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Trade Name: Solu-MEDROL

Generic Name:
methylPREDNISolone

Pt Weight: 96.6kg

Classification: corticosteroids
Indications:
Used systemically and locally in a wide variety of chronic diseases including:
Inflammatory,
Allergic,
Hematologic,
Neoplastic,
Autoimmune disorders,
Immunosuppresant.
May be suitable for alternate-day dosing in the management of chronic illness.
Replacement therapy in adrenal insufficiency.
Why is your patient taking this drug? Management of chronic illnesses
Standard doses and routes: IM: (Adults) Methylprednisolone acetate 40120 mg daily, weekly,
or every 2 wk.
Patient Dose: 125mg I.V. q8h
Adverse Reactions & Side Fx:

Patient/Family Teaching:

Adverse reactions/side effects are much more common with


high-dose/long-term therapy
CNS: depression, euphoria, headache, intracranial pressure
(children only), personality changes, psychoses, restlessness
EENT: cataracts, intraocular pressure
CV: hypertension
GI: PEPTIC ULCERATION, anorexia, nausea, vomiting
Derm: acne, 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
Metabolic: weight gain, weight loss
MS: muscle wasting, osteoporosis, avascular necrosis of
joints, muscle pain
Misc: cushingoid appearance (moon face, buffalo hump),
susceptibility to infection
* CAPITALS indicate life-threatening.
Italics indicate most frequent.

1. Instruct patient on correct


technique of medication
administration. Advise
patient to take medication
as directed. Take missed
doses as soon as
remembered unless almost
time for next dose. Do not
double doses. Stopping the
medication suddenly may
result in adrenal
insufficiency (anorexia,
nausea, weakness, fatigue,
dyspnea, hypotension,
hypoglycemia). If these
signs appear, notify health
care professional
immediately. This can be
life-threatening.
2. Glucocorticoids cause
immunosuppression and

Trade Name: Solu-MEDROL

Generic Name:
methylPREDNISolone

Pt Weight: 96.6kg

Contraindications:
Active untreated infections (may be used in patients being
treated for tuberculous meningitis)
Known alcohol, bisulfite, or tartrazine hypersensitivity or
intolerance (some products contain these and should be
avoided in susceptible patients)
Administration of live virus vaccines.

3.

Nursing Implications:
1. Medrol may contain tartrazine. Watch for allergic reaction to
tartrazine in patients with sensitivity to aspirin
2. Drug may be used for alternate-day therapy
3. Most adverse reactions to corticosteroids are dose or
duration dependent. For better results and less toxicity, give
once-daily dose in the morning
4. If immediate onset of action is needed dont use acetate
form
5. Always adjust to lowest effective dose
6. Monitor patients weight, blood pressure, electrolyte level,
and sleep patterns. Euphoria may initially interfere with
sleep, but patients typically adjust therapy in 1 to 3 weeks
7. Monitor patients for cushingoid effects, including moon
face, buffalo hump, central obesity, thinning hair,
hypertension, and increased susceptibility to infection
8. Drug may mask or worsen infections, including latent
amebiasis
9. Watch for depression or psychotic episodes, especially in
high-dose therapy
10. Diabetic pt may need increased insulin; monitor glucose
level
11. Watch for enhanced response to drug in patients with
hypothyroidism or cirrhosis
12. Unless contraindicated, give low-sodium diet thats high in
potassium and protein. Give potassium supplements as
needed
13. Elderly patients may be more susceptible to osteoporosis
with prolonged use
14. Taper off dosage after long-term therapy
Lab Test Considerations:
1. May increase glucose and cholesterol levels and ALT, AST,
alkaline phosphatase, and urine calcium levels
2. May decrease T3, T4, potassium, and calcium levels
3. May decrease 131 I uptake and protein bound iodine levels
in thyroid fen tests. May cause false-negative results in
nitroblue tetrazolium test for systemic bacterial infections.
May alter reactions to skin tests

4.

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9.

immunosuppression and
may mask symptoms of
infection. Instruct patient
to avoid people with known
contagious illnesses and to
report possible infections
immediately.
Caution patient to avoid
vaccinations without first
consulting health care
professional.
Review side effects with
patient. Instruct patient to
inform health care
professional promptly if
severe abdominal pain or
tarry stools occur. Patient
should also report unusual
swelling, weight gain,
tiredness, bone pain,
bruising, nonhealing sores,
visual disturbances, or
behavior changes.
Advise patient to notify
health care professional of
medication regimen before
treatment or surgery.
Discuss possible effects
on body image. Explore
coping mechanisms.
Instruct patient to inform
health care professional if
symptoms of underlying
disease return or worsen.
Advise patient to carry
identification describing
disease process and
medication regimen in the
event of emergency in
which patient cannot relate
medical history.
Explain need for continued
medical follow-up to
assess effectiveness and
possible side effects of
medication. Periodic lab
tests and eye exams may
be needed.