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Methylprednisolone Acetate (methylprednisolone + acetate)

Distribution by Scientific Domains

Medical Sciences	85%

Selected Abstracts

Size and Aggregation of Corticosteroids Used for Epidural Injections

PAIN MEDICINE, Issue 2 2008
Richard Derby MD
ABSTRACT Objective., The purpose of this study was to document particulate size in commonly used corticosteroid preparations. Inadvertent injection of particulate corticosteroids into a vertebral or foraminal artery can cause brain and spinal cord embolic infarcts and the size of the particles could be directly related to the chance that a clinically significant infarct would occur. One might assume that corticosteroids with particles significantly smaller than red blood cells might be safer. Design., The following four types of corticosteroid preparations were used in various solutions and evaluated under light microscopy: dexamethasone sodium phosphate injection, triamcinolone acetonide injectable suspension, betamethasone sodium phosphate and betamethasone acetate injectable suspension, and methylprednisolone acetate injectable suspension. Results., Dexamethasone sodium phosphate particle size was approximately 10 times smaller than red blood cells and the particles did not appear to aggregate; even mixed with 1% lidocaine HCl solution and with contrast dye, the size of the particles were unchanged. Triamcinolone acetonide and betamethasone sodium phosphate showed variable sizes; some particles were larger than red blood cells, and aggregation of particles was evident. Methylprednisolone acetate showed uniformity in size and the majority were smaller than red blood cells which were not aggregated, but the particles were densely packed. Conclusions., Compared with the particulate steroid solutions, dexamethasone sodium phosphate had particles that were significantly smaller than red blood cells, had the least tendency to aggregation, and had the lowest density. These characteristics should significantly reduce the risk of embolic infarcts or prevent them from occurring after intra-arterial injection. Until shown otherwise in clinical studies, interventionalists might consider using dexamethasone or another corticosteroid preparation with similar high solubility and negligible particle size when performing epidural injections. [source]

Concentration of methylprednisolone in the centrodistal joint after administration of methylprednisolone acetate in the tarsometatarsal joint

EQUINE VETERINARY JOURNAL, Issue 2 2005
A. SERENA
Summary Reasons for performing study: The centrodistal (CD) and tarsometatarsal (TMT) joints are often injected individually with a corticosteroid to resolve lameness caused by osteoarthritis (OA). There are no data available regarding diffusion of methylprednisolone (MP) from the TMT joint to the CD joint. Hypothesis: A therapeutic concentration of MP diffuses into the CD joint after methylprednisolone acetate (MPA) is administered into the TMT joint. Objective: To measure the concentration of MP in the CD joint after MPA was administered into the TMT joint. Methods: MPA was administered into a TMT joint of 16 horses. At different times, the ipsilateral CD joint of these horses was injected with a small amount of saline and recovered saline was measured for concentration of MP using high performance liquid chromatography. Results: Six hours after administration of MPA into the TMT joint, a therapeutic concentration of MP was found in all 10 CD joints sampled at this time. Conclusions: Horses with pain arising from the distal 2 joints of the hock can be treated by administering MPA into the TMT joint alone. Potential relevance: Administering MPA into the TMT joint only, to treat OA of the distal 2 hock joints, reduces the difficulties and risks associated with centesis of the CD joint. [source]

Prospective randomised single blind study of epidural steroid injection comparing triamcinalone acetonide with methylprednisolone acetate

INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2005
A. ANWAR
Abstract Aim:, This study aims to assess the effectiveness of epidural steroid injection as well as comparing two agents commonly used in these procedures, namely triamcinalone acetonide and methylprednisolone acetate. Method:, Twenty subjects were recruited into each group receiving either agent. Results:, Overall result showed that there were marked improvement in symptoms in both agents but there were no differences in terms of superiority from one agent to another. Conclusion:, Epidural steroid injection is effective and both agents are equipotent. [source]

MMP-mediated collagen breakdown induced by activated protein C in equine cartilage is reduced by corticosteroids

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2010
Elaine R. Garvican
Abstract The plasma serine protease activated protein C (APC) is synthesized by human chondrocytes at sites of pathological cartilage fibrillation. APC levels are increased in osteoarthritis (OA) synovial fluid, and in vitro APC has been shown to synergize with interleukin-1, (IL-1) to promote degradation from ovine cartilage. A model of equine cartilage degradation was established and used to explore corticosteroid activities. Intraarticular corticosteroids are a commonly prescribed treatment for joint disease, however their role in disease modification remains unclear. APC synergized with IL-1 or tumor necrosis factor-, (TNF,), promoting significant collagen degradation from equine cartilage explants within 4 days, but did not augment glycoaminoglycan (GAG) release. APC activated pro-matrix metalloproteinases (MMP)-2 but not pro-MMP-9, as assessed by gelatin zymography. APC did not directly activate pro-MMP-13. Dexamethasone, triamcinolone, and methylprednisolone acetate (MPA) were evaluated at concentrations between 10, 5M and 10,10M. High concentrations significantly increased GAG release from IL-1+APC,treated explants. With the exception of MPA at 10,10M, all concentrations of corticosteroids caused significant decreases in IL-1+APC-driven hydroxyproline loss. Treatment with corticosteroids suppressed expression of MMP-1, -3, and -13 mRNA. The collagenolysis associated with IL-1+APC synergy, and the inhibition of this effect by corticosteroids may involve gelatinase activation and downregulation of MMP expression, respectively. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:370,378, 2010 [source]

MULTIDISCIPLINARY PAIN ABSTRACTS: 5

PAIN PRACTICE, Issue 1 2004
Article first published online: 15 MAR 200
In this study, the authors prospectively evaluated whether abnormalities at the lumbar level as diagnosed by magnetic resonance imaging (MRI) are confirmed by epiduroscopy, and assessed if targeted epidural injection of medication alleviates sciatic pain. A flexible, 0.9-mm fiberoptic endoscope was introduced through a disposable steering shaft into the caudal epidural space and advanced until the targeted spinal nerve was identified. Adhesions were mechanically mobilized under direct vision, and a mixture of 120 mg methylprednisolone acetate, 600 IU hyaluronidase, and 150 ,g clonidine was applied locally. Pain scores were measured by the visual analog scale (VAS) and global subjective efficacy rating. Nineteen of 20 patients studied showed adhesions via epiduroscopy. Six patients showed concomitant signs of active root inflammation. Of 20 patients treated with a targeted epidural injection, 11 patients experienced significant pain relief at 3 months. This was maintained at 6 months for eight of the patients, at 9 months for seven of the patients, and at 12 months for seven of the patients. Mean VAS at 3 months was significantly reduced and this persisted at 12 months Epiduroscopy is of value in the diagnosis of spinal root pathology. In sciatica, adhesions unreported by MRI can be identified. Targeted epidural medication administered near the compromised spinal nerve results in substantial and prolonged pain relief. [source]