Bedside Snapshot
- Use It For
- Asthma and COPD exacerbations (ED dose and discharge course); adjunct after epinephrine in severe allergic reactions; acute gout flare; sick-day dosing in long-term steroid users
- Adult Dose
- Asthma: 40–50 mg PO once daily for 5–7 days (max 50 mg/day)
- COPD: 40 mg PO once daily for 5 days
- Gout flare: 30 mg PO once daily for 5 days
- Pediatric Dose
- Asthma, age 2 yr and older: 1 mg/kg PO, max 60 mg per dose (NASEMSO); under 2 yr: specialist use only. Differs: GINA 2026 caps 40, 30 or 20 mg/day by age
- Onset / Duration
- PO: clinical improvement after at least 4 hr; one dose suppresses the HPA axis for about 30–36 hr, so dose once daily
- Do Not Give / Hold If
- Systemic fungal infection; hypersensitivity; live vaccines at immunosuppressive doses; cerebral malaria. Caution: active herpetic eye infection (ophthalmology input). Cannot swallow or vomiting: use an IV steroid
- Watch For
- Hyperglycemia (glucose); masked or worsening infection (fever may be blunted); mood change or steroid psychosis (mental status); GI bleeding, worse with NSAIDs (melena, hemoglobin)
- Reversal / Rescue
- No reversal agent: supportive care. Long-term user who is vomiting, hypotensive or acutely ill (possible adrenal crisis): hydrocortisone IV/IM now, adult 100 mg then 200 mg/24 hr; child 2 mg/kg (max 100 mg)
- Must Remember
- Not a rescue drug: it needs at least 4 hr to work. Give it early, but bronchodilators and epinephrine come first. Never stop long-term prednisone abruptly.
Indications
Emergency & Prehospital
- Asthma exacerbation: in acute care, give a systemic steroid for all but the mildest exacerbations (GINA). Oral is the choice when the patient can swallow. Give it within 1 hr of presentation, then a short discharge course. (Labeled under allergic states: bronchial asthma.)
- COPD exacerbation: a 5-day course for significant exacerbations. Oral works as well as IV. (Listed in the delayed-release prednisone label.) In practice, use immediate-release tablets. The delayed-release form has about a 4-hr lag.
- Anaphylaxis and severe allergic reactions: adjunct only, given after IM epinephrine. It is also used for severe urticaria, contact dermatitis, serum sickness and drug reactions (labeled under allergic states).
- Patients on long-term glucocorticoids who become ill: a sick-day dose increase for minor illness. Switch to parenteral hydrocortisone for vomiting, shock or major stress.
ED / ICU / Transport
- Acute gout flare: a first-line option with colchicine or NSAIDs. Useful when NSAIDs are contraindicated. (Labeled: acute gouty arthritis.)
- Bell palsy: age 16 yr and older, started within 72 hr of onset (off-label)
- HIV-associated Pneumocystis jirovecii pneumonia (PJP) with hypoxemia: an adjunct to anti-PJP antimicrobial therapy. (Labeled in the delayed-release prednisone label.)
- Croup: dexamethasone is the usual choice. Prednisolone is an off-label alternative. It was noninferior to dexamethasone in one randomized trial.
Other Uses
- Labeled inflammatory and immune disorders: rheumatoid and psoriatic arthritis, lupus, dermatomyositis, pemphigus, severe psoriasis, sarcoidosis, ulcerative colitis and Crohn disease flares, idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia in adults, nephrotic syndrome, leukemia and lymphoma, acute multiple sclerosis exacerbation
- Adrenal insufficiency: hydrocortisone is the labeled first choice. Prednisone may be used in primary insufficiency, paired with a mineralocorticoid. In glucocorticoid-induced insufficiency, fludrocortisone is not advised (ESE/ES 2024).
- Not for: optic neuritis (oral steroids may increase new episodes), cerebral malaria
Dosing & Administration
Available Forms
- Immediate-release tablets (generic): 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg and 50 mg; most are scored. Most ED discharges use this form.
- Oral solution: 5 mg/5 mL (1 mg/mL), contains 5% alcohol.
- Prednisone Intensol oral concentrate: 5 mg/mL, contains 30% alcohol; dispensed only with its own calibrated oral syringe (0.25 mL = 1.25 mg to 1 mL = 5 mg).
- Delayed-release tablets: 1 mg and 2 mg. Release starts about 4 hr after a dose taken with food. Swallow whole. Not for acute exacerbations.
- No parenteral form: if you cannot give it by mouth, use IV methylprednisolone, hydrocortisone or dexamethasone.
Adult Dosing
| Indication | Dose & Route | Repeat / Max | Notes |
|---|---|---|---|
| Asthma exacerbation (all but the mildest, in acute care) | 40–50 mg PO once daily (or 1 mg/kg/day, max 50 mg) | 5–7 days; max 50 mg/day; no taper needed for courses under 2 weeks | Give within 1 hr of presentation, morning dosing after the first dose. Oral equals IV; use IV methylprednisolone only if the patient cannot swallow, is vomiting, or needs noninvasive ventilation or intubation. Differs: NASEMSO and many US protocols: 60 mg. |
| COPD exacerbation | 40 mg PO once daily | 5 days; max 40 mg/day | Per GOLD 2026. Treat significant exacerbations only, since longer or repeated courses add pneumonia risk. Benefit is greater when blood eosinophils are raised. |
| Severe allergic reaction, urticaria or angioedema (adjunct) | Individualized; labeled initial range 5–60 mg PO daily | Short course per prescriber; usual initial max 60 mg/day | Epinephrine first for anaphylaxis. Steroids do not treat hypotension or airway compromise, never replace epinephrine, and are not recommended to prevent biphasic reactions. |
| Acute gout flare | 30 mg PO once daily | 5 days; max 30 mg/day | Matched indomethacin for pain relief in an ED trial. Start as early as possible after flare onset. |
| Bell palsy (age 16 yr and older, within 72 hr) | 60 mg PO once daily for 5 days, then taper over 5 days | 10 days total; max 60 mg/day | Alternative: prednisolone 50 mg daily for 10 days. |
| HIV-associated PJP, PaO₂ <70 mmHg on room air or A–a gradient ≥35 mmHg | 40 mg PO twice daily days 1–5, 40 mg once daily days 6–10, then 20 mg once daily days 11–21 | 21 days; max 80 mg/day | Start as early as possible and within 72 hr of starting PJP treatment; benefit is unclear if started later. Adjunct only; follow infectious disease protocol. |
| Sick-day dosing: long-term steroid user with minor illness (fever, illness needing bed rest) | If taking less than 10 mg/day: increase to 10 mg/day PO in 1–2 doses | For 2–5 days until well, or for the duration of antibiotic treatment; no increase needed if already on 10 mg/day or more, unless hemodynamically unstable | Vomiting, diarrhea, unable to take tablets, hypotension or major stress: give hydrocortisone 100 mg IV/IM now, then 200 mg/24 hr. |
Pediatric Dosing
Here is how the pediatric doses are sourced. AHA/AAP 2025 comes first, when it states a dose. The NASEMSO National Model EMS Clinical Guidelines v3.0 (2022) comes next, then the US label. If none of them gives a dose, none is shown. Pediatric maximums stay at or under the adult maximum unless a guideline says otherwise (NASEMSO Universal Care Guideline). NASEMSO's asthma dose tops out at 60 mg per dose, for age 2 yr and older. That sits above the 50 mg/day adult cap shown here (GINA). Off-label unless marked labeled.
| Indication | Dose (per kg) & Route | Max Single / Max Total | Notes |
|---|---|---|---|
| Asthma exacerbation, age 2 yr and older | 1 mg/kg PO | Max 60 mg per dose | Liquid preferred. Differs: GINA 2026 gives 1–2 mg/kg/day for 3–5 days, max 40 mg/day (6–11 yr), 30 mg/day (2–5 yr) and 20 mg/day (under 2 yr); EPR-3 allows up to 60 mg/day in children. Alternative: dexamethasone 0.6 mg/kg, max 16 mg. |
| Asthma exacerbation, age 14 yr and older or over 40 kg | Adult dose: 40–50 mg PO once daily | Max 50 mg/day; 5–7 days | Pediatric group ends at 14 yr or 40 kg (NASEMSO). The 40–50 mg figure is the GINA adult dose; NASEMSO gives 1 mg/kg, max 60 mg, up to that age. |
| Croup | Not routinely used (dexamethasone preferred) | — | See dexamethasone. Prednisolone 1 mg/kg is an off-label alternative (noninferior to dexamethasone in Parker & Cooper 2019, children over 6 months and up to 20 kg). |
| Long-term steroid user who is acutely ill; adrenal crisis | Use hydrocortisone | — | Parenteral hydrocortisone 2 mg/kg IV/IO/IM (max 100 mg) for age over 28 days; weight unknown: 25 mg under 1 yr, 50 mg 1–5 yr, 100 mg 6 yr and older (BSPED; US age bands differ, follow local protocol). Do not rely on oral prednisone if vomiting or unwell. |
| Neonates and infants; nephrotic syndrome, leukemia and other chronic indications | Specialist use only | — | Label pediatric evidence covers nephrotic syndrome (over 2 yr) and leukemia/lymphoma. In infants with adrenal insufficiency, mineralocorticoid replacement is especially important. |
See weight-based dosing for calculation checks.
Preparation & Administration
- Timing: give the first ED dose on arrival. Give each daily dose in the morning, before 9 am, to match the cortisol peak and limit insomnia.
- With food: take it with a meal or milk, or right after one. That cuts down on gastric irritation.
- Stopping: courses under 2 weeks (GINA) or under 3–4 weeks (endocrine guideline) can stop without a taper. Longer courses need a gradual taper.
Dosing Notes:
- Equivalent oral doses: prednisone 5 mg ≈ prednisolone 5 mg ≈ methylprednisolone 4 mg ≈ hydrocortisone 20 mg ≈ dexamethasone 0.75 mg.
- Physiologic replacement is about prednisone 4–6 mg/day (hydrocortisone 15–25 mg/day).
- Adult asthma caps follow GINA. Older US guidance (NAEPP EPR-3) and many US ED and EMS protocols go higher: 40–80 mg/day in adults and adolescents. Follow local protocol.
- Dose prednisone and prednisolone mg for mg.
- For renal and hepatic issues, see Special Populations.
Contraindications & Precautions
Contraindications
- Systemic fungal infection (unless needed to control a drug reaction)
- Known hypersensitivity to prednisone or a tablet or solution component
- Live or live-attenuated vaccines while on immunosuppressive doses
- Cerebral malaria: avoid (label Warnings)
Precautions
- Ocular herpes simplex: use cautiously, since corneal perforation is possible. Active herpetic keratitis? Hold it and get ophthalmology input.
- Infection: It hides the signs. It also raises the risk of any infection, including tuberculosis, hepatitis B reactivation and Strongyloides hyperinfection. Varicella or measles can be fatal in non-immune patients.
- Diabetes: Glucose and insulin needs go up.
- Heart failure, hypertension, renal insufficiency: you get sodium and fluid retention, and potassium loss. Recent myocardial infarction: linked to left ventricular free-wall rupture.
- GI disease: active or latent peptic ulcer, diverticulitis, fresh intestinal anastomosis. Signs of perforation may be absent.
- Psychiatric history, myasthenia gravis, osteoporosis, glaucoma: psychosis, acute weakness, fractures, raised eye pressure.
Hold / Reassess If
- Cannot swallow, vomiting, or needs noninvasive ventilation or intubation: switch to an IV steroid
- Glucose above the individualized target despite treatment, or new delirium or psychosis
- Melena, hematemesis or abdominal pain (GI bleeding or perforation)
Never stop long-term prednisone abruptly: HPA-axis suppression can last months to years. Count serious illness, surgery or trauma as possible adrenal insufficiency. Give stress-dose hydrocortisone until recovery is confirmed (see Monitoring). Axis still not recovered after 1 year on a physiologic dose? Refer to endocrinology.
Adverse Effects & Toxicity
Common
- Sleep disturbance and insomnia
- Increased appetite and weight gain
- Reflux, dyspepsia, nausea
- Mood changes, euphoria, irritability
- Fluid retention, raised blood pressure, hypokalemia
- With prolonged use: Cushingoid features, osteoporosis, cataracts, glaucoma, growth suppression, avascular necrosis
Serious / Life-Threatening
| Effect | Recognition | Management |
|---|---|---|
| Hyperglycemia | Rising glucose; thirst, polyuria; worse in diabetes | Check glucose; adjust insulin or oral agents |
| Infection (masked, opportunistic, reactivated) | Fever and peritoneal signs may be blunted; even short bursts raise sepsis and pneumonia risk | Culture early and treat; reduce the dose if possible |
| GI bleeding or perforation | Melena, falling hemoglobin, abdominal pain with few peritoneal signs; higher with NSAIDs | Resuscitate, imaging, surgical consult |
| Steroid psychosis, mania, depression | Insomnia, agitation, hallucinations, severe mood change | Safety measures; lowest effective dose; psychiatry review |
| Thromboembolism | Leg swelling, pleuritic chest pain, hypoxia; thrombophlebitis and thromboembolism are labeled adverse reactions | Evaluate for DVT or PE |
| Adrenal insufficiency after withdrawal | Hypotension, hypoglycemia, vomiting, weakness under stress | Parenteral hydrocortisone and isotonic fluids; taper long courses |
| Acute myopathy | Generalized weakness, including respiratory muscles, with high doses in myasthenia gravis or with neuromuscular blockers | Minimize steroid and blocker exposure; recovery may take weeks to years |
Overdose & Toxicity Management
- Acute ingestion: effects of a single large ingestion are not described (the label reports no data). Anticipate exaggerated known effects, such as hyperglycemia, hypokalemia, fluid retention, raised blood pressure and agitation.
- Management: Supportive and symptomatic care. Check glucose and electrolytes. Contact poison control.
- Antidote: none.
- Chronic excess (Cushingoid state): Reduce the dose gradually, or move to alternate-day dosing. Never stop abruptly.
Monitoring
| Parameter | When / How Often | Target / Act If |
|---|---|---|
| Clinical: respiratory response | Work of breathing, SpO₂, peak flow or FEV₁ after bronchodilators | No improvement: escalate bronchodilators, magnesium and ventilatory support; the steroid needs at least 4 hr |
| Clinical: blood pressure, weight, edema | Each visit; regularly on prolonged therapy | Rising BP or edema: salt restriction, review dose |
| Clinical: mental status and sleep | Every assessment, especially older adults | New delirium or psychosis: reassess dose and other causes |
| Laboratory: glucose | Diabetes or hyperglycemia risk: during every course; 2-hr postprandial checks on prolonged therapy | Glucose above target: adjust insulin or oral agents |
| Laboratory: potassium | Multi-day or high-dose courses; with diuretics or digoxin | Low K⁺: replace; ECG if on digoxin |
| Laboratory: INR on warfarin | Within 3–7 days of starting and of stopping the steroid, then frequently while combined | INR may rise (more often with short oral courses) or fall: watch for bleeding; adjust warfarin to target INR |
| Before prolonged immunosuppressive therapy | Baseline | Screen for hepatitis B and latent tuberculosis; treat or give prophylaxis as indicated |
| Prolonged therapy: eyes, bone, growth | Intraocular pressure beyond 6 weeks; prednisone 2.5 mg/day or more for over 3 months: fracture-risk assessment soon after starting (fracture history, bone density with vertebral fracture assessment, FRAX if 40 yr or older); height in children | Medium or higher fracture risk: bone-protective drug therapy; raised pressure or slowed growth: specialist review |
| Adrenal recovery after a long course | Morning cortisol once the dose is physiologic (about 4–6 mg/day), drawn 8–9 am after holding the dose for at least 24 hr (a same-day dose gives a falsely high result) | Above 300 nmol/L (10 mcg/dL): recovery likely. 150–300 nmol/L: continue the physiologic dose and retest in weeks to months. Under 150 nmol/L (5 mcg/dL): retest in a few months |
Interactions & Compatibility
Clinically Significant Interactions
| Drug / Class | Effect | What To Do |
|---|---|---|
| CYP3A4 inducers (phenytoin, carbamazepine, phenobarbital, rifampin) | Faster steroid clearance; reduced effect | A higher prednisone dose may be needed |
| CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, macrolides) | Higher steroid levels; ketoconazole cuts metabolism by up to 60% | Watch for steroid adverse effects; adrenal insufficiency risk on withdrawal |
| NSAIDs and aspirin | More GI ulceration and bleeding; salicylate levels fall, then can rise to toxic levels when the steroid stops | Avoid or add GI protection per protocol; monitor salicylate therapy |
| Warfarin | Variable: short oral courses usually raise the INR (often within about a week); the label also describes a reduced response | Check the INR within 3–7 days of starting and after stopping; watch for bleeding; adjust warfarin to target |
| Insulin and other antidiabetics | Higher glucose | Adjust doses; monitor glucose |
| Potassium-depleting drugs (diuretics, amphotericin B), digoxin | Hypokalemia; arrhythmia with digoxin | Monitor K⁺ and ECG |
| Fluoroquinolones (ciprofloxacin, levofloxacin) | Higher risk of tendon rupture, especially in older adults | Avoid the combination when possible; warn about tendon pain |
| Anticholinesterases in myasthenia gravis; neuromuscular blockers | Severe weakness; acute myopathy | Stop anticholinesterases 24 hr before if possible; anticipate respiratory support |
Watch for these as well. Seizures are reported with cyclosporine. Estrogens strengthen the steroid effect. Bupropion lowers the seizure threshold. Vaccines get a weaker response, and skin tests are suppressed. Cholestyramine, isoniazid, quetiapine and thalidomide also belong on the list.
It is an oral drug, so IV compatibility does not apply.
Special Populations
- Pediatrics: asthma is the main acute use. Check the Pediatric Dosing table. Liquids are preferred. Prednisone solutions contain alcohol (5% and 30%), so prednisolone liquid is often used. Even low doses can slow growth on prolonged therapy.
- Pregnancy: human studies show a small, inconsistent rise in orofacial clefts with first-trimester use. Growth restriction is reported, partly from maternal disease. Don't withhold it for a serious indication. GINA advises early systemic steroids for asthma in pregnancy. Watch the newborn for hypoadrenalism after substantial maternal doses.
- Lactation: milk levels run 5–25% of maternal serum. The infant gets about 0.14% of the maternal daily dose. No adverse infant effects are reported. Use the lowest effective dose.
- Older Adults: start at the low end of the range. Diabetes, fluid retention, hypertension, delirium and osteoporosis are more likely, and more serious.
- Renal Impairment: no dose adjustment is established. Watch fluid retention, BP and potassium.
- Hepatic Impairment: in cirrhosis, metabolism is reduced, so the effect is enhanced. There is no labeled adjustment. Use the lowest effective dose.
- Obesity / Dosing Weight: adult acute doses do not change with weight. Pediatric per-kg doses stop at the maximum dose (60 mg). A higher body weight may need higher stress doses.
- Long-Term Glucocorticoid Users: courses of 3–4 weeks or more above physiologic doses can suppress the HPA axis. For prednisone, that means more than about 4–6 mg/day. These patients need stress-dose cover for illness, surgery or trauma. They should also carry a steroid emergency card.
- Thyroid Disease: In hypothyroidism, clearance falls. In hyperthyroidism, it rises.
Field & Transport Considerations
- Scope: Paramedic and above give oral prednisone in EMS systems that carry it. The NASEMSO model gives 1 mg/kg PO, maximum 60 mg, for bronchospasm in patients not sick enough to need IV access, alongside albuterol and ipratropium. It is not on the EMT list of the National EMS Scope of Practice Model. RN and critical-care transport continue it on order. Varies by state and agency protocol.
- Handoff Essentials: Give the drug, mg dose and time given. Say whether any steroid was taken in the last 24 hr. Say the doses are not to be duplicated in the ED.
Clinical Pearls
The sick steroid-dependent patient: Hypotensive, vomiting or confused, in a long-term steroid user? Call it adrenal crisis until proven otherwise. Give parenteral hydrocortisone before labs or imaging.
A steroid is not a rescue drug: Oral steroids need at least 4 hr to improve asthma. Give the dose early anyway. Right now, bronchodilators, oxygen and epinephrine are what treat the patient.
Oral works as well as IV: In asthma and COPD, oral prednisone does the same job as IV methylprednisolone, and it is quicker and cheaper. Reserve IV for the patient who cannot swallow, is vomiting, or needs noninvasive ventilation or intubation.
Exam discriminator: which steroid?:
- Prednisone: oral, intermediate-acting, for asthma and COPD discharge courses and gout.
- Methylprednisolone: IV when the patient cannot take PO.
- Dexamethasone: long-acting, for croup, 1–2 day pediatric asthma courses and meningitis.
- Hydrocortisone: salt-retaining, for adrenal crisis and septic shock.
Concentrate vs solution: Prednisone Intensol packs five times the strength per mL of the standard oral solution. Check the bottle first. Then measure with its own syringe only.
Short bursts are not harmless: Pneumonia and sepsis are more common in adults after even a brief course. Repeated courses add up to long-term adverse effects. So each burst should prompt a review of maintenance inhaler therapy.
Pharmacology
Mechanism of Action
- A prodrug. The liver converts it to prednisolone, which binds intracellular glucocorticoid receptors. That changes gene transcription and gives broad anti-inflammatory and immunosuppressive effects.
- It reduces airway inflammation and edema over hours. The result is faster recovery and fewer early relapses after asthma and COPD exacerbations.
- Its salt-retaining effect is modest next to hydrocortisone. That is why it is not the first choice for adrenal replacement on its own.
Pharmacokinetics
| Route | Onset | Peak | Duration |
|---|---|---|---|
| PO (immediate-release) | Clinical improvement after at least 4 hr | Plasma: about 2 hr | A single dose suppresses the HPA axis for about 1¼–1½ days (30–36 hr); dosed once daily |
| PO (delayed-release) | Release begins about 4 hr after a dose with food | Plasma: 6–6.5 hr | Same exposure as immediate-release |
- Half-life: the plasma T½ of prednisone and prednisolone is about 2–3 hr. The biologic effect lasts much longer.
- Metabolism: it is completely converted to active prednisolone, with exposure 4–6 times that of prednisone. Hepatic metabolism follows, in part by CYP3A4.
- Elimination: It leaves in urine, as sulfate and glucuronide conjugates.
- Alternate-day therapy: its short HPA suppression makes it suitable for every-other-morning maintenance dosing. Dexamethasone does not work that way.
Names & Classification
- Generic Name
- Prednisone
- Brand Names
- Deltasone (brand; current US supply is mainly generic); Prednisone Intensol (oral concentrate); delayed-release prednisone tablets
- Pharmacologic Class
- Synthetic systemic glucocorticoid (prodrug of prednisolone)
- Therapeutic Class
- Anti-inflammatory and immunosuppressant corticosteroid
- Controlled Substance
- Not controlled
- ISMP High-Alert
- No
- Look-Alike / Sound-Alike
- predniSONE / prednisoLONE (US labels print the tall-man form predniSONE); oral solution 1 mg/mL vs Intensol concentrate 5 mg/mL
References
- Hikma Pharmaceuticals USA. (2024). PredniSONE tablets USP, predniSONE oral solution USP and predniSONE Intensol oral solution (concentrate) [prescribing information] (revised February 2024); and Dr. Reddy's Laboratories. (2025). Prednisone delayed-release tablets [prescribing information] (revised November 2025). DailyMed, National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3115aef0-fd50-4ec8-a064-3effb695f3f2 ; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=01bdc479-1f1f-af94-837c-12e7e861321a ; and Hazlewood, K. A., Fugate, S. E., & Harrison, D. L. (2006). Effect of oral corticosteroids on chronic warfarin therapy. Annals of Pharmacotherapy, 40(12), 2101–2106. https://doi.org/10.1345/aph.1H418
- Global Initiative for Asthma. (2026). Global strategy for asthma management and prevention (2026 update) (adult and pediatric exacerbation management). https://ginasthma.org/wp-content/uploads/2026/05/GINA-2026-Strategy-Report-WMS.pdf
- Global Initiative for Chronic Obstructive Lung Disease. (2026). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2026 report). https://goldcopd.org/wp-content/uploads/2026/01/GOLD-REPORT-2026-v1.3-8Dec2025_WMV2.pdf
- Beuschlein, F., Else, T., Bancos, I., Hahner, S., Hamidi, O., van Hulsteijn, L., et al. (2024). European Society of Endocrinology and Endocrine Society joint clinical guideline: Diagnosis and therapy of glucocorticoid-induced adrenal insufficiency. Journal of Clinical Endocrinology & Metabolism, 109(7), 1657–1683. https://doi.org/10.1210/clinem/dgae250 ; and Mushtaq, T., Ali, S. R., Boulos, N., Boyle, R., et al. (2023). Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance. Archives of Disease in Childhood, 108(11), 871–878. https://doi.org/10.1136/archdischild-2022-325156
- Dahan, E., El Ghazal, N., Nakanishi, H., El Haddad, J., Matar, R. H., Tosovic, D., et al. (2023). Dexamethasone versus prednisone/prednisolone in the management of pediatric patients with acute asthmatic exacerbations: A systematic review and meta-analysis. Journal of Asthma, 60(8), 1481–1492. https://doi.org/10.1080/02770903.2022.2155189 ; and Parker, C. M., & Cooper, M. N. (2019). Prednisolone versus dexamethasone for croup: a randomized controlled trial. Pediatrics, article e20183772. https://doi.org/10.1542/peds.2018-3772
- Shaker, M. S., Wallace, D. V., Golden, D. B. K., Oppenheimer, J., Bernstein, J. A., Campbell, R. L., et al. (2020). Anaphylaxis: A 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology, 145(4), 1082–1123. https://doi.org/10.1016/j.jaci.2020.01.017
- FitzGerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A. M., et al. (2020). 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care & Research, 72(6), 744–760. https://doi.org/10.1002/acr.24180 ; and Rainer, T. H., Cheng, C. H., Janssens, H. J. E. M., Man, C. Y., Tam, L. S., Choi, Y. F., et al. (2016). Oral prednisolone in the treatment of acute gout: A pragmatic, multicenter, double-blind, randomized trial. Annals of Internal Medicine, 164(7), 464–471. https://doi.org/10.7326/M14-2070
- Baugh, R. F., Basura, G. J., Ishii, L. E., Schwartz, S. R., Drumheller, C. M., Burkholder, R., et al. (2013). Clinical practice guideline: Bell's palsy. Otolaryngology–Head and Neck Surgery, 149(3 Suppl), S1–S27. https://doi.org/10.1177/0194599813505967 ; and Engström, M., Berg, T., Stjernquist-Desatnik, A., Axelsson, S., Pitkäranta, A., Hultcrantz, M., et al. (2008). Prednisolone and valaciclovir in Bell's palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurology, 993–1000. https://doi.org/10.1016/s1474-4422(08)70221-7
- Gupta, S., & Bebell, L. M. (2024). When should I give corticosteroids to my patient with Pneumocystis pneumonia? Cleveland Clinic Journal of Medicine, 91(4), 217–219. https://doi.org/10.3949/ccjm.91a.23082
- Humphrey, M. B., Russell, L., Danila, M. I., et al. (2023). 2022 American College of Rheumatology guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care & Research, 75, 2405–2419. https://doi.org/10.1002/acr.25240
- National Association of State EMS Officials. (2022). NASEMSO National Model EMS Clinical Guidelines, Version 3.0 (March 2022): Respiratory Distress, pp. 191–192 (prednisone 1 mg/kg, maximum 60 mg PO); Universal Care Guideline, Patient Care Goals. https://nasemso.org/docs.ashx?id=1444322
- National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the diagnosis and management of asthma, summary report 2007. Journal of Allergy and Clinical Immunology, S94–S138. https://doi.org/10.1016/j.jaci.2007.09.043
Medical Disclaimer
- For Educational Purposes Only: This content is intended for educational reference and should not be used for clinical decision-making.
- Not a Substitute for Professional Judgment: Always consult your local protocols, institutional guidelines, and supervising physicians.
- Verify Before Acting: Users are responsible for verifying information through authoritative sources before any clinical application.
AI Assistance Notice
AI was used to assist in organizing, paraphrasing, and formatting this information.