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Prednisolone has a relatively short half-life, ranging 2–4 hours. It also has a large therapeutic window, considering the dosage required to produce a therapeutic effect is a few times higher than what the body naturally produces. [14] Prednisolone is 70–90% plasma protein bound, it binds to proteins such as albumin. [14]
The neuropsychiatric effects are partly mediated by sensitization of the body to the actions of adrenaline. Therapeutically, the bulk of corticosteroid dose is given in the morning to mimic the body's diurnal rhythm; if given at night, the feeling of being energized will interfere with sleep. An extensive review is provided by Flores and Gumina ...
A separate list for children up to 12 years of age, known as the WHO Model List of Essential Medicines for Children (EMLc), was created in 2007 and is in its 9th edition. [ 10 ] [ 21 ] [ 22 ] [ 23 ] It was created to make sure that the needs of children were systematically considered such as availability of proper formulations .
The selection and use of essential medicines: report of the WHO Expert Committee, 2017 (including the 20th WHO Model List of Essential Medicines and the 6th Model List of Essential Medicines for Children). Geneva: World Health Organization. hdl: 10665/259481. ISBN 978-92-4-121015-7. ISSN 0512-3054. WHO technical report series; no. 1006.
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.
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[57] [needs update] Prednisone is usually prescribed at a dose of 60 mg/m 2 of body surface area/day in a first treatment for 4–8 weeks. After this period the dose is reduced to 40 mg/m 2 for a further 4 weeks. People experiencing a relapse or children are treated with prednisolone 2 mg/kg/day until urine becomes negative for protein.
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