Medrol steroid injection

An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with disorders of neuromuscular transmission (., myasthenia gravis ), or in patients receiving concomitant therapy with neuromuscular blocking drugs (., pancuronium). This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis . Elevations of creatine kinase may occur. Clinical improvement or recovery after stopping corticosteroids may require weeks to years.

In patients with the adrenogenital syndrome, a single intramuscular injection of 40 mg every two weeks may be adequate. For maintenance of patients with rheumatoid arthritis , the weekly intramuscular dose will vary from 40 to 120 mg. The usual dosage for patients with dermatologic lesions benefited by systemic corticoid therapy is 40 to 120 mg of methylprednisolone acetate administered intramuscularly at weekly intervals for one to four weeks. In acute severe dermatitis due to poison ivy, relief may result within 8 to 12 hours following intramuscular administration of a single dose of 80 to 120 mg. In chronic contact dermatitis, repeated injections at 5 to 10 day intervals may be necessary. In seborrheic dermatitis, a weekly dose of 80 mg may be adequate to control the condition.

Early trials of intra-articular corticosteroids showed equal systemic absorption of methylprednisolone in patients with rheumatic and osteoarthritic hands 42 and knees. 43 This suggests that steroid pharmacokinetics, rather than disease-related factors, should guide steroid selection. A recent review by the National Health Service of the United Kingdom 44   recommends triamcino-lone and methylprednisolone as preferred agents for injection of large joints (., knee). For smaller joints (., finger), either hydrocortisone or methylprednisolone (Hydeltrasol, brand no longer available in the United States) is recommended. Tables 5 and 6 45 compare commonly available steroid preparations.

Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation (., decreasing absorption and increasing excretion) and inhibition of osteoblast function. This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism , and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age. Special consideration should be given to patients at increased risk of osteoporosis (., postmenopausal women) before initiating corticosteroid therapy.

Direct intravenous injection:
Use only methylprednisolone sodium succinate.
Reconstitute with provided diluent or add 2 ml of bacteriostatic water (with benzyl alcohol) for injection.
May be administered undiluted.
Administer directly into a vein over 3—15 minutes. Doses >= 2 mg/kg or 250 mg should be given by intermittent infusion (see below), unless the potential benefits of direct IV injection outweigh the potential risks (., life-threatening shock).
 
Intermittent intravenous infusion:
Use only methylprednisolone sodium succinate.
Dilute in D5W, % Sodium Chloride (NS), or D5NS injection. Haze may form upon dilution.
Infuse over 15—60 minutes. Large doses (., >= 500 mg) should be administered over at least 30—60 minutes.

Medrol steroid injection

medrol steroid injection

Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation (., decreasing absorption and increasing excretion) and inhibition of osteoblast function. This, together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism , and reduced sex hormone production, may lead to inhibition of bone growth in pediatric patients and the development of osteoporosis at any age. Special consideration should be given to patients at increased risk of osteoporosis (., postmenopausal women) before initiating corticosteroid therapy.

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