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Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
Prednisone is a prodrug and must be converted to prednisolone by the liver before it becomes active. [6] [7] Prednisolone then binds to glucocorticoid receptors, activating them and triggering changes in gene expression. [4] Prednisone was patented in 1954 and approved for medical use in the United States in 1955.
[6] [7] [8] Applying once daily is enough as it is as effective as twice or more daily application. [9] To prevent tachyphylaxis, a topical steroid is often prescribed to be used on a week on, week off routine. Some recommend using the topical steroid for 3 consecutive days on, followed by 4 consecutive days off. [10]
6.5 – 1.3 Fludrocortisone acetate: 15 200 24 Deoxycorticosterone acetate: 0 20 – Aldosterone: 0.3 200–1000 – Beclometasone: 8 sprays 4 times every day equivalent to orally 14 mg prednisone once a day – –
every day mistaken for "QOD" or "qds," AMA style avoids use of this abbreviation (spell out "every day") q.d.a.m. quaque die ante meridiem: once daily in the morning q.d.p.m. quaque die post meridiem: once daily in the evening q.d.s. quater die sumendus: 4 times a day can be mistaken for "qd" (every day) q.p.m. quaque die post meridiem
[7] [8] [6] It differs from the similarly named prednisone in having a hydroxyl at the 11th carbon instead of a ketone. Common side effects with short-term use include nausea, difficulty concentrating, insomnia, increased appetite, and fatigue. [5] More severe side effects include psychiatric problems, which may occur in about 5% of people. [9]
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50 mg hydrocortisone IV: 25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) 100 mg hydrocortisone IV: 50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level.
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