同: methylprednisolone sodium succinate

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the blood group whose red cells carry the A antigen (同)type_A, group A

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/05/13 20:53:23」(JST)

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Methylprednisolone is a synthetic glucocorticoid or corticosteroid drug. It is marketed in the USA and Canada under the brand names Medrol and Solu-Medrol.^[1] It is also available as a generic drug.

It is a variant of prednisolone, methylated at carbon 6 of the B ring.

Uses [edit]

Like most adrenocortical steroids, methylprednisolone is typically used for its anti-inflammatory effects. However, glucocorticoids have a wide range of effects, including changes to metabolism and immune responses. The list of medical conditions for which methylprednisolone 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. It is also used as a treatment for multiple sclerosis.

Methylprednisolone is also prescribed for nonpenetrating spinal cord injuries. It has been shown that a dose of 30 mg/kg IV followed by IV drip at 5.4 mg/kg/hr for 23 hours improves sensory and motor recovery if given within eight hours of the injury.^{[citation needed]}

It is also used for vestibular neuritis.^[2]

Side effects [edit]

Long-term use of methylprednisolone, as with all corticosteroids, can be associated with hyperglycemia, decreased resistance to infection, swelling of face, weight gain, congestive cardiac insufficiency, fluid and sodium retention, edema, hypertension, increased eye pressure, glaucoma, osteoporosis and psychosis, especially when used at high dosage.^[3]^[4] The most serious side effect occurs after the adrenal glands cease natural production of cortisol, which methylprednisolone will replace. Abrupt cessation of the drug after this occurs can result in a condition known as Addisonian crisis, which can be fatal. To prevent this, the drug is usually prescribed with a tapering dosage, including a pre-dosed "dose pack" detailing a specific number of tablets to take at designated times over a several-day period. Pharmacists sometimes advise that this drug can cause sleeplessness and "down" moods.

Individuals on methylprednisolone therapy should assiduously avoid exposure to measles and chicken pox as contracting these viral infections while on high dose corticosteroids can result in a potentially fatal viral course. Any accidental exposure to these viral infections by individuals uncertain of their immunity to chicken pox or measles should be reported immediately as prophylactic immunoglobulin therapy may be administered. Additionally, the administration of live, attenuated vaccines is contraindicated for individuals taking immunosuppressive doses of methylprednisolone. The exception to this rule is patients receiving complete corticosteroid replacement therapy, e.g., for Addison's disease, who may follow standard immunization protocols.

Additional images [edit]

4mg Methylprednisolone tablets by Sandoz
Medrol
32mg Methylprednisolone tablets by Pfizer

References [edit]

^ Methylprednisolone - Compound Summary PubChem
^ Strupp M, Zingler VC, Arbusow V, Niklas D, Maag KP, Dieterich M, Bense S, Theil D, Jahn K, Brandt T (July 2004). "Methylprednisolone, valacyclovir, or the combination for vestibular neuritis" (PDF). N. Engl. J. Med. 351 (4): 354–61. doi:10.1056/NEJMoa033280. PMID 15269315.
^ "SOLU-MEDROL (methylprednisolone sodium succinate) injection, powder, for solution". National Institutes of Health. Retrieved 24 August 2012.
^ "Medrol (Methylprednisolone - Tablets by Pfizer)". Sfatul Medicului. Retrieved 14 April 2013.

External links [edit]

Medrol Prescribing Information Pfizer
U.S. National Library of Medicine: Drug Information Portal - Methylprednisolone
"methylprednisolone" at medicinenet.com

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
2. 頸部の疼痛または損傷がみられる小児または思春期のアスリートに対するアプローチ approach to the child or adolescent athlete with neck pain or injury
3. 小児および思春期におけるクローン病マネージメントの概要 overview of the management of crohn disease in children and adolescents
4. Acquired TTP: Treatment of refractory or relapsed disease
5. ステロイド用量の決定因子 determinants of glucocorticoid dosing

English Journal

Steroid-free Liver Transplantation Using Rabbit Antithymocyte Globulin Induction in 500 Consecutive Patients.

Yoo MC1, Vanatta JM, Modanlou KA, Campos L, Nezakatgoo N, Nair S, Eason JD.
Transplantation.Transplantation.2015 Jun;99(6):1231-5. doi: 10.1097/TP.0000000000000477.
BACKGROUND: We have previously documented the efficacy of a steroid-free immunosuppression protocol using rabbit antithymocyte globulin (RATG) induction in orthotopic liver transplantation (OLT) with tacrolimus minimization. The purpose of this report is to demonstrate the benefits of this protocol
PMID 25539464

Protective effects of systemic treatment with methylprednisolone in a rodent model of non-arteritic anterior ischemic optic neuropathy (rAION).

Huang TL1, Huang SP2, Chang CH3, Lin KH4, Chang SW5, Tsai RK6.
Experimental eye research.Exp Eye Res.2015 Feb;131:69-76. doi: 10.1016/j.exer.2014.12.014. Epub 2014 Dec 24.
This study investigated the protective effects of the administration of steroids on optic nerves (ON) and retinal ganglion cells (RGCs) in a rodent model of non-arteritic anterior ischemic optic neuropathy (rAION). We induced rAION using rose bengal and argon laser irradiation in a photodynamic proc
PMID 25543054

Anaphylaxis to Intravenous Methylprednisolone Hemisuccinate in a Patient With Immune Thrombocytopenia.

Alvarez Caro F, García González V, González García J, García Mozo R, García Norniella B, Gómez Farpó A.
Journal of investigational allergology & clinical immunology.J Investig Allergol Clin Immunol.2015;25(4):309-10.
PMID 26310052

Related Pictures

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Methylprednisolone
Systematic (IUPAC) name
	(1S,2R,8S,10S,11S,14R,15S,17S)-14,17-dihydroxy-14-(2-hydroxyacetyl)-2,8,15-trimethyltetracyclo[8.7.0.02,7.011,15]heptadeca-3,6-dien-5-one
Clinical data
Trade names	Medrol, Meprolone
AHFS/Drugs.com	monograph
MedlinePlus	a682795
Licence data	US FDA:link
Pregnancy cat.	A (AU) C (US)
Legal status	POM (UK) ℞-only (US)
Routes	IV, IM, IV Infusion, Oral, Rectal, Topical
Pharmacokinetic data
Protein binding	78%
Metabolism	liver primarily, kidney, tissues; CYP450: 3A4 substrate
Half-life	urine; Half-life: 18-26h (biological)
Identifiers
CAS number	83-43-2
ATC code	D07AA01 D07AC14, D10AA02, H02AB04
PubChem	CID 6741
DrugBank	DB00959
ChemSpider	6485
UNII	X4W7ZR7023
KEGG	D00407
ChEBI	CHEBI:6888
ChEMBL	CHEMBL650
Synonyms	(6α, 11β)-11,17,21-trihydroxy-6-methyl-pregna-1,4-diene-3,20-dione
Chemical data
Formula	C22H30O5
Mol. mass	374.471 g/mol
	SMILES O=C\1\C=C/[C@]4(/C(=C/1)[C@@H](C)C[C@@H]2[C@@H]4[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@@H]23)C)C;
	InChI InChI=1S/C22H30O5/c1-12-8-14-15-5-7-22(27,18(26)11-23)21(15,3)10-17(25)19(14)20(2)6-4-13(24)9-16(12)20/h4,6,9,12,14-15,17,19,23,25,27H,5,7-8,10-11H2,1-3H3/t12-,14-,15-,17-,19+,20-,21-,22-/m0/s1 ; Key:VHRSUDSXCMQTMA-PJHHCJLFSA-N ;
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