ic! corticoid t!era%y is indicated, it $ay e %ossile to initiate treat$ent "it! ADT. >ore se4ere disease states usually "ill re:uiredaily di4ided !ig! dose t!era%y #or initial control o# t!e disease %rocess. T!e initial su%%ressi4e dose le4el s!ould e continued until satis#actory clinical res%onse is otained, usually #our to ten days in t!e case o# $any allergic and collagen diseases. Itis i$%ortant to ;ee% t!e %eriod o# initial su%%ressi4e dose as rie# as %ossile %articularly "!en suse:uent use o# alternate day t!era%y is intended. Once control !as een estalis!ed, t"o courses are a4ailale1 5a6 c!ange to ADT and t!en gradually reduce t!e a$ount o# corticoid gi4en e4ery day or 56 #ollo"ing control o# t!e disease %rocess reduce t!e daily dose o# corticoid to t!e lo"est e##ecti4e le4el as ra%idly as %ossile and t!en c!ange o4er to an alternate day sc!edule. T!eoretically, course 5a6 $ay e %re#erale..6 Because o# t!e ad4antages o# ADT, it $ay e desirale to try %atients on t!is #or$ o# t!era%y "!o !a4e een on daily corticoids #or long %eriods o# ti$e 5eg, %atients "it! r!eu$atoid art!ritis6. Since t!ese %atients $ay already !a4e a su%%ressed )PA axis, estalis!ing t!e$ on ADT $ay e di##icult and not al"ays success#ul. )o"e4er, it is reco$$ended t!at regular atte$%ts e $ade to c!ange t!e$ o4er. It $ay e !el%#ul to tri%le or e4en :uadru%le t!e daily $aintenance dose and ad$inister t!is e4ery ot!er day rat!er t!an 9ust douling t!e daily dose i# di##iculty is encountered. Once t!e %atient is again controlled, an atte$%t s!ould e $ade to reduce t!is dose to a $ini$u$.+6 As indicated ao4e, certain corticosteroids, ecause o# t!eir %rolonged su%%ressi4e e##ect on adrenal acti4ity, are not reco$$ended #or alternate day t!era%y 5eg, dexa$et!asone and eta$et!asone6.*6 T!e $axi$al acti4ity o# t!e adrenal cortex is et"een ' a$ and 2 a$, and it is $ini$al et"een . %$ and $idnig!t. Exogenous corticosteroids su%%ress adrenocortical acti4ity t!e least, "!en gi4en at t!e ti$e o# $axi$al acti4ity 5a$6.,6 In using ADT it is i$%ortant, as in all t!era%eutic situations to indi4iduali=e and tailor t!e t!era%y to eac! %atient. &o$%lete control o# sy$%to$s "ill not e %ossile in all %atients. An ex%lanation o# t!e ene#its o# ADT "ill !el% t!e %atient to understand and tolerate t!e %ossile #lare-u% in sy$%to$s "!ic! $ay occur in t!e latter %art o# t!e o##-steroid day. Ot!er sy$%to$atic t!era%y $ay e added or increased at t!is ti$e i# needed.26 In t!e e4ent o# an acute #lare-u% o# t!e disease %rocess, it $ay e necessary to return to a #ull su%%ressi4e daily di4ided corticoid dose #or control. Once control is again estalis!ed alternate day t!era%y $ay e re-instituted.K6 Alt!oug! $any o# t!e undesirale #eatures o# corticosteroid t!era%y can e $ini$i=ed y ADT, as in any t!era%eutic situation, t!e %!ysician $ust care#ully "eig!t!e ene#it-ris; ratio #or eac! %atient in "!o$ corticoid t!era%y is eing considered.Prednisone Side Efects: Deal With The Devil?Prednisone is a valuable medication for many serious conditions, butit can also carry grave consequences including sychological reactions!ext day, didn!t hurt to the touch anymore. >ew side effect : rash from head to toe and severe indigestion. ?ollowing day, rash subsiding, indigestion getting better. -till feeling a bit loopy, but I am told by next wee* I should be bac* to myself again.I am warning everyone i *now not to ever ta*e a steroid unless your life is in danger. It is a very scary feeling : all for a sinus infection.:)%-I!m having Prednisone side effects. %y doctor prescribed this drug last Thursday. -he prescribed ;@ @>0 should ever stop ta*ing a drug li*e prednisone suddenly. It must be phased off gradually under medical supervision.&ther side efects associated %ith corticosteroids li"e Prednisone ?luid retention, edema Insomnia Irritability, nervousness, mood swings, mania, depression, psychosis $isorientation, confusion "ypertension Boss of potassium "eadache $i11iness, vertigo %uscle wea*ness ,lood sugar elevation (diabetes) Irregular menstrual cycles -wollen face "air growth (including on the face) Itching, rash, hives Increased susceptibility to infection Cea*ened bones (osteopenia, osteoporosis) Tendon rupture /laucoma #ataracts FlcersThe higher the dose and the longer someone ta*es a drug li*e prednisone the more li*ely there will be side effects. %a*e sure your physician is monitoring things li*e potassium, blood sugar, bone density and psychological well being. )nd never stop a corticosteroid suddenly9Share this ost: FACEBOOK TWITTER GOOGLE+TA*&8 (re)n#%$ne'elated Peole(s Pharmacy )ealth *uide+lternatives for +rthritisOnlyL')ccording to the )rthritis ?oundation, =< million )mericans (one inthree adults) suffer from arthritis. Prescribed medications have potential side effects, but there are ways to cope with the pain.*"T *9+)",oin &ver -.,/// Subscribers at ThePeole(s Pharmacy0ach wee* we send two free email newsletters with brea*ing health news, prescription drug information, home remedies and a preview of our award+winning radio show. Goin our mailing list and get the information you need to ma*e confident choices about your health.0-1 Thoughts SharedA)) M: T7O9*7T&(.,2334+'255E+66&7E#5E' 80, 0/8. +T 9:/. +#Reply)fter contracting #hicangunya, with one wee* of fever and agoni1ing &oint pain, followed by A wee*s of debilitating, persistent &oint pain, ma*ing it very painful to wal*, stand up, roll over in bed, etc.)ll the literature indicates there is no cure for #hi*angunya, only pain relief with aspirin and Ibuprofen. These helped my pain, but gave no improvement to range of movement or severe &oint swelling.)fter H wee*s I went to my $r. and he prescribed a 2H day course of Prednisone. Cithin hours of the first tablet, I experienced profound and complete relief from all &oint symptoms, feel li*e a woman reborn.>ow, reading of possible side effects I am concerned about what will happen after I am off the drug. ?or now, I am pain free, energetic, feeling great, though suffering insomnia.'.D&62S #!W23DW&&D, :36&7E#5E' 8/, 0/8. +T 8/:8/ P#ReplyThis is my ;nd. .ound of this medicine ( first time to repair myhearing that was damaged due to 0ncephilits in ;