메틸프레드니솔론

용도

• Labeled uses (Oral)
• Labeled uses (Injectable)
• Intralesional (sub-lesional) use
• Antiinflammatory (glucocorticoid effects)
• Intra-articular use
• Labeled uses (Oral)
• Labeled uses (Injectable)
• Intralesional (sub-lesional) use

투여 방법

가능한 부작용

• Polyuria (PU), polydipsia (PD), polyphagia (PP)
• Iatrogenic hyperadrenocorticism (Cushingoid signs) with sustained use
• HPA axis suppression
• Weight gain and lipidemias
• Dull, dry haircoat and alopecia
• Muscle wasting and weakness
• Gastrointestinal ulceration, vomiting, diarrhea, melena, hematochezia
• Elevated liver enzymes (ALP, ALT) and hepatopathy
• Pancreatitis
• Activation or worsening of diabetes mellitus (especially in cats)
• Behavioral changes (depression, lethargy, viciousness, panting)
• Extracellular hyperglycemia leading to volume expansion and potential CHF (cats)
• Hypothalamic-pituitary-adrenal (HPA) axis suppression

주의사항 및 금기

• Systemic fungal infections (unless used for Addison's replacement)
• Viral infections
• Arrested tuberculosis
• Peptic or corneal ulcers
• Acute psychoses
• Cushingoid syndrome
• Idiopathic thrombocytopenia (for IM administration)
• Acute local infections (for intrasynovial/intratendinous use)
• Chronic systemic therapy using sustained-release injectable forms
• Pregnant animals
• Renal disease
• Diabetes mellitus
• > **Tapering Required:** Animals receiving systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and corticosteroid function to recover. Abrupt withdrawal can precipitate an Addisonian crisis. * **Stress Dosing:** Additional glucocorticoids may be needed during stressors (surgery, trauma, illness) during the tapering process. * **Use with Caution:** In patients with diabetes mellitus, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), and renal insufficiency. * **Pregnancy:** FDA Category C. May cause teratogenic effects in early pregnancy. Exogenous steroids can induce parturition in the latter stages of pregnancy in horses and ruminants. * **Nursing Dams:** Glucocorticoids enter milk and may inhibit growth or interfere with endogenous corticosteroid production in nursing offspring.

약물 상호작용

• Amphotericin B: May cause hypokalemia; potential for CHF and cardiac enlargement
• Analgesics/Opiates/Local Anesthetics (epidural): Combination in epidurals has caused serious CNS injuries and death
• Anticholinesterase agents (e.g., pyridostigmine): May lead to profound muscle weakness in myasthenia gravis patients
• Aspirin: Glucocorticoids may reduce salicylate blood levels
• Barbiturates: May increase the metabolism of glucocorticoids and decrease blood levels
• Cyclophosphamide: Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
• Cyclosporine: May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
• Potassium-depleting diuretics: May cause hypokalemia
• Ephedrine: May reduce methylprednisolone blood levels
• Estrogens: May potentiate the effects of methylprednisolone
• Insulin: Insulin requirements may increase due to glucocorticoid-induced insulin resistance

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