프레드니솔론
Prednisolone
Prednisolone acetate, Prednisolone sodium phosphate
다른 이름: Pred Forte · Pred Mild · Econopred Plus · Mydrapred · PLT · Prednicare · Prednidale · Prednisolone acetate · Prednisolone sodium phosphate · Prednisolonum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Medical management of insulinoma after stabilization of hypoglycemic crisis
- divided q12h
반드시 함께 고려할 임상 맥락 (3)
- Once hypoglycemic crisis stabilized
- may need to increase dose over time
- Ideal to use H2 blocker concurrently
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
프레드니솔론은 수의학에서 널리 사용되는 강력한 중간 작용형 합성 코르티코스테로이드입니다. 안과에서는 전포도막염 치료에 있어 가장 효과적인 약물이자 표준 치료제로 간주됩니다.
제형에 따라 임상적으로 중요한 차이가 있습니다:
- 프레드니솔론 아세트산염: 현탁액으로 제조됩니다. 우수한 항염증 활성을 가지며, 손상되지 않은 각막을 통해 눈의 전안부로 매우 우수하게 침투하여 덱사메타손 제품보다 뛰어난 효과를 보입니다.
- 프레드니솔론 인산나트륨: 용액으로 제조됩니다. 온전한 각막을 통과하는 능력은 아세트산염 형태보다 떨어지지만 안구 표면의 염증에 유용합니다.
임상 팁: 눈에 국소적으로 투여하더라도 비루관과 결막 혈관을 통해 전신으로 흡수될 수 있습니다. 소형 동물(20kg 미만)의 경우 빈번한 투여가 당뇨병 조절의 불안정화를 포함한 전신 부작용을 유발할 수 있습니다.
작용 기전
Prednisolone exerts its effects by diffusing across cell membranes and binding to specific cytosolic glucocorticoid receptors.
The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on DNA → alters gene transcription.
Mechanistically, it induces the synthesis of lipocortin-1 (annexin-1), which inhibits the enzyme phospholipase A2. This inhibition prevents the release of arachidonic acid from membrane phospholipids, thereby potently shutting down the downstream synthesis of inflammatory mediators, including prostaglandins and leukotrienes.
안전성·주의사항
금기사항
- Corneal ulcers (absolute contraindication for topical use)
- Ocular viral infections (e.g., Feline Herpesvirus-1)
- Ocular fungal infections
- Use with extreme caution in patients with uncontrolled diabetes mellitus or systemic infectious diseases
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Ulcerative keratitis (topical ophthalmic use)
- Systemic fungal infections
- Concurrent NSAID administration
부작용
- Systemic absorption leading to iatrogenic hyperadrenocorticism (PU/PD/PP, panting, alopecia)
- Insulin resistance and destabilization of diabetes mellitus
- Delayed corneal healing
- Potentiation or exacerbation of ocular infections (bacterial, viral, fungal)
- Corneal degeneration or calcification (with long-term topical use)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Proteinuria and glomerular changes (dogs)
- Weight loss and muscle atrophy (catabolic effects)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome)
- Vomiting and diarrhoea
- Gastrointestinal ulceration
- Hyperglycaemia
- Decreased serum T4 values
- Impaired wound healing
- Delayed recovery from infections
- Polyuria/polydipsia (PU/PD)
- Polyphagia
- Immunosuppression
- Muscle wasting
주의
Important Warning: Subconjunctival and topical steroids can be absorbed systemically. Use with extreme caution in patients with endocrinopathies (e.g., diabetes mellitus) or infectious diseases.
Even frequent topical steroid application in small animal patients under 20 kg can cause difficulties with diabetes mellitus regulation. Once the peak inflammatory response has been suppressed, consider transitioning to nonsteroidal anti-inflammatory drugs (NSAIDs) for ongoing maintenance treatment to minimize systemic steroid exposure.
약물 상호작용
Concurrent use may increase the risk of delayed corneal healing or corneal melting, though sometimes used together cautiously for severe inflammation.
Systemically absorbed prednisolone antagonizes insulin, increasing blood glucose and complicating diabetes regulation.
Increased risk of gastrointestinal ulceration if significant systemic absorption of prednisolone occurs.
Increased risk of gastrointestinal ulceration
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Increased risk of hypokalaemia
Enhanced metabolism of corticosteroids
Enhanced metabolism of corticosteroids
Decreased metabolism of corticosteroids
Synergistic immunosuppression; may alter pharmacokinetics
모니터링
- Resolution of clinical signs of uveitis (aqueous flare, miosis, pain, photophobia)
- Intraocular pressure (IOP) to monitor for secondary glaucoma
- Fluorescein staining (to ensure no corneal ulceration develops)
- Blood glucose and water intake/urine output in diabetic or small patients
- Clinical response to therapy
- Haematocrit (in cases of IMHA)
- Blood glucose (risk of hyperglycaemia)
- Serum T4 values (may be decreased)
- Renal parameters and urinalysis (proteinuria in dogs)
- Signs of GI ulceration (vomiting, melaena)
- Haematology at each visit (including 4 and 8 weeks after cessation of therapy)
- PCV (Packed Cell Volume)
- Liver parameters (especially if combined with azathioprine)
- Clinical signs of anaemia or GI bleeding
약동학
반감기
흡수
Prednisolone acetate is highly lipophilic and readily penetrates the intact corneal epithelium to reach therapeutic concentrations in the aqueous humor. Systemic absorption occurs via drainage through the nasolacrimal duct into the nasal mucosa and GI tract.
분포
Distributes widely into ocular tissues (anterior segment). Systemically absorbed drug distributes throughout total body water and binds to plasma proteins (transcortin and albumin).
대사
Systemically absorbed prednisolone is metabolized primarily in the liver.
배설
Excreted primarily by the kidneys as conjugated metabolites.
과다투여
Acute overdose from topical ophthalmic application is highly unlikely to cause severe toxicity. However, chronic overdosage or overly frequent application (especially in small patients <20 kg) can lead to systemic absorption resulting in iatrogenic hyperadrenocorticism (Cushing's syndrome), adrenal suppression, and destabilization of blood glucose in diabetic patients. If a corneal ulcer is present, overuse can lead to rapid corneal melting and perforation.
제품
제형
- Ophthalmic suspension (0.12%, 0.125%, 1%)
- Ophthalmic solution (0.125%, 1%)
- Ophthalmic drops combined with atropine
- Ophthalmic suspension: 0.5%, 1% (5 ml, 10 ml bottles)
- Topical preparations (dermatological, otic, ophthalmic)
- Injectable solution: prednisolone sodium succinate 10 mg/ml
- Injectable suspension: 7.5 mg/ml (plus 2.5 mg/ml dexamethasone)
- Oral tablets: 1 mg, 5 mg, 25 mg
- Oral compound: PLT (contains cinchophen)
- Oral suspension
동물용의약품
- PLT (compound with cinchophen)
- Prednicare
- Prednidale
인용의약품
- Prednisolone Acetate Drops: 0.12% Suspension (Pred Mild®)
- Prednisolone Acetate Drops: 0.125% Suspension (Econopred®)
- Prednisolone Acetate Drops: 1% Suspension (Econopred Plus®, Pred Forte®, generic)
- Prednisolone Sodium Phosphate Drops: 0.125% & 1% Solution (various)
- Prednisolone (0.25%) and Atropine (1%) Drops (Mydrapred®)
- Pred-forte (ophthalmic suspension 0.5%, 1%)
- Prednisolone tablets
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at room temperature (15°-25°C / 59°-77°F). Protect from freezing. Keep the bottle tightly closed when not in use. Suspensions must be stored upright.
보호자 정보
중요한 단계: 아세트산염 현탁액(예: Pred Forte)을 사용하는 경우, 매번 사용하기 전에 병을 강하게 흔들어야 합니다. 약물 성분이 바닥에 가라앉기 때문에 흔들지 않으면 눈에 물만 넣게 됩니다.
- 투여 방법: 사용 전에 손을 씻으십시오. 오염을 방지하기 위해 점안액 용기의 끝이 반려동물의 눈, 눈꺼풀 또는 다른 표면에 닿지 않도록 하십시오.
- 투여 간격: 여러 종류의 안약을 넣는 경우, 각 약물 사이에 최소 5~10분의 간격을 두십시오.
- 궤양 징후 주의: 스테로이드는 치유를 지연시킵니다. 반려동물의 눈이 더 붉어지거나 탁해지거나, 눈을 가늘게 뜨거나 비비기 시작하면 즉시 투약을 중단하고 수의사에게 연락하십시오. 이는 각막 긁힘이나 궤양을 의미할 수 있습니다.
- 전신 증상: 안약이라도 체내로 흡수될 수 있습니다. 반려동물의 음수량, 배뇨량 또는 식욕이 증가하는지 관찰하고 수의사에게 알리십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.