Steroids
Prednisone is a corticosteroid. If indicated, you will be asked
to take 5 or 10 mg orally twice a day upon confirmation of pregnancy
(patients with immune mediated infertility may be on a different
schedule). Drug dosage may be adjusted depending upon follow-up
blood tests. Allergy to prednisone is rare, as the human body
manufactures a similar compound. In fact prednisone is used
to treat moderate to life threatening allergies. Possible adverse
reaction to moderate and high doses of prednisone include fluid
and electrolyte imbalance; metabolic disturbances e.g. hyperglycemia
or gestational diabetes and osteoporosis; susceptibility to
infection; peptic ulcer; behavioral changes e.g. nervousness,
insomnia, irritability and mood swings; myopathy; and cataracts.
Prednisone should be used with caution in people with hypertension,
congestive heart failure, diabetes mellitus, osteoporosis, ulcerative
colitis, ocular herpes and others (please consult with doctor
if you have any chronic illness). Osteoporosis can be retarded
with calcium supplementation and exercise. Rapid withdrawal
of prednisone may cause fatigue, myalgias, arthralgias, dizziness,
hypotension, hypoglycemia and dyspnea. If you experience these
symptoms, please contact your doctor. There are a number of
studies that review the use of prednisone during pregnancy and
effects on the fetus. The fetus appears to be protected by at
least three mechanisms: 1) enzymes in the placenta degrade the
drug to an inactive form, 2) prednisone in maternal circulation
is bound to a large protein making it harder to cross the placenta
and 3) fetal liver is not able to activate prednisone until
the end of the second trimester. Trace amounts of prednisone
have been measured in breast milk. Although these quantities
are of doubtful clinical significance, your baby's pediatrician
should be notified. Laboratory studies to monitor while on prednisone
include complete blood count, chemistries, electrolytes and
antinuclear antibody panel. (Source: Reproductive Immunology
Associates website, 2001) ebsite,
2001)
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