프레드니솔론

동물 종별 용량

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금기

• 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
• Corneal ulcers

이상반응

• 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

약물 상호작용

• Topical NSAIDs (e.g., flurbiprofen, diclofenac) · Concurrent use may increase the risk of delayed corneal healing or corneal melting, though sometimes used together cautiously for severe inflammation.
• Insulin · Systemically absorbed prednisolone antagonizes insulin, increasing blood glucose and complicating diabetes regulation. · major
• Systemic NSAIDs · Increased risk of gastrointestinal ulceration if significant systemic absorption of prednisolone occurs.
• NSAIDs · Increased risk of gastrointestinal ulceration · major
• Acetazolamide · Increased risk of hypokalaemia · moderate
• Amphotericin B · Increased risk of hypokalaemia · moderate
• Potassium-depleting diuretics (e.g., furosemide, thiazides) · Increased risk of hypokalaemia · moderate
• Phenytoin · Enhanced metabolism of corticosteroids · moderate
• Phenobarbital · Enhanced metabolism of corticosteroids · moderate
• Itraconazole · Decreased metabolism of corticosteroids · moderate
• Ciclosporin · Synergistic immunosuppression; may alter pharmacokinetics · moderate

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

과용량

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.