The difference between Prednisolone and Dexamethasone

Glucocorticosteroids have a powerful effect on the human body. They have high biological activity, so they are often used in emergency situations, with threats of life. Treatment of almost all serious diseases is carried out with the help of steroid drugs. Dexamethasone and Prednisolone are artificially manufactured analogues of hydrocortisone - one of the most potent natural glucocorticoids.

Mechanism of action of

preparations Both preparations are available in tablets and ampoules in the form of a solution. This allows you to use different ways of getting the medicine into the body: enteral and parenteral. Glucocorticosteroids affect the entire body as a whole and change metabolic processes.

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Prednisolone

Prednisolone has a pronounced anti-inflammatory effect, due to its ability to suppress the work of leukocytes and macrophages, and prevent their movement to the site of inflammation. In addition, the drug does not give immunity to absorb cells and secrete interleukin.

The effect on fat metabolism lies in the fact that prednisolone does not allow fat cells to fully capture glucose, this leads to lipolysis. But because of the high sugar content in the blood, insulin production is stimulated, and as a result, lipogenesis processes are activated, fat accumulation takes place.

Prednisolone, in contrast to dexamethasone, lessens the water-electrolyte metabolism to a lesser extent. It promotes the excretion of potassium and calcium, but delays water and sodium. The antiallergic effect is provided by the ability of the drug to reduce the number of basophils, as well as to inhibit the production of biologically active components.

Dexamethasone

Dexamethasone has a similar effect, but with a different mechanism of action. The drug stimulates an increase in the number of triglycerides and fatty acids, contributes to the increase of cholesterol in the blood. With prolonged admission, a redistribution of the subcutaneous fat base is possible. Fat moves to the upper part of the body and is localized mainly on the hands, face and stomach.

Like Prednisolone, Dexamethasone promotes hyperglycemia, that is, an elevated level of sugar. But in this case, this is not due to the effect on fat cells, but due to the activation of the excretion of glucose into the blood from the liver depot. On the electrolyte-water balance, both drugs act almost identically, but Dexamethasone has a great influence.

Inflammation drug removes by inhibiting eosinophils and mast cells, as well as by increasing the stability of membranes. The antiallergic effect is the same as that of Prednisolone.

When prednisalone and dexamethasone are used

Glucocorticosteroid drugs are used as a substitute, suppressive and pharmacodynamic therapy. The first resort to diseases, which are accompanied by a decrease in natural GCS.To the second for the purpose of suppressing the production of other hormones. Pharmacodynamic treatment, in fact, is symptomatic, since it is rare when steroids are able to eliminate the cause of the disease, but they are excellent at coping with unpleasant manifestations.

Prednisolone is preferred in the following cases:

• collagenoses, that is extensive damage to blood vessels or connective tissue;
• polyarthritis;
• rheumatic fever;
• Addison's disease;
• infectious mononucleosis;
• bronchial asthma;
• allergic and inflammatory eye injuries;
• anemia associated with hemolysis of erythrocytes;
• acute pancreatitis or exacerbation of chronic;
• suppression of immunity after transplantation;
• emergency conditions such as shock or collapse.

In some situations, the choice is made in favor of dexamethasone, for example in multiple sclerosis. Also, it is more often than other similar drugs used when:

• severe infections;
• asthmatic status;
• septicemia;
• anaphylactic reactions;
• toxemia;
• strong pyrogenic responses of the body;
• peritonitis;
• of eclampsia.

Methods of application

The dose is always selected individually. It is important to remember that glucocorticosteroids are strong substances, therefore only a qualified specialist can prescribe a course of treatment. Taking medication should be under the supervision of a doctor.

The average dose of prednisolone during acute conditions is approximately 20-30 mg, which is divided into several doses during the day. The initial dosage can also be up to 30 mg. With further use, the amount of Prednisolone should not exceed 5-10 mg. The child's dosage is 1 mg per 1 kg of body weight.

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During emergency situations, for example, with shock or brain edema, it is allowed to increase the single dose to 60-90 mg. In such cases, prednisolone is administered into the body with the help of a dropper or slowly jet.

At the beginning of the illness or during an exacerbation a large amount of Dexamethasone is used, but then it is gradually reduced. For example, with multiple sclerosis, Dexamethasone is dripped in a dosage of 10-20 mg initially, and on the third day, the dose is reduced to 2-5 mg. Unlike Prednisolone, this drug is used in a smaller amount. Usually the average dose is 2-4 mg.

During long-term use of GCS, it is recommended to carefully monitor the electrolyte-water state of the body. It is also desirable to regularly take blood tests, urine and feces. Especially it is worth paying attention to the sugar level in the patient. Usually, in order to prevent hypokalemia, simultaneously in glucocorticoids prescribe potassium preparations.

Important! It should be remembered that you should stop taking the drug very carefully and gradually to avoid withdrawal symptoms.

What to choose?

Although prednisolone and dexamethasone belong to one group of drugs, their effect on the body is different. Therefore, you should entrust the choice to a specialist who knows all the nuances of taking these drugs.