Solu-Medrol

solu-medrol

I rank Solu-Medrol 21 of the 33 drugs we carry.

Solu-Medrol is a systemic steroid that works as an anti-inflamatory.

We used to carry 1 gram vials of Solu-Medrol to give to head injured patients until studies showed that it wasn’t the best thing for them to be getting. Now we give 125 mg Solu-Medrol slow IV to patients having asthma and COPD exacerbations, and those having allergic reactions.

The drug has a funny little mechanism on the vial, where we push down on the top and it releases the rubber chamber divider enabling you to shake the bottle and mix the powered drug with the solution so you can draw it up. I always enjoy watching my preceptees try to figure out how it works the first time they have to give it. “Like this,” I always end up saying as I demonstrate.

It is my understanding that Solu-Medrol doesn’t reach its peak effect for 6-12 hours after we give it, but that studies have shown the earlier it is given, the less likely the patient will have to be admitted to the hospital.

I had a hard time remembering to give the drug when we first got it for these indications, but now I am getting better and am fairly used to giving it and do it routinely now, perhaps not on all calls I should, but certainly on the more serious ones.

You could say we go without carrying the drug without much harm to the patients, but the question is how quickly does the hospital jump to give the drug if EMS has failed to. I would say our giving the drug right away may save the patient an hour (from when we can give the drug to when he would otherwise get it in the hospital), which may make a difference.

***

Methylprednisolone (Solu-Medrol)

Class: Steroid
Glucocorticoid
Anti-inflammatory

Action: Thought to stabilize cellular and intracellular membranes

Indication: Asthma attack of greater than 2 hour’s duration,
Anaphylactic reaction

Contraindication: none for emergency field use

Dose: Reactive airway disease – 40 to 125mg

Pedi dose: Reactive airway disease – 2 mg/kg (max 125 mg)

Route: IV push – slow

4 Comments

  • CBEMT says:

    We got our Solu-Medrol changed out in favor of Solu-Cortef by the state. Works the same as -Medrol- even packaged the same- with the bonus that we can also use it for shock with a history of adrenal issuficiency. Dose and packaging is 100mg.

  • medicscribe says:

    thanks for the comment. Sounds like a good drug. I will have to have our region look into this during our next guideline rewrite.

    Peter

  • totwtytr says:

    You could say we go without carrying the drug without much harm to the patients, but the question is how quickly does the hospital jump to give the drug if EMS has failed to.

    Of course I’d say that there is line between giving patients medications that provide a benefit and giving patients medications because the ED staff is to frigging lazy or inefficient. One is clearly within our job scope, the other isn’t.

    That’s just cranky old TOTWTYTR, though.

  • McGee says:

    TOTWTYTR:
    How can you say that ED staff are lazy or inefficient? You don’t know what are you talking about mate!!!
    Big difference between EMT/Paramedics and ED staff…is you can give medication when you want and you don’t need to wait for a medic to prescribe that drug.

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Peter Canning

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  • Comments
    Don
    STEMI Call
    Thank you for a good honest post. I think those classic or "typical" presentations we learn in school are the exceptions really.
    2014-10-18 17:34:21
    Ezio
    STEMI Call
    Someone has rearranged the position of the leads for a quicker reading, personally I would use that format because I read the leads in groups (II III AvF, I AvL, AvR)
    2014-10-16 05:22:59
    medicscribe
    STEMI Call
    Hi Alex, feel free to use. Peter
    2014-10-16 00:02:25
    Alex
    STEMI Call
    Fantastic case for education. Would you mind if I shared with some colleagues at med school (will give credit of course)?
    2014-10-15 23:02:25
    medicscribe
    STEMI Call
    Great, thanks, Christopher. Mystery solved. Best, Peter
    2014-10-15 02:37:40

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