medrol

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Depo-Medrol, Medrol, Solu-Medrol

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Methylprednisolone

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/25 15:21:20」(JST)

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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 Y
ATC code	D07AA01 D07AC14, D10AA02, H02AB04
PubChem	CID 6741
DrugBank	DB00959
ChemSpider	6485 Y
UNII	X4W7ZR7023 Y
KEGG	D00407 Y
ChEBI	CHEBI:6888 Y
ChEMBL	CHEMBL650 Y
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 Y Key:VHRSUDSXCMQTMA-PJHHCJLFSA-N Y
Y (what is this?)  (verify)

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

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

Uses

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.

After egg retrieval for a cycle of in vitro fertilization, methylprednisolone may be prescribed to prevent the body from rejecting the embryos being transferred, up to the time of implantation.

Side effects

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. 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

• 4mg Methylprednisolone tablets by Sandoz

• Medrol
  32mg Methylprednisolone tablets by Pfizer

See also

• Guanacastepene A - also composed as C22H30O5
• Prednisone - also a corticosteroid
• Dexamethasone - also a corticosteroid

References

External links

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

UpToDate Contents

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• 2. 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 crohns disease in children and adolescents
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• 5. 成人における多発性硬化症の急性増悪の治療 treatment of acute exacerbations of multiple sclerosis in adults

English Journal

• Concomitant thrombotic thrombocytopenic purpura and ANCA-associated vasculitis in an adolescent.

• Agrawal V, Vaidya CK, Ye J, Freeman J, McKiernan C, Blier PR, Andrzejewski C Jr, Germain M, Braden GL.SourceRenal Division, Department of Internal Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, USA, varunagrawal1996@yahoo.com.
• Pediatric nephrology (Berlin, Germany).Pediatr Nephrol.2011 Aug;26(8):1317-20. Epub 2011 Apr 16.
• Thrombotic thrombocytopenic purpura (TTP) rarely occurs with systemic vasculitis. A 17-year-old girl presented with non-bloody diarrhea, menorrhagia, and syncope. She had severe anemia (hemoglobin?=?3.8?g/dl), thrombocytopenia (platelet?=?7,000/mm(3)), and acute kidney injury (serum creatin
• PMID 21499772

• Determination of steroids adulterated in liquid herbal medicines using QuEChERS sample preparation and high-performance liquid chromatography.

• Klinsunthorn N, Petsom A, Nhujak T.SourceChromatography and Separation Research Unit, Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand; Regional Medical Sciences Center Samut Songkhram, Department of Medical Sciences, Ministry of Public Health, Samut Songkhram 75000, Thailand.
• Journal of pharmaceutical and biomedical analysis.J Pharm Biomed Anal.2011 Jul 15;55(5):1175-8. Epub 2011 Apr 8.
• QuEChERS sample preparation was optimized using solvent extraction with acetonitrile and dispersive-solid phase extraction with primary and secondary amine sorbents, and validated for high-performance liquid chromatographic determination of nine steroids commonly used to adulterate herbal medicines:
• PMID 21531110

Japanese Journal

• 懸濁性ステロイド剤を用いた頸部神経根ブロックにより小脳・脳幹部梗塞をきたした1例

• 川股 知之,並木 昭義
• The journal of the Japan Society of Pain Clinicians = 日本ペインクリニック学会誌 17(1), 25-28, 2010-01-25
• 頸部神経根ブロックに使用した懸濁性メチルプレドニゾロンによると思われる小脳・脳幹部梗塞を経験した．症例，57歳女性．頸椎椎間板ヘルニアによるC6，C7の根性痛が増強したため，近医より神経根ブロック目的で当科に紹介された．X線透視下で神経根ブロックを試み，造影剤にて血管陰影を認めずC6神経根鞘が描出されたため，0.75％ロピバカイン1 mlと懸濁性メチルプレドニゾロン1 mlの混合液を1 ml注入し …
• NAID 10026389009

• 塩酸イリノテカン注と他注射剤との配合変化 (第一報)

• 田上 直美,上田 一美,森山 祐輔,有森 和彦,中野 眞汎,菊池 正彦,佐野 瑞生,片岡 捷夫
• 病院薬学 22(5), 457-465, 1996-10-10
• … With the admixture with Solu-Medrol^<[!R]> …
• NAID 110001799601

Related Links

• methylprednisolone (Medrol) - drug class, medical uses, medication ...

29 Jun 2011 ... Explains the medication thmethylprednisolone (Medrol) a drug used to achieve prompt suppression of inflammation. Article includes descriptions, uses, drug interactions, and side effects.

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