Information on ACTH (Acton Prolongatum)/Prednisolone- Keep these facts in mind
Content by-Dr Sumeet Dhawan,
Consultant Neurologist,
DM Pediatric Neurology (PGI, Chandigarh),
Contact 8208537763
- Inj ACTH (1ml=60 Units) Intramuscular in anterolateral thigh after checking BP at 8 am. ACTH injection is available at wholesale proces in sector 11, Kumar and Company and Sector 24, Gupta Agencies. Pls keep the injection on ice pack during transport and in fridge at home (lower compartment. Not in freezer)
- BP monitoring daily before ACTH. If BP > ______to start tablet Amlodipine 2.5 mg ¼ twice a day. Pls buy a separate BP cuff for your child. BP cuffs are available in Chandigarh, Sector 16 market. Size _____ is needed for your child. Pls ask your doctor for blood pressure cutoff and blood pressure cuff size
- Blood sugar is too be tested daily for first three days. Then urine sugar can be tested with urine dipstick
- Precautions for child on corticosteroids (oral prednisolone/ Inj ACTH): Low salt, low oil, low ghee, low butter
- Opthal evaluation for cataract and glaucoma after every month
- Foods advisable: green vegetables, salads, dal, paneer, egg without yellow part… This is for children above 6 months
- Eat Less roti and rice and more of vegetables
- Hygiene measures: avoid many visitors, handle after washing hands with soap, use sterilium
- Minimize outdoor visits, parties, market visits, large crowd, travel, public travel to reduce risk of infection
- Live vaccination (Measles, MMR, varicella, BCG, Oral polio vaccine) to be avoided for 6 months.
- Report to nearest physician of child has fever, cough cold or loose stools. Probiotics are to be avoided in the treatment of loose stools. Do not stop prednisolone/ACTH without consulting the doctor
- Side effects which are common but not worrying- darkening of skin colour, weight gain, fullness of cheeks, excessive eating, demanding feeds too frequently and during night also. Weight gain reverses in 6-12 months
- Side effects which are common, which need to be brought to the notice of doctor- vomiting, regurgitation of feed, irritability, reduced sleep, excessive crying, increased BP, increased sugar, positive urine sugar
- Signs of improvement- improved eye contact, increased response to name sound and light, improvement in holding of head, reduction in number of seizures per day. Pls maintain a seizure diary
- You have been advised corticosteroids (oral prednisolone/ Inj ACTH) for the treatment of seizures/jerks of your child. Please keep in mind that this is currently the best available treatment (but not 100%, success rate 40-50% with injections, 30% with oral prednisolone). Results are better with injections compared to medicines
- Seizures of other types besides jerks can occur inspite of taking corticosteroids (oral prednisolone/ Inj ACTH). Please discuss with your doctor if you need any concomitant anti-epileptic drug
- Seizures of other types like tightening/ loss of consciousness can occur while on treatment inspite of treatment
- Jerks can recur after reducing/tapering of ACTH/oral prednisolone
- Do not stop steroids suddenly. Do not keep on continuing these medication without consultation. Sudden stopping and prolonged use of steroids can become serious