Prednisolone

The role of corticosteroids has been studied in the IMPI trial, a large trial in Africa.

Prednisolone did not reduce the combined outcome of death, tamponade, and constriction overall, but it did reduce the incidence of constriction by roughly half.

However, it increased the risk of certain cancers in patients with HIV infection, so many experts consider adjunctive steroids in HIV-negative patients with large effusions or high inflammatory activity to reduce the risk of constriction.

Draining large effusions completely and, in some centers, using intrapericardial fibrinolysis may also reduce constriction.

Mm.

But there's always risks with every medication that patients take, okay? Prednisolone indeed might immunosuppress patients, so they might be more exposed to virus, bacteria, et cetera.

And it doesn't mean that they need to go in confinement or isolation once, whilst they're taking the prednisolone tablets, but they do need to be more careful because it's not only them, it's a baby that they're potentially carrying at the same time.

Mm.

Not only that, but prednisolone as well has been associated with preeclampsia, IUGR in pregnancies.

Prednisolone-

Mm

...

These are, you're going to be taking these hopefully fairly short term, so they shouldn't cause a big effect, but they can worsen your insulin resistance.

The next drug class is corticosteroids like Deltazone, Prednisone, Methylprednisolone and Prednisolone.

You would typically hope to take these short term for an inflammatory disorder.

But many people take these long-term and even though they're trying to improve their diet, their insulin resistance won't improve and this is why.

So starting from day two for seven days, blood test 7 a.m., 10 milligrams of – sorry, 15 milligrams of prednisolone a day, little tiny steroids, so a lot of – I know I've got a client going through cancer at the moment.

He has to have them too.

Prednisolone is basically a steroid that stops the side effects of IVF drugs, my understanding of this is, and basically it cools my body down, basically makes it calmer, makes it absorb the medication better, just makes it better.

So that starts.

Literal devil steroids, if you have to have these.

And I think, again, you know, talking about the use of steroids, steroids are so valuable in otitis externa.

Prednisolone is really useful.

Topical steroids are really useful.

And although we've got these fabulous drugs in the form of our JAK inhibitors and our monoclonals, steroids really are the drugs that dig us out of holes so often when we're managing ear disease.