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Depo-Medrol Review Article

 

rheumatoid arthritisMethylprednisolone, known as Depo-Medrol, is a synthetic glucocorticoid drug which is sold in the USA and Canada under the brand names Phocenta, Medrol, Solu-Medrol or Cadista. It is typically used for its anti-inflammatory effects, like most adrenocortical steroids, but it can change the metabolism and the immune responses. The list of medical conditions for which methlyprednisolone is prescribed is rather long, and is similar to other corticosteroids such as prednisolone. Common uses include arthritis therapy and short-term treatment of bronchial inflammation or acute bronchitis due to various respiratory diseases. It is used both in the treatment of acute periods and long-term management of autoimmune diseases, most notably Systemic lupus erythematosus. Depo-Medrol, also known by the name of methylprednisolone is basically a synthetic glucocortocoid drug. In countries like Canada and USA, it is sold under the brand names like Phocenta, Medrol, Cadista and Solu-Medrol. It falls under the category of adrenocortical steroids that are used for their anti-inflammatory effects and there are numerous purposes for which methylprednisolone are used. However, glucocorticoids are used for other purposes related to metabolism and immune responses. Some of the common problems for which it is used include short-term treatment for bronchial inflammation and arthritis therapy. It can be used for both long-term and short-term treatment of autoimmune diseases, especially lupus erythematosus. Continue reading...

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Indications

Prescribed for Endocrine Disorders
Primary as well as Secondary adrenocortical insufficiency
Acute adrenocortical insufficiency
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
Rheumatic Disorders
Post-traumatic osteoarthritis
Synovitis of osteoarthritis
Acute and subacute bursitis
Acute nonspecific tenosynovitis
Epicondylitis
Psoriatic arthritis
Acute gouty arthritis


Collagen diseases

Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
Systemic lupus erythematosus


Dermatologic Diseases

Mycosis fungoides
Severe psoriasis
Severe seborrheic dermatitis
Bullous dermatitis herpetiformis
Exfoliative dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome)
Pemphigus

In state of Allergy

Bronchial asthma
Contact dermatitis
Seasonal or perennial allergic rhinitis
Atopic dermatitis
Serum sickness
Drug hypersensitivity reactions
Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
Urticarial transfusion reactions

Ophthalmic Diseases

Chorioretinitis
Herpes zoster ophthalmicus
Iritis, iridocyclitis
Sympathetic ophthalmia
Diffuse posterior uveitis and choroiditis
Optic neuritis
Anterior segment inflammation
Keratitis
Allergic conjunctivitis
Allergic corneal marginal ulcers


Gastrointestinal Diseases

Regional enteritis (systemic therapy)
Ulcerative colitis (systemic therapy)


Respiratory Diseases

Aspiration pneumonitis
Loeffler's syndrome
Symptomatic sarcoidosis
Berylliosis

Hematologic Disorders

Congenital (erythroid) hypoplastic anaemia
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anaemia)
Acquired (autoimmune) haemolytic anaemia

Neoplastic Diseases

Acute leukaemia of childhood
Leukaemia and lymphomas in adults

Nervous System

Exacerbations of multiple sclerosis


Dosage

Due to physical incompatibilities, Depo-Medrol should not be mixed with other solutions.
Administration for Local Effect
In case of Rheumatoid and Osteoarthritis
The dosage in these cases varies with the size of the joints and the severity of the condition of the patient. In severe cases, the dosage is repeated from one to five weeks depending on the relief that it provides to the patient.
In case Dermatologic Conditions
The dosage in this case varies from 20 mg to 60 mg and divided doses of 20 mg to 40 mg in case of large lesions.


Administration for Systemic Effect

For patients who are suffering from adrenogenital syndrome, a single dose of 40 mg in every two weeks is enough. In case of patients suffering from rheumatoid arthritis, the intramuscular dose varies from 40 mg to 120 mg. For patients with dermatologic lesions, the dosage caries from 40 to 120 mg of methylprednisolone acetate intramuscularly for one to four weeks.


Side effects

Fluid and electrolyte disturbances
Sodium retention
Potassium loss
Congestive heart failure in susceptible patients
Hypertension
Hypokalemic alkalosis
Fluid retention
Ophthalmic
Exophthalmos
Posterior subcapsular cataracts
Increased intraocular pressure
Glaucoma


Endocrine
Development of Cushingoid state
Decreased carbohydrate tolerance
Suppression of growth in children
Menstrual irregularities
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Increased requirements for insulin or oral hypoglycemic agents in diabetes
Manifestations of latent diabetes mellitus


Musculoskeletal
Steroid myopathy
Muscle weakness
Loss of muscle mass
Tendon rupture, particularly of the Achilles tendon
Osteoporosis
Aseptic necrosis of femoral and humeral heads
Vertebral compression fractures
Pathologic fracture of long bones


Gastrointestinal
Pancreatitis
Peptic ulcer with possible subsequent perforation and haemorrhage
Abdominal distention
Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.
Ulcerative esophagitis


Dermatologic
Petechiae and ecchymoses
Impaired wound healing
Facial erythema
Thin fragile skin
May suppress reactions to skin tests
Increased sweating

Neurological
Convulsions
Vertigo
Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment
Headache


 

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