NATIONAL
CALIFORNIA
VENTURA
category
Corticosteroid
mechanism
  • Decreases inflammation by suppressing white blood cells and reverses of increased capillary permeability.
  • Corticosteroids exert a wide array of physiologic effects including metabolism and fluid and electrolyte homeostasis. Cardiovascular, immunologic, musculoskeletal, endocrine, and neurologic physiology are influenced by corticosteroids.
indications
  • Anti-inflammatory for the treatment of a variety of diseases including allergic reactions and anaphylaxis, asthma and COPD.
contraindications
  • Systemic fungal infection
  • Recent live or attenuated virus vaccines
  • Immune thrombocytopenia
dosing

IV: 40 to 125 mg

IM: 40 to 60 mg

administration
IM: Avoid injection into the deltoid muscle due to a high incidence of subcutaneous atrophy IV: Administer as a slow IV injection.
onset

1 hour

peak

1 to 2 hours

duration

12 hours

notes
  • Older adult: Use with caution in older adults with the smallest possible effective dose
  • Pediatrics: May cause osteoporosis (at any age) or inhibition of bone growth
  • Discontinuation: Stop use with a gradual tapering of dose
dosage form
IV solution: 40 mg; 80 mg; 125 mg (various concentrations)
brand name
SOLU-Medrol
adverse reactions
  • Adrenal suppression
    • Results from inadequate stimulation of the adrenal glands. Adrenal insufficiency usually resolves with discontinuation of methylprednisolone, but symptoms may persist for 6 to 12 months.
  • Central Nervous System and psychiatric/behavioral
    • Apathy
    • Depression
    • Excitatory psychiatric disturbances (including agitation, anxiety, distractibility, fear, hypomania, insomnia, irritability, lethargy, labile mood, mania, pressured speech, restlessness, and tearfulness)
  • Cushingoid features/Cushing syndrome
    • Truncal obesity
    • Facial adipose tissue
    • Dorsocervical (behind the neck) adipose tissue
  • Gastrointestinal
    • Peptic ulcer
    • Dyspepsia
    • Gastritis
    • Esophagitis
  • Hyperglycemia
    • New-onset hyperglycemia in patients without a history of diabetes
    • Exacerbation of diabetes mellitus
  • Infection
    • Immunosuppressive and anti-inflammatory effects increase risk of infection
  • Neuromuscular and skeletal
    • Osteoporosis
    • Myopathy (muscle weakness)
    • Osteonecrosis (decreased blood flow to bone leading to bone death)
  • Ocular
    • Increased intraocular pressure
    • Glaucoma
    • Cataract
structure
methylprednisolone.svg molecular structure