METHYLPREDNISOLONE (Solu-Medrol®)

Question 1

Drug Classification

Answer 1

Corticosteroid /Anti-inflammatory

Question 2

Mechanism of Action

Answer 2

Diffuses across the cell membranes of various cells present in all tissues, binds to DNA, regulates gene expression and increases synthesis of proteins and enzymes that inhibit inflammatory agents (cytokines, interleukin, interferon); inhibits synthesis of pro-inflammatory enzymes
Is an immunosuppressant

Question 3

Pharmacokinetics

Answer 3

Onset of Action = 2-6 hours
Peak Effects = 4-8 days
Duration of Effect = 1-5 weeks
Half-Life = 3.5 hours

Question 4

Indications/Field Use

Answer 4

Allergic reaction/anaphylaxis
Asthma/COPD/RAD
Adrenal insufficiency

Question 5

Contraindications

Answer 5

None

Question 6

Side effects/Adverse reactions

Answer 6

Hypertension, congestive heart failure, fluid retention, headache, vertigo, malaise, nausea, abdominal distention, hiccups, psychosis

Question 7

Dose

Answer 7

A: 125mg slow IV/IO
P: 2mg/kg slow IV/IO (max dose 125mg)

Question 8

Precautions

Answer 8

Give only one dose prehospitally, long-term steroid use can cause GI bleeding, prolonged wound healing, and suppression of adrenocortical steroids

Question 9

Drug Interactions

Answer 9

Decreased effect with phenytoin, phenobarbital, and rifampin due to increased metabolism of steroids