say: PRED-na-sone and dex-ah-METH-a-sone
Prednisone is 17,21-dihydroxypregna-1,4-diene-3,11,20-trione, CAS 53-03-2; dexamethasone is 11beta, 16 alpha, 9-fluoro-11,17,21-trihydroxy-16-methylpregna-1,4-diene-3,20-dione, CAS 50-02-2. Both are white powders, prednisone melts at 233-5 and dexamethasone at 262-4 degrees centigrade.
These are both steroid drugs. Most drug databases state that they suppress muscle inflammation and the normal immune response. I could not find them mentioned in the chemotherapy books that I searched, so I asked my oncodoc about their purpose in the treatment of leukemia. She stated that they cause lyses of lymphoblasts, leukemia cells. Alone, prednisone initiates remission in 40-45% of leukemia patients. The Chem Finder site does list dexamethasone as "anti-inflammatory, immunomodulator, and antineoplastic" but it only lists prednisone as a "glucocorticoid".
Any parent of a child taking one of these steroid drugs has their own story to tell about its effects. This is the drug responsible for the puffy look of patients on chemotherapy, especially noticeable around the face, although it also causes a whole body redistribution of fatty tissues to the face and the abdomen. It also causes mood swings, from bouncing off the walls to mopiness and depression. And . . . it causes hunger! This causes some of the funniest stories among parents of kids with cancer. The amount of food consumed by these kids is amazing!
Potassium and prednisone/dexamethasone
In the ALL-kids email list, many parents report that their children had less severe side effects from the steroid pulses when they took potassium. Some doctors prescribed/recommended this to the parents; some doctors know nothing. Care must be taken, since too much potassium can be harmful. At least, it might help to eat food rich in potassium while on steroids.
Information on potassium
Oregon State University
Side Effects (usually do not need to be reported to the oncodoc)
(*Inflammation is one of the ways your body fights off infection, and if the inflammatory response has to be suppressed, then the immune system is not as ale to fight off infections)
Uncommon Side Effects
The chemotherapy effect of these steroids necessitates high dose amounts. You can be assured that your oncodoc will only let your child be on these steroids for as long as is necessary, so that the effects listed above for long-term use can be ignored.
AND: the puffiness and mood changes disappear when the drugs are discontinued. You must remember at all times that these effects are temporary!! Just start cookin', and you will be fine. Go to the "feeding the chemo kids" page for hints.
To manage the side effects, take the pills with meals. Eat a diet high in protein, calcium and potassium, low in salt and moderate in carbohydrates. Avoid aspirin. Dexamethasone is not compatible with the anthracyclines.
We did not get a sheet from the hospital for this drug.