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.
