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.
Phenobarbital, phenytoin
(Dilantin), and rifampin
(Rifadin, Rimactane) may increase the metabolism of
methylprednisolone and other corticosteroids, resulting in lower blood levels
and reduced effects. Therefore, the dose of methylprednisolone may need to be
increased if treatment with phenobarbital is begun.
PREGNANCY: Methylprednisolone has not been adequately evaluated in
pregnant women.
NURSING MOTHERS: Methylprednisolone has not been adequately evaluated
in nursing mothers.
SIDE EFFECTS: Adverse effects of methylprednisolone depend on dose,
duration and frequency of administration. Short courses of methylprednisolone
are usually well-tolerated with few, mild side effects. Long term, high doses of
methylprednisolone may produce predictable and potentially serious side effects.
Whenever possible, the lowest effective doses of methylprednisolone should be
used for the shortest length of time to minimize side effects. Alternate day
dosing also can help reduce side effects.
Side effects of methylprednisolone and other corticosteroids range from mild
annoyances to serious irreversible bodily damage. Side effects include fluid
retention, weight gain, high blood pressure, potassium loss, headache, muscle
weakness, puffiness of the face, hair growth on the face, thinning and easy
bruising of the skin, glaucoma, cataracts,
peptic ulceration, worsening of
diabetes,
irregular menses, growth retardation in children, convulsions, and
psychic disturbances. Psychic disturbances may include depression, euphoria,
insomnia, mood swings, personality changes, and even
psychotic behavior.
Prolonged use of methylprednisolone can depress the ability of the body's
adrenal glands to produce corticosteroids. Abruptly stopping methylprednisolone
in these individuals can cause symptoms of corticosteroid insufficiency, with
accompanying nausea,
vomiting, and even shock. Therefore, withdrawal of
methylprednisolone usually is accomplished by gradually lowering the dose.
Gradually tapering methylprednisolone not only minimizes the symptoms of
corticosteroid insufficiency, it also reduces the risk of an abrupt flare of the
disease being treated.
Methylprednisolone and other corticosteroids can mask signs of infection and
impair the body's natural immune response to infection. Patients on
corticosteroids are more susceptible to infections and can develop more serious
infections than individuals not on corticosteroids. For example,
chickenpox and
measles viruses can produce serious and even fatal illnesses in patients on high
doses of methylprednisolone. Live virus vaccines, such as
smallpox vaccine,
should be avoided in patients taking high doses of methylprednisolone since even
vaccine viruses may cause disease in these patients. Some infectious organisms,
such as tuberculosis (TB) and malaria, can remain dormant in patients for years.
Methylprednisolone and other corticosteroids can allow these infections to
reactivate and cause serious illness. Patients with dormant TB may require
anti-TB medications while undergoing prolonged corticosteroid treatment.
By interfering with the patient's immune response, methylprednisolone can
prevent vaccines from being effective. Methylprednisolone also can interfere
with the TB skin test and cause falsely negative results in patients with
dormant TB infections.
Methylprednisolone impairs calcium absorption and new bone formation.
Patients on prolonged treatment with methylprednisolone and other
corticosteroids can develop osteoporosis and an increased risk of
bone
fractures. Supplemental calcium and
vitamin D are encouraged to slow this
process of bone thinning. In rare individuals, destruction of large joints can
occur while undergoing treatment with methylprednisolone or other
corticosteroids (aseptic necrosis). These patients experience severe pain in the
joints involved, and can require joint replacement. The reason behind such
destruction is not clear. Methylprednisolone can be used in pregnancy, but is
generally avoided.
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.
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