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If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin may be indicated. (See the respective package inserts for complete VZIG and IG prescribing information.) If chickenpox develops,treatment with antiviral agents may be considered. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. It should be kept in mind that constant monitoring is needed in regard to drug dosage.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual. Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses. Glucocorticoids such as prednisolone cause profound and varied metabolic effects.
This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Infants born of mothers who have received substantial doses of corticosteroid during pregnancy should be carefully observed for signs of hypoadrenalism. While on corticosteroid therapy, patients should not be vaccinated against smallpox. Other immunization procedures should not be undertaken in patients who are on corticosteroids, especially on high dose, because of possible hazards of neurological complications and a lack of antibody response.
Hormone therapy is an adjunct to and not a replacement for conventional therapy. In addition to the above indications PRELONE (prednisolone ) Syrup is indicated for systemic dermatomyositis .
During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis. Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay. Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.
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