The importance of monitoring prescribed drugs: Prednisolone

The misuse of any prescription drug can cause both short term and long terms health implications. All prescription drugs can trigger effects and side effects; therefore it is imperative for anyone administering such drugs to effectively prescribe, monitor and comprehensively explain the impact they can have on anyone taking them.

Recently, we have observed an increased quantity of reports of harmful side effects and injuries resulting from the use (or misuse) of Prednisolone, ensuing a number of clinical negligence claims against practitioners. Prednisolone is a steroid or corticosteroid medicine (in tablet and liquid form) that is available via prescription to treat a wide range of health issues including:

• severe allergies;

• arthritis;

• blood disorders;

• skin diseases;

• infections;

• inflammation;

• cancers; and

• prevention of organ rejection post-transplant.

Prednisolone works by acting as an anti-inflammatory also and slowing down an overactive immune system.

The use of corticosteroids, like Prednisolone, can result in various side effects such as (but not limited to) weight gain, hypertension, glucose intolerance, mood changes, acne, and nausea. However, it is apparent that individuals are also suffering from much more severe complications. Patients have fallen susceptible to infections from flu and minor fungal infections like thrush and in more severe cases this is leading to osteomyelitis, bone thinning, avascular necrosis of the bone and severe conditions such as pneumocystis carinii pneumonia. The severity of such side effects tends to correlate to the patient’s dosage and the period they remain on Prednisolone for. The higher the dosage and longer the patient takes the drug for, the more susceptible you become to developing side effects. Although, only a number of patients will actually experience such side-effects it must be noted that studies indicate that even small doses (less than 5mg) can increase effects like the risk of infection (Mar Pujades-Rodriguez CMAJ 2019 – National Library of Medicine - Incidence of infections associated with oral glucocorticoid dose in people diagnosed with polymyalgia rheumatica or giant cell arteritis: a cohort study in England - PubMed (nih.gov))

Consequentially, this highlights the necessity and importance to use drugs, like Prednisolone, under regular medical supervision, especially with long-term use. Anyone administering such drugs should aim to prescribe the lowest effective doses, for the shortest duration of time to minimise the potential for any damaging side effects. Practitioners should also ensure that supervision is undertaken:

• essential regular monitoring/laboratory tests (i.e blood sugar & blood pressure) to assess/ensure there are no infections and monitor toxicity;

•  educating the patient on the potential side effects on taking such drugs;

• recommend lifestyle modifications under the usage of such drugs (i.e. reducing your weight, smoking and taking up regular exercise); and

• check for any pre-existing conditions that may be exacerbated by the use of Prednisolone.

A failure to effectively and regularly monitor patients and their response to taking these kinds of prescription medications can be just as damaging and debilitating as providing the incorrect treatment initially. Such failures can constitute a substandard medical care and a breach of duty by your medical practitioner. If you have suffered a personal injury due to negligent monitoring or administering of prescription drugs and steroids, like Prednisolone, please contact a member of our clinical negligence team as you may be able to seek compensation.