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a salt or ester of acetic acid (同)ethanoate

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酢酸(さくさん)塩;アセテート(酢酸人造絹糸)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/06/22 06:50:20」(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

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. Also for use 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

Methylprednisolone has some serious side effects if taken long-term, including weight loss, 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 pills to take at designated times over a several-day period. Pharmacists sometimes advise that this drug can cause sleeplessness and "down" moods.

Additional images

4mg Methylprednisolone tablets by Sandoz

References

^ 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. http://www.nejm.org/doi/pdf/10.1056/NEJMoa033280.

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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1. 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
2. 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
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. 関節内および軟部組織注射：注射剤の種類および投与頻度 intraarticular and soft tissue injections what agents to inject and how frequently
5. ステロイド用量の決定因子 determinants of glucocorticoid dosing

English Journal

A Cluster of Methicillin-Susceptible Staphylococcus aureus Infections at a Rheumatology Practice, New York City, 2011.

Drezner K, Antwi M, Del Rosso P, Dorsinville M, Kellner P, Ackelsberg J.Author information New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Queens, New York.AbstractA cluster of 5 methicillin-susceptible Staphylococcus aureus infections occurred after administration of methylprednisolone acetate injections in a rheumatology practice. A site visit was conducted to inspect examination rooms, observe techniques, and review charts. The investigation revealed a pervasive lack of aseptic technique that led to multiple opportunities for medication contamination.
Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America.Infect Control Hosp Epidemiol.2014 Feb;35(2):187-9. doi: 10.1086/674850. Epub 2013 Dec 23.
A cluster of 5 methicillin-susceptible Staphylococcus aureus infections occurred after administration of methylprednisolone acetate injections in a rheumatology practice. A site visit was conducted to inspect examination rooms, observe techniques, and review charts. The investigation revealed a perv
PMID 24442083

Outcomes of greater occipital nerve injections in pediatric patients with chronic primary headache disorders.

Gelfand AA1, Reider AC2, Goadsby PJ3.Author information 1Headache Center, University of California, San Francisco, San Francisco, California; Division of Child Neurology, University of California, San Francisco, San Francisco, California. Electronic address: GelfandA@neuropeds.ucsf.edu.2School of Medicine, University of California, San Francisco, San Francisco, California.3Headache Center, University of California, San Francisco, San Francisco, California.AbstractBACKGROUND: Chronic migraine is common in pediatrics and generally disabling. In adults, infiltration of the area around the greater occipital nerve can provide short- to medium-term benefit in some patients. This study reports the efficacy of greater occipital nerve infiltrations in pediatric patients with chronic primary headache disorders.
Pediatric neurology.Pediatr Neurol.2014 Feb;50(2):135-9. doi: 10.1016/j.pediatrneurol.2013.09.008. Epub 2013 Nov 20.
BACKGROUND: Chronic migraine is common in pediatrics and generally disabling. In adults, infiltration of the area around the greater occipital nerve can provide short- to medium-term benefit in some patients. This study reports the efficacy of greater occipital nerve infiltrations in pediatric patie
PMID 24268688

Japanese Journal

剤形，種類の異なる合成グルココルチコイド製剤の副腎軸と甲状腺軸に対する影響

佐藤穂高,川原井晋平,根尾櫻子,東宮敦士,山田隆紹,折戸謙介,斑目広郎,茅沼秀樹
日本獣医師会雑誌 67(9), 679-685, 2014
小動物臨床では，合成グルココルチコイド（GC）製剤が幅広く使用されているが，剤形，種類の異なる合成GC製剤の視床下部─下垂体─副腎軸（HPAA）と甲状腺軸（HPTA）に対する影響を評価した報告は少ない．本研究では，使用頻度の高い3種類の合成GC製剤のHPAAとHPTAに対する影響を検討した．16頭のビーグル犬を4群に分け，抗炎症量のプレドニゾロン，ベタメタゾン，メチルプレドニゾロン酢酸エステル投与 …
NAID 130004700091

網膜静脈閉塞症に対する酢酸メチルプレドニゾロンのテノン嚢下注射の効果 (特集第63回日本臨床眼科学会講演集(3))

中井孝史,内田真理子,辻本淳子 [他]
臨床眼科 64(5), 763-768, 2010-05
NAID 40017157523

「メチルプレドニゾロン」

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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