Corticosteroids are part of treatment options for various conditions including immune reactions and inflammation linked to ailments that afflict different organs in the body. Neoplastic diseases and certain endocrine related ailments also require the use of corticosteroid class of medications for treatment. Methylprednisolone belonging to the category of glucocorticoids is a prednisolone derivative and is known to have a better outcome due to increased potency. In use for around 65 years since FDA approval, the drug is known for its efficacy. Following subsections turn the focus on methylprednisolone mechanism of action during treatment of various conditions. This will help understand more about the efficacy, and the possible undesirable outcomes of the drug.

Overview of methylprednisolone

Before looking at the description of the corticosteroid, an interesting fact about methylprednisolone for patients with Covid-19. The drug was administered in low dosages as part of a trial therapy in a patient diagnosed with pneumonia due to Covid. The patient had a history of immunosuppression, and the corticosteroid was used with good results and outcomes. Further studies have been conducted and are ongoing to assess the effectiveness of the drug in treating specific Covid related conditions.  

Methylprednisolone is available as tablets, and injections and as outlined above, is mainly used to reduce inflammation linked to different conditions. For instance, patients diagnosed with endocrine related conditions and serious cases of allergies are known to experience inflammation and the drug helps to control inflammation, offering relief. Other conditions that also trigger inflammation include ulcerative colitis, multiple sclerosis, and rheumatic conditions. Conditions treated also extend to lupus, psoriasis eye ulcers, lung problems linked to beryllium poisoning, low platelet count in adults, low red blood cell count in children, multiple sclerosis, and trichinosis.

How long does it take methylprednisolone to start working? 

To know more about the time it takes for methylprednisolone to start working, it is necessary to more about how it works. The drug, belongs to the category of synthetic glucocorticoids, and are recommended because of the immunosuppressive properties and the anti-inflammatory action linked to it. One of the highlights of the drug is that it is known to have potency that is measured as five times greater than certain other formulations, while delivering the outcomes with relatively lesser effects.

The medication is known to bind to the intracellular glucocorticoid receptor, and this results in blocking the sites that are responsible for inflammatory action. The binding action, actually causes an interaction with certain DNA sequences, and the consequence of this is either a suppression or an enhancement of specific genes. In addition to the blocking of proinflammatory genes, the action is also known to be responsible for inducing anti-inflammatory genes. Additionally, the blocking of particular transcription factors results in the inhibition of inflammatory cytokines.

Inflammation is attributed to cyclooxygenase synthesis, which in turn results in prostaglandins production, and effective medications are known to work by suppressing this synthesis. Methylprednisolone mechanism of action also includes this suppression, and this is one of the reasons for the efficacy and outcomes of the corticosteroid.

The outcomes of the drug are attributed to various actions, and not just a single action or property. For instance, the drug is also known to reverse capillary permeability, and the resultant sequence of actions include suppression of fibroblasts migration, and a reduction in protein synthesis rate. These actions are known to be responsible for reducing and also preventing inflammation.  Additionally, the drug is also known to bring about an increase in monocytes, while reducing circulating eosinophils significantly, apart from lymphocytes reduction in a smaller number.

The mechanism of action of the drug is known to trigger certain effects, and the more prominent effects include increase in blood glucose levels. The corticosteroid is also known to be responsible for breaking down muscle protein, and as a result, the patient may experience increase visible changes due to fat. For instance, the face, the shoulders and the back are likely to have increase in fat due to this effect on muscle protein.  Catabolism is not restricted to muscle protein, but may also extend to connective tissue, skin and fat, if the drug is administered in high doses. Bone may also experience the effect of catabolism and this is one of the reasons for certain effects among patients, such as impact on growth of children, and osteoporosis in adults.

The onset of action of drug when administered intravenously, is approximately one hour, and the bio-availability is a little more than 85%. When administered intravenously, the drug as a half-life of 15 minutes, while the half-life of the drug when administered orally is anywhere between two to five hours. The route of elimination of the drug is through urine.

How is methylprednisolone administered?

Methylprednisolone is given either orally or administered intramuscularly or intravenously. When taken orally, it is typically taken along with food or milk in order to reduce the possibility of gastrointestinal effects. When the drug is administered as an intramuscular injection, it is important to ensure that it is not injected into the deltoid muscle. Similarly, the injection is not to be given into the dermis.  The drug, when administered intravenously, is given at a rate that depends on the severity of the condition and the dosage. For instance, intermittent infusion, is typically administered in a period that could be anywhere between 15 minutes to one hour. Large doses are to be administered over a longer period, that could be anywhere between half an hour to one hour.

It important to follow instructions regarding dosage, schedule and manner of administration. As outlined above, when given as an injection, there are clear cut instructions on the manner in which it is to be given. Similarly, when taken orally, it helps to avoid adverse effects, by being consumed along with food. The rate of administration and the dose is extremely important to avoid any possible adverse effects of methylprednisolone. For instance, if the drug is administered in high doses within a short period, such as 30 minutes, there is a possibility of it causing hypotension. There is also the likelihood of cardiac arrhythmias and in extremely rare cases, death fatalities cannot be ruled out.

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