Methylprednisolone

dr.joan

Methylprednisolone :
Trade names: Solumedrol
Pregnancy: (Category C)

Class: Corticosteroids "Glucocorticoid therapy ' , anti inflammatory

Action:
In pharmacologic doses, all agents suppress inflammation and the normal immune response
All agents have numerous intense metabolic effects (see Adverse Reactions and Side Effects)
Suppress adrenal function Have negligible mineralocorticoid activity
Uses:
suppression of inflammation ( rheumatoid arthritis, systemic lupus erythematosus, acute gouty arthritis, psoriatic arthritis, ulcerative colitis, and Crohn's disease).
Severe allergic conditions that fail conventional treatment (bronchial asthma, allergic rhinitis, drug–induced dermatitis, and contact and atopic dermatitis).
Chronic skin conditions ( dermatitis herpetiformis, pemphigus, severe psoriasis and severe seborrheic dermatitis).
Chronic allergic and inflammatory conditions of the uvea, iris, conjunctiva and optic nerves of the eyes .

Dose:
by mouth, usual range 2–40 mg daily;
By intramuscular injection or slow intravenous injection or infusion , initially 10–500 mg; graft rejection, up to 1 g daily by intravenous infusion for up to 3 days

Contraindications:
Active untreated infections (may be used in patients being treated for some forms of meningitis)
Lactation (avoid chronic use)
Known alcohol, bisulfite, or tartrazine hypersensitivity or intolerance (some products contain these and should be avoided in susceptible patients).
Side effects:
CNS: depression, euphoria, headache, increased intracranial pressure (children only), personality changes, psychoses, restlessness.
EENT: cataracts, increased intraocular pressure.
CV: hypertension.
GI: PEPTIC ULCERATION, anorexia, nausea, vomiting.
Derm: acne, decreased wound healing, ecchymoses, fragility, hirsutism, petechiae.
Endo: adrenal suppression, hyperglycemia.
F and E: fluid retention (long-term high doses), hypokalemia, hypokalemic alkalosis.
Hemat: THROMBOEMBOLISM, thrombophlebitis.
Metab: weight gain, weight loss.
MS: muscle wasting, osteoporosis, aseptic necrosis of joints, muscle pain.
Misc: cushingoid appearance (moon face, buffalo hump), increased susceptibility to infection.
Nursing considerations:
ü Administer oral forms with food to minimize ulcerogenic effect.
ü For chronic use, give the smallest dose possible.
ü Corticosteroids should be discontinued gradually if used chronically.
ü Document baseline weight , B.P. , Pulse & temperature.
ü Frequently take BP, monitor body weight (signs of Na+ & H2O retention).
ü Periodic serum electrolytes, blood sugar monitoring.
ü Report signs & symptoms of side effects (cushing-like syndrome).
ü Discuss with female client potentials of menstrual difficulties.
ü Instruct the client to take diet high in protein & potassium.
ü Instruct the client to avoid falls & accidents (osteoporosis causes
ü pathological fracture).
ü Remind the client to carry a card identifying the drug being used.
ü Stress the need for regular medical supervision.
ü Advise the client to delay any vaccination while taking these medications
ü (weakened immunity).
ü Explain the need to maintain general hygiene & cleanliness to prevent
ü infection.