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To prevent steroid-induced osteoporosis, the steroid dose and duration should be as low and as short as possible. All patients on long term glucocorticoids (≥3 months) should be encouraged to do weightbearing exercise, avoid smoking and excess alcohol and take fall prevention measures. Daily calcium and vitamin d intake should be sufficient.
Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
Prednisone is a glucocorticoid medication mostly used to suppress the immune system and decrease inflammation in conditions such as asthma, COPD, and rheumatologic diseases. [3] It is also used to treat high blood calcium due to cancer and adrenal insufficiency along with other steroids . [ 3 ]
Prednisolone is a synthetic pregnane corticosteroid closely related to its cognate prednisone, having identical structure save for two fewer hydrogens near C 11. It is also known as δ 1 -cortisol , δ 1 -hydrocortisone , 1,2-dehydrocortisol , or 1,2-dehydrohydrocortisone , as well as 11β,17α,21-trihydroxypregna-1,4-diene-3,20-dione .
The WHO Model List of Essential Medicines (aka Essential Medicines List or EML [1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health system. [2]
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R-Maxi-CHOP is used in mantle cell lymphoma and is given in 21-day intervals, alternating with R-HDAC (rituximab + high-dose cytarabine). [ 3 ] In most other non-Hodgkin lymphomas (excluding some aggressive forms), standard-dose [R]-CHOP is generally used as first-line therapy.
In a prospective study, the cumulative incidence of CIL with high-dose prednisone therapy was found to be 61% after 3 months, 65% after 6 months, 68% after 9 months, and 69% after 12 months. [1] One study found that even a very low dosage of prednisone of 5 mg/day was associated with symptoms of "Cushing's syndrome". [ 1 ]