Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Methylprednisolone is a synthetic (man-made)
corticosteroid. Corticosteroids are naturally-occurring chemicals produced by
the adrenal glands located adjacent to the kidneys. Corticosteroids affect
metabolism in various ways and modify the immune system. Corticosteroids also
block inflammation and are used in a wide variety of inflammatory diseases
affecting many organs.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2, 4, 8, 16, 24, and 32 mg. Injection: 20, 40,
and 80 mg/ml.
STORAGE: Tablets should be kept at room temperature, between 20° and
25°C (68-77°F).
PRESCRIBED FOR: Methylprednisolone is used to achieve prompt
suppression of inflammation. Examples of inflammatory conditions for which
methylprednisolone is used include rheumatoid arthritis,
systemic lupus
erythematosus, acute gouty arthritis, psoriatic arthritis, ulcerative colitis,
and Crohn's disease. Severe allergic conditions that fail conventional treatment
also may respond to methylprednisolone. Examples include bronchial asthma,
allergic rhinitis, drug-induced
dermatitis, and contact and atopic dermatitis.
Chronic skin conditions treated with methylprednisolone include dermatitis
herpetiformis, pemphigus, severe psoriasis and severe
seborrheic dermatitis.
Chronic allergic and inflammatory conditions of the uvea, iris, conjunctiva and
optic nerves of the eyes also are treated with methylprednisolone.
DOSING: Dosage requirements of corticosteroids vary among individuals
and the diseases being treated. In general, the lowest effective dose is used.
The initial oral dose is 4-48 mg daily depending on the disease. The initial
dose should be adjusted based on response. Corticosteroids given in multiple
doses throughout the day are more effective but also more toxic than the same
total daily dose given once daily, or every other day. Methylprednisolone should
be taken with food.
DRUG INTERACTIONS:Troleandomycin (TAO), an infrequently used
macrolide antibiotic, reduces the liver's ability to metabolize
methylprednisolone (and possibly other corticosteroids). This interaction can
result in higher blood levels of methylprednisolone and a higher probability of
side effects. Erythromycin and clarithromycin (Biaxin) are likely to share this
interaction, and ketoconazole (Nizoral) also inhibits the metabolism of
methylprednisolone. Estrogens, including
birth control pills, can increase the
effect of corticosteroids by 50% by mechanisms that are not completely
understood. For all of the above interactions, the dose of methylprednisolone
may need to be lowered. Cyclosporin reduces the metabolism of methylprednisolone
while methylprednisolone reduces the metabolism of cyclosporin. When given
together, the dose of both drugs may need to be reduced to avoid increased side
effects.
Methylprednisolone may increase or decrease the effect of blood thinners [for
example, warfarin (Coumadin)]. Blood clotting should be monitored and therapy adjusted in
order to achieve the desired level of blood thinning (anti-coagulation).
Eczema, also known as dermatitis, is a general term for many types of skin inflammation. The most common form of eczema is atopic dermatitis. The other forms of eczema include: contact eczema, seborrheic eczema, Nummular eczema, Neurodermatitis, stasis dermatitis, and dyshidrotic eczema. Symptoms, diagnosis, and treatment of eczema may vary from person to person and may depend on the type of eczema.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Psoriasis is a long-term skin condition that may cause large plaques of red, raised skin, flakes of dry skin, and skin scales. There are several types of psoriasis, including psoriasis vulgaris, guttate psoriasis, inverse psoriasis, and pustular psoriasis. Symptoms vary depending on the type of psoriasis the patient has. Treatment of psoriasis may include creams, lotions, oral medications, injections and infusions of biologics, and light therapy. There is no cure for psoriasis.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Eczema is a general term for many types dermatitis (skin inflammation). Atopic dermatitis is the most common of the many types of eczema. Other types of eczema include: contact eczema, allergic contact eczema, seborrheic eczema, nummular eczema, stasis dermatitis, and. dyshidrotic eczema.
Temporomandibular joint disorder, or TMJ, is a disorder of the temporomandibular joint(s) that causes signs and symptoms including ear pain, bite problems, headaches, dizziness, clicking sounds in the jaw, tinnitus and/or locked jaws. Behaviors or conditions that can lead to TMJ include teeth grinding or clenching, fingernail biting, habitual gum chewing, trauma to the jaw, stress, and occupational hazards. Treatment for TMJ may include heat, ice, a soft diet, antiinflammatory medications, physical therapy, stress management, occlusal therapy, correction of bite abnormalities, and surgery.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
Poison ivy, oak, and sumac are plants that cause an itchy skin rash and skin inflamation when contacted directly. This poison can be treated with medications such as calamine lotion and cortisone drugs.
Hay fever (allergic rhinitis) is an irritation of the nose caused by pollen and is associated with the following allergic symptoms: nasal congestion, runny nose, sneezing, eye and nose itching, and tearing eyes. Avoidance of known allergens is the recommended treatment, but if this is not possible, antihistamines, decongestants, and nasal sprays may help alleviate symptoms.
When vertebrae are broken or dislocated, the result can cause traumatic injury to the spinal cord. A spinal cord injury can have significant physiological consequences. One indication of the severity of a spinal cord injury are respiratory complications. Spinal cord injuries are classified as either complete or incomplete. A spinal cord injury can affect breathing, lead to pneumonia, low blood pressure, irregular heart beat, blood clots, spasms, autonomic dysreflexia, bed sores (pressure sores), chronic pain, bladder and bowel problems, and reproductive and sexual function issues. Rehabilitation and recovery of a spinal cord injury is dependant upon the type of injury.
Superior vena cava syndrome is compression of the superior vena cava vein located in the upper chest. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or infection. Symptoms of the syndrome include shortness of breath. Superior vena cava syndrome is diagnosed by ultrasound, chest x-ray, CT scan, and in some cases biopsy. Treatment depends upon the cause of the syndrome.
Neuromyelitis optica (Devic's syndrome) is a disease of the CNS that affects the optic nerves and spinal cord. People with neuromyelitis optica develop optic neuritis and transverse myelitis. There is no cure for neuromyelitis optica; however, there are therapies to treat attacks when they occur.
Lupus is an autoimmune disease characterized by acute and chronic
inflammation of various tissues of the body. Autoimmune diseases are illnesses
that occur when the body's tissues are attacked by its own immune system. The
immune system is a complex system within the body that is designed to fight
infectious agents, such as bacteria and other foreign microbes. One of the ways
that the immune system fights infections is by producing antibodies that bind to
the microbes. People with lupus produce abnormal antibodies in their blood
that target tissues within their own body rather than foreign infectious agents.
Because the antibodies and accompanying cells of inflammation can affect tissues
anywhere in the body, lupus has the potential to affect a variety of areas.
Sometimes lupus can cause disease of the skin, heart, lungs, kidneys, joints,
and/or nervous system. When only the skin is involved, the conditi...
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