====== Prednisolone ======

===== Classification =====
  * Intermediate-acting systemic glucocorticoid
  * Active metabolite of prednisone

Parent class:
  * [[endocrine:drug_classes:corticosteroids|Corticosteroids]]

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===== Mechanism of Action =====

Binds intracellular glucocorticoid receptor → alters gene transcription → suppresses inflammatory cytokines and immune activation.

See:
  * [[endocrine:physiology:glucocorticoid_signaling|Glucocorticoid Signaling]]

Equivalent anti-inflammatory mechanism to [[endocrine:drugs:prednisone|Prednisone]].

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===== Key Distinction =====

Prednisone = prodrug  
Prednisolone = active form

Prednisolone does NOT require hepatic activation.

Preferred in:
  * Severe hepatic impairment
  * Pediatric liquid formulations

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===== Clinical Uses =====

  * [[respiratory:clinical:asthma|Asthma]] exacerbations
  * Autoimmune disease
  * Severe allergic reactions
  * Inflammatory disorders

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===== Adverse Effects =====

Short-term:
  * Hyperglycemia
  * Mood changes
  * Insomnia

Long-term:
  * HPA suppression
  * Osteoporosis
  * Cushingoid features
  * Immunosuppression

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===== Clinical Pearls =====

  * Same potency and duration as prednisone.
  * Preferred in patients with significant liver disease.
  * Liquid form commonly used in pediatrics.
  * Taper required with prolonged therapy.