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Clark's rule is a medical term referring to a mathematical formula used to calculate the proper dosage of medicine for children aged 2–17 based on the weight of the patient and the appropriate adult dose. [1] The formula was named after Cecil Belfield Clarke (1894–1970), a Barbadian physician who practiced throughout the UK, the West Indies ...
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. [50] [51]
Prednisone is a synthetic glucocorticoid used for its anti-inflammatory and immunosuppressive properties. [36] [37] Prednisone is a prodrug; it is metabolised in the liver by 11-β-HSD to prednisolone, the active drug. Prednisone has no substantial biological effects until converted via hepatic metabolism to prednisolone. [38]
Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Then change to oral hydrocortisone or cortisone as a single morning dose, and gradually decrease by 2.5 mg each week. When the morning dose is less than replacement, the return of normal basal adrenal function may be documented by checking 0800 cortisol levels prior to the morning dose; stop drugs when 0800 cortisol is 10 μg/dl.
Continuing the maintenance dose for about 4 to 5 half-lives (t 1/2) of the drug will approximate the steady state level. [1] One or more doses higher than the maintenance dose can be given together at the beginning of therapy with a loading dose. [2] A loading dose is most useful for drugs that are eliminated from the body relatively slowly ...
Serious side effects include iatrogenic Cushing's syndrome, hypertension, osteoporosis, diabetes, infection, and skin atrophy. [9] Chemically, methylprednisolone is a synthetic pregnane steroid hormone derived from hydrocortisone and prednisolone. It belongs to a class of synthetic glucocorticoids and more generally, corticosteroids. It acts as ...
Taper dose by half per day to maintenance level. Pediatric doses ... 50 mg for children >3 yrs – 12 years; 100 mg for children 12 years and older. References
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