Methylprednisolone (Solu-Medrol®)

5.37 Methylprednisolone (Solu-Medrol®)
 
 

CLASS
Glucocorticoid, Corticosteroid

ACTIONS
While the exact mechanism of corticosteroid activity is unknown, these agents decrease inflammatory and immune responses by stabilizing membranes within white blood cells responding to a site of infection, injury, irritation, or inflammation.

INDICATIONS

  • Allergic Reaction
  • Respiratory Distress

CONTRAINDICATIONS
Use of this agent is contraindicated in patients allergic to any component of the formulation, those with systemic fungal infections (ask about these in patients on chemotherapy or with AIDS), and in premature infants.

ADVERSE REACTIONS AND SIDE EFFECTS
The majority of adverse reactions to corticosteriods are dose and duration dependent. In the EMS setting, look for euphoria, behavioral alterations, hypertension, and hyperglycemia. Effects of long-term use include edema, cataracts, peptic ulceration, pancreatitis, delayed wound healing, acne, the development of a "buffalo hump" (a subcutaneous fat deposit over the upper thoracic vertebrae), rounded "moon facies", osteoporosis, hirsutism, hypokalemia, and increased susceptibility to infection.

DOSAGE
Adult: 125 mg in both respiratory and allergic conditions

Pediatric: 2 mg/kg in both respiratory and allergic conditions

ROUTE OF ADMINISTRATION:

  • Methylprednisolone is preferentially administered IV.
  • It may also be administered IM in equivalent doses in adults.

NOTES
Methylprednisolone is also used in emergency care in the initial management of spinal trauma. A dose of 30 mg/kg is administered over one hour followed by a 5.4 mg/kg/hour drip. As this medication has a "window" of 3-8 hours after injury for administration, it is not in protocol for this agent to be used by BSOFD or FLFD EMS personnel for this indication.